CLLC Summer Camp Registration Form
Email address *
Student Name ( s) *
Starting Date *
MM
/
DD
/
YYYY
Last Day of Camp *
MM
/
DD
/
YYYY
Parent/Guardian Name *
Student Date of Birth *
MM
/
DD
/
YYYY
Emergency Contact and phone number
Address *
Phone number *
Previous Exposure to Mandarin Chinese *
Food allergies if any
CLLC Media Consent and Release : Photos and videos allowed to share among students, parents and teachers ( if not, neither pictures or videos will be taken for your children/child) and used on CLLC website and local magazines, etc. *
Required
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