Summer Camp Registration Form

Summer Camp Registration Form

Here's an educational registration form for a Summer Camp. Form Preview
  • 夏令营报名表

    Summer Camp Registration Form

  • 学生信息 Camper Information

  • 家长或者监护人信息 Parent/Guardian Information 

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  • 紧急联系人 Emergency Information

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  • 紧急救护授权书  Medical Release and Authorization

    As Parent and/or Guardian of the camper, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

    Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

    This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence. This authorization is given pursuant to the provisions of Section 25.8 of the Civil Code of California. This authorization shall remain effective until my child completes his/her activities in this program unless sooner revoked in writing. I understand that as a parent/guardian, I will be responsible for the cost of any service or treatment provided.

    Release authorized on the dates and/or duration of the registered season.

  • 课程安排选择 Program Schedule

    10% off of tuition when register before May 31st, 2014 (This discount does not apply to Registration Fee, Extedned Care and Field Trip)

  • Session 1: June 9th - June 20th Panda Emperor's National Holidays & Game Master

  • Session 2:June 23rd – July 3rd My Journey to the Land of Shénzhōu & Little Gourmet Enthusiast (July 4th, Independence Day - Holiday)

  • Session 3: July 7th - July 18th Little Artists of Traditional Arts & Little Folk Artists

  • Session 4: July 21st - Aug 1st Little Story Tellers & Little Oscar Winners

  • 付款及退款政策 Payment & Refund Policy

    Once you submit the online registration form, we will send you a confirmation email including the total amount of tuition and applied fees for the applicant.

    Once you recieve the confirmation code via email, please make checks payable to:  

    All Stars Mandarin Center and mail it to 1979 28th ave. San Francisco, CA 94116

    or drop it off at the main office of A.P Gianini Middle School at 3151 Ortega Street, San Francisco, CA 94122 (between 38th ave. and 40th ave.)

    *Withdraw request must be submitted via a physical letter or an email  2 weeks prior to the starting date to receive a full refund. Any withdraw request submitted  after May 26th, 2014 will be considered as late request, and only partial refund will be issued.

  • 家长或监护人同意书 Informed Consent and Acknowledgement

    I hereby give my approval for my child’s participation in any and all activities prepared by ASMC辰星中文during the selected camp. In exchange for the acceptance of said child’s candidacy by ASMC辰星中文, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless ASMC辰星中文 and all its respective staff and personnel  from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

    In case of injury to said child, I hereby waive all claims against  ASMC辰星中文 including all teachers, affiliates and all participants, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all lesosns and include all sports activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

  • 肖像权使用授权书 Permission to Use Photograph

    hereby grantthe permission to ASMC辰星中文, to take and use: photographs and/or digital images of my child for use in news releases and/or educational materials as follows: 

    printed publications or materials, electronic publications, or Web sites. I agree that my child’s name and identity: may be revealed in descriptive text or commentary in connection with the image(s). I authorize the use of these images without compensation to me. All negatives, prints, digital reproductions and shall be the property of ASMC辰星中文

  • 确认 Confirmation

    BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

    我明白上述条款并同意签名。我明白我的电子签名与手写签名一样具有同等的法律效应。

  •  -  - Pick a Date
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