Fall 2017 Sign Up

Participants: 1st-5th graders (by Fall 2017)
Parent’s Participation: Every parent will rotate to be our room parent once. Duty roaster will be announced via email.

Fees: $60/child
Payment: Please write your check payable to “CCIC-SJ” with memo “Choir – Student Name” and pass it to sister Yujia on the 1st practice day on 8/13.

Date: 8/13-12/16 (except 9/3, 9/17, 10/15 and 11/26)
Time: 12:30pm-1:30pm
Venue: Fireside Room
Services: 9/16 Mission Conference (Saturday), 12/15 & 12/16 Christmas (Friday & Saturday)

The instructor is a professional music teacher from http://musicplace.com/.  The choir will perform on Mission Conference 9/16 and Christmas 12/15 & 12/16.

Registration is on a first come, first served basis and SPACES ARE LIMITED! We will only accept 30 students. Those who registered after the spots are filled will be on waiting list. If you don’t want your child(ren) to miss this golden opportunity, please sign them up now!

Our 2017 Easter Performance

 

Our 2016 Christmas Performance

   

Parent/Guardian's Information 父母/代理监护人资料

Parent/Guardian's English Name 父母/代理监护人英文名字:
Parent/Guardian's Chinese Name 父母/代理监护人中文名字:
Parent/Guardian's Email 父母/代理监护人电邮:
Parent/Guardian's Cell Phone 父母/代理监护人手机:
-
Address 地址 (SKIP if you signed up 2016 Fall Choir 若您注册了 2016 秋季诗班,地址可不填):
Are You Attending church? 是否上教会?:
In case of an EMERGENCY and the above person(s) cannot be contacted, please notify: 紧急联络人(若无法联络以上父母/代理监护人):
Cell Phone 紧急联络人手机:
-
Relationship with Child 选择与小孩的关系:
Select Fellowship Group 团契:
If Zion or Others, please specify若属锡安或其他,请填哪组或团契:

Child's Information 小孩资料

1st Child's Name 第1个孩子姓名:
Gender for 1st child 性别:
Select grade by FALL 2017 秋季班级:
Allergy 1:
Medical Company & Policy Number 1:

========================================================

2nd Child's Name 第2个孩子姓名:
Gender 2 性别:
Select grade 2nd Child 班级:
Allergy 2:
Medical Company & Policy Number 2:

========================================================

3rd Child's Name 第3个孩子姓名:
Gender 3 性别:
Select grade 3rd Child 班级:
Allergy 3:
Medical Company & Policy Number 3:

========================================================

Checkbox:

Authorization, Medical and Media Release 授权

I agree (by checking this box, I recognize that this is equivalent to my legal signature) to give my child permission to participate in Chinese Church in Christ (CCIC) Children Choir on every Sundays from August 13th, 2017 to December 16th, 2017 (except 9/3, 9/17, 10/15 & 11/26) from 12:30pm to 1:30pm.

I UNDERSTAND AND DO HEREBY AGREE TO ASSUME ALL OF THE RISKS AND OTHER RELATED RISKS WHICH MAY BE ENCOUNTERED BY MY SON/DAUGHTER PARTICIPATING IN THE ABOVE ACTIVITY.

I agree that I hereby hold harmless and waive any and all claims against CCIC, its staff, and leaders for any accident, bodily or personal injury, damage to or loss or theft of any property, illness, or death of any person, including without limitation demands, liabilities, damages, judgments, losses, costs, expenses and/or penalties, including attorneys’ and consultants’ fee and disbursements, which arise out of joining the Summer Program sponsored by CCIC.

I further state that I HAVE CAREFULLY READ THE FORGOING RELEASE AND KNOWN THE CONTENTS THEREOF AND IS SIGNING THIS RELEASE AS AN ACT OF MY OWN FREE WILL.  This is a legally binding agreement, which I have read and understand.

I give my permission for my child to be photographed, videotaped, and/or interviewed by representatives from CCIC for the purpose of publications which include church bulletins, promotion, online media, website, and church presentations. I fully relinquish my right or interest in any film, tape, or photograph which may be used for any legitimate purpose.

MEDICAL RELEASE
I also hereby authorize and consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed advisable by, and is to be rendered under the general or special supervision of any licensed medical personnel on the staff of any licensed hospital. This authorization is given in advance of any specific diagnosis, treatment or hospital care required, but is given to provide authority and power to render care which is deemed advisable in the best judgment of the physician.

I further state that I HAVE CAREFULLY READ THE FORGOING RELEASE AND KNOWN THE CONTENTS THEREOF AND IS SIGNING THIS RELEASE AS AN ACT OF MY OWN FREE WILL. This is a legally binding agreement, which I have read and understand.

Recaptcha Word Verification: