亲爱的家长们,

为了您小孩的安全,CCIC 儿童部決定不让1-5年級的小孩在聚会完毕后自行离开,除非家长授权。所以,若您想让您家小孩自行离开我们的聚会,敬请填写以下表格。若您想让您家青少年代领小孩,您也必须填写此表格。

所有被授权自行离开的小孩将会有“Self-Dismiss Authorized” 打印在周六AWANA及周日崇拜及主日学的名片贴纸上及收到1个小贴纸“Self-Dismiss Authorized” 贴在他们周五的AWANA 名片上。

所有沒交上此表格的家長敬请准时在以下地点领取您的小孩:

  • 星期日 第一堂 10:30am 各教室 (查看您的領取卷)
  • 星期日 第二堂 12:00pm 各教室 (查看您的領取卷)
  • 星期五 AWANA 9:25pm 1楼
  • 星期六 AWANA 8:55pm Fireside

在领取小孩時,请给所负责的老師或leader查看您的家长领取卷。(电脑打印出的小贴纸)注意:家長必須领取5岁以下的幼兒包括AWANA Sparks 五岁的小孩。五岁以下的幼兒沒有自行离开的选择。

若有需要代領,家長必須每一次让來代領幼兒的哥哥或姐姐或青少年带1個字条给所负责的老師或leader。谢谢您的配搭。

CCIC Children’s Ministry

Permission to Self-Dismiss Form

Without prior permission from parents/guardians, it is CCIC Children’s Ministry’s policy to not allow elementary children (1st-5th grade) to self-dismiss from any of our programs. By completing and signing below, you authorize The Church (CCIC) to allow your child(ren) to self-dismiss from the program(s) below, without being picked up by a parent, guardian, or other authorized adult (above 18).

I, with the following name as the parent/guardian,

Check box:

I agree (by checking this box, I recognize that this is equivalent to my legal signature) to give permission for my child(ren) listed below to self-dismiss from the following program(s):

Parent/Guardian's Name 家长/监护人:
Parent/Guardian's E-mail 家长/监护人电邮:
1st Child 第一小孩:
Grade (1):
2nd Child 第二小孩:
Grade (2):
3rd Child 第三小孩:
Grade (3):
Check the box ✓:

I UNDERSTAND AND DO HEREBY AGREE TO ASSUME ALL OF THE RISKS AND OTHER RELATED RISKS WHICH MAY BE ENCOUNTERED BY MY CHILD(REN) FOR ALLOWING HIM/HER/THEM TO SELF-DISMISS FROM THE ABOVE PROGRAM(S).

I agree that I hereby hold harmless and waive any and all claims against Chinese Church in Christ (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 allowing my child(ren) to self-dismiss from the above program(s).

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.

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