兒 童 日 營 報 名 表

DAY CAMP APPLICATION

 

自立中華基督教會        暨          溫哥華中文圖書館

合  辦

The Christ Church of China & The Chinese Community Library Services Association

 

以藝術為媒體﹐培養孩子們透過美勞及劇場遊戲形式﹐發揮他們無限的創意和想象力﹗

At Lava Lava Island, everyday kids will have a wonderful adventure.  They will discover the light of hope, the right way, the impossible courage, a sip of salvation, and party in the house.

 

DAY CAMP APPLICATION

姓名(Name): _______________________(中文) _______________________(英文)

性別(Sex): _______ 年齡(Age): __________現就讀年級(Present Grade) _________

地址(Address): ________________________________________________________

城市(City): _________ 郵區號碼(Postal Code): ________ 電話(Tel)____________

 

醫療保險卡號碼(B.C. Medical Plan Number):_______________________________

敏感(Allergies): □ 不知道 (Unknown)        □ 知道(Known): ___________________

若知道﹐請說明情況及藥物 (If known, specify reaction and any medication required) _____________________________________________________________________

醫生姓名 (Doctor’s Name): ________________ 電話(Tel): ___________________

 

家長姓名(Parent’s Name): (中) __________(英)___________電話(Tel):__________

若適用﹐所屬教會(If any, Church affiliation): _______________________________

 

除了父母以外﹐若有緊急請聯絡 (Emergency Contact, other than parents):

姓名(Name): _________關係(Relationship):__________電話(Tel):______________

 

Theme: Lava Lava Island, Where Jesus’s Love Flows

Date: Week 1: July 5-9 (Mon – Fri)	日期﹕七月五至九日 (星期一至五)
Week 2: July 12-16 (Mon - Fri)	七月十二至十六日 (星期一至五)
Time: 9:30 ~ 12:30 a.m.	時間﹕九時三十分 至 十二時三十分
Place: 300 E. Pender Street, Vancouver	地點﹕片打東街三百號
Contact Person: (604) 254-4219 Grace Chang	聯絡電話﹕(604) 254-4219 Grace Chang
Ages: 4-11 years old	參加者年齡﹕4 – 11 歲
Fee: $10 Per child (Per week)	費用﹕ $ 10 (每星期)