主后2011年大湖区国殇节华语特会通启
一、时间：2011年5月28至（周六）上午至30日（周一）中午
二、报到：2011年5月27日（周五）5:00PM之后报到
三、地点：克利夫兰教会一会所 3170 Warren Rd, Cleveland OH 44111
四、住宿：需接待的部分，因接待名额有限，请尽早报名，按优先顺序（各教会参会人数多寡、各地距Cleveland远近，和报名先后）安排，额满为止。其他的请自行联系旅馆。
五、青少年/儿童：特会期间，安排有青少年服事和儿童服事
六、费用：个人照主引导奉献
七、报名：请在4月17日前报名（请使用电子邮件报名jimchen1992@gmail.com）
报名表
主后2011年大湖区国殇节华语特会报名表
Registration Form
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教会所在地
Locality
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联络人／电话
Contact Person
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青少年/儿童服事召集人
Contact person for Children Service |
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* 请务必填写随行青少年/儿童姓名、年龄及相关资料（please provide the children’s information）
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编号
No.
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中文姓名
Chinese Name
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英文姓名
English Name
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弟兄／姊妹
B/S
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年龄
Age
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如果是青少年/儿童
请注明 Grade
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1
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2
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3
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5
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7
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附件-1
主后2011年大湖区国殇节华语特会接待报名表
Registration Form for Hospitality
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教会所在地
Locality
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联络人／电话
Contact Person
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* 请务必填写随行青少年/儿童姓名、年龄及相关资料（please provide the children’s information）
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编号
No.
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中文姓名
Chinese Name
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英文姓名
English Name
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弟兄／姊妹
B/S
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年龄
Age
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如果是青少年/儿童
请注明Grade
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1
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2
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3
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4
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5
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7
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附件-2
Permission Slip for Minors (17 and younger)
Memorial Day Weekend Young People’s Conference
Cleveland, Ohio
May 28-30, 2011
I, a parent or a guardian, of ______________________ (child’s full name) give permission to participate in the Memorial Day Weekend Young People’s Conference in Cleveland, Ohio (May 28-30, 2011) and agree with the terms stated below.
I hereby indemnify, agree to hold harmless, the organizers and the churches involved in the conference for any injury, all loss, damage and liability whatsoever arising out of my child’s participation in the conference.
I give permission for emergency medical care to be given if judged necessary by the adult supervisors during the event.
_____________________________ ________________
(Parent/Guardian Signature) (Date)
Emergency Contact and Care Information
Emergency Contact 1: _____________________ Relationship: _____________________
Daytime Evening
Phone: ___________________ Phone: _____________________
Emergency Contact 2: _____________________ Relationship: _____________________
Daytime Evening
Phone: ___________________ Phone: _____________________
Medical Insurance Company: _______________________ Policy #: ______________________
Comments (any existing medical conditions, etc.):