Application for 2003 Summer Camp Program

STUDENT INFORMATION
Family Name
 Given Name
 Chinese Name
Sex
Male     Female		 Date of Birth (Month / Day / Year)
 Age
CONTACT INFORMATION
Mailing Address
Street
City

Telephone (required)
 Country

Fax (if available)
 Postal Code

Email (required)
FAMILY INFORMATION
Father
Name

Occupation
 Mother
Name

Occupation
 Emergency Contact
Name

Telephone
CAMP INFORMATION
Camp Organizer
 Date (Start date / End date)
 Camp Fee (US$)
Camp Description (Name of camp, Program number, Campsite name)
SUPPLEMENTARY SERVICES NEEDED
Detail Description of Supplementary Services Needed

Thank you for your registration. To complete your registration, please fill in these documents which will be 
emailed to you in 48 hours:
    1. Health Information Form
    2. Students and Parents Responsibilities Form
    3. Payment Form