青少年禪修營報名表

2020 the 7th Summer Youth Meditation Camp Application Form

本人及參加營隊孩童已充分瞭解「2020年第七屆暑期青少年卓越禪修營小菩薩行前同意書」所載內容，並同意本人子女於 2020年 8月3日至 2020年8月8日，六天期間參加本寺規劃之所有課程活動，且遵守相關規範。 

YES 同意*
Name of Parent 家長姓名:*
Participant’s Special Health Conditions:
您的孩子是否有特殊健康情況 ?
If applicable, please provide more details on the health conditions or allergies.
請提供關於健康狀況及過敏的詳細資料.
In case of a severe allergy or anaphylactic reaction, I agree to provide my child with the appropriate EpiPen to be used during such a reaction. If any other course of action needs to be taken (such as other emergency medication eg. antihistamines, puffers, etc), please state below and ensure that the camp staff have access to these medications.
Youth English Name*
Youth Chinese Name*
Date of Birth:*
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Gender:*
Day School:*
Day School Grade*
Youth OHIP Health Card Number:*
Parents E-mail:*
Father’s legal Name:*
Father’s Cell phone#:*
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Mother's legal Name:*
Mother’s Cell phone#:*
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Home address:*
Emergency Person’s Name:*
Emergency Person’s Cell phone#:*
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Home Language:*
Other Language:
Referral by 介紹人:*
Suggested Donation: Tuition fee：CAD $800/ per participant 每位小朋友
Payment Methods:*

以下部分，請由小孩自行填寫：

What’s your Chinese level?:*
Have you participated in Youth Meditation camp before? If yes, what year and what you had learnt? *
What’s the motivation for you to attend the camp?*
Have you participated in Great Compassion Bodhi Prajna temple’s weekend youth program?*
How long do you think you can sit quietly and still? *
What’s your hobbies and interests?*
Please describe yourself in a couple of sentences.*
Date:*
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By submitting this form, you have read and agree to camp agreement; you also confirm that the information given in this form is true, complete and accurate.

YES 同意*