EmailMe Form - 2019-2020 뉴저지 온누리교회 한글학교

Student Name (Child 1)
학생이름 *

Grade (Child 1)
학년 *

Birth Date (Child 1)
생년월일 *

MM / DD / YYYY

Preferred Language
선호하는 언어 *

Korean 한국어

English 영어

Both 둘다

Attending Church
출석 교회 *

NJ Onnuri (뉴저지 온누리교회)

Other Church (다른 교회)

Not Attending (다니고 있지 않음)

Allergies or Other Medical Conditions
알레르기나 건강 유의사항

To register additional child(ren), please continue to fill out the form or skip to the next section.

Student Name (Child 2)
학생이름

Birth Date (Child 2)
생년월일

MM / DD / YYYY

Grade (Child 2)
학년

Preferred Language
선호하는 언어

Korean 한국어

English 영어

Both 둘다

Allergies or Other Medical Conditions
알레르기나 건강 유의사항

Student Name (Child 3)
학생이름

Birth Date (Child 3)
생년월일

MM / DD / YYYY

Grade (Child 3)

Preferred Language

Korean 한국어

English 영어

Both 둘다

Allergies or Other Medical Conditions
알레르기나 건강 유의사항

Please complete all of this section

Parent/Guardian Name
학부모 이름 *

First Last

Parent/Guardian Phone No.
부모님 전화번호 *

### - ### - ####

Email
이메일 주소 *

Address
주소 *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Emergency Contact
응급상황시 연락처 *

First Last

Emergency Contact Phone No.

### - ### - ####

Relationship to Student
학생과의 관계

Payment
신청 방법 *

Credit Card: Child 1 ($200)

Credit Card: Child 2 ($150)

Credit Card: Child 3 ($100)

Name on Card *

First Last

Billing Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Please Sign the Following

#1 I register my child for the 2018 Korean Language and Culture School at NJ Onnuri Church. Please write your name on the line as an agreement of registration
뉴저지 온누리교회 여름캠프 등록을 희망합니다.
성함을 적어주세요. *

#2 Photo Release Form: I hereby grant permission to New Jersey Onnuri Community Church to use my child’s photograph(s) on its Web site or in other official church printed publications without further consideration. I acknowledge the church has the right to crop or treat the photograph(s) at its discretion. I also acknowledge that the church may choose not to use the photograph(s) at this time, but may do so at its own discretion at a later date, up to 6 years from the date of the photograph was taken. I also understand that once the picture is posted on the church’s website, the image can be downloaded by any computer user, anywhere in the world. Therefore, I agree to indemnify and hold harmless the church, its trustees, pastor, associate pastors, deacons, its members and designee from any claims arising out of the use of the photograph(s). The church reserves the right to discontinue use of any photograph(s) without notice. (Please Print Parent's name)
부모님의 성함을 적어주세요. *