2021頭城農場 瘋狂蟲林 四天三夜夏令營 T.C.FARM SUMMER CAMPS
線上報名表~
Sign in to Google to save your progress. Learn more
頭城農場夏令營推廣短片
活動日期
2021年7月7日（三）至7月10日（六）
Email： *
學生中文姓名/ English Name *
是否為舊生? 參與哪一年與梯次? Have you ever attended any of TC farm’s previous camp? Yes，which year?  Or NO. *
性別Sex *
出生日期Date of Birth(19XX/X/X) *
MM
/
DD
/
YYYY
身分証字號ID Number *
就讀學校與年級Name of school you are attending now ? in which year(grade)? *
監護人姓名Parents / Guardian’s Name *
監護人電話Tel *
緊急聯絡人Emergency contact person *
緊急聯絡人電話Tel *
聯絡地址(含郵遞區號)Contact Address *
是否吃素Vegetarian *
是否需要指定學員同住Special request for room arrangement? *
身體狀況Health Condition *
在營隊活動期間，如因突發疾病或狀況發生，需要緊急醫療急救時，本人同意採取適當的措施。本人同意，並已了解(報名須知)所述之各項規定。During the Summer Camp days, in case of emergency or an urgent medical first aid is necessary, I (Toucheng Farm) take responsibility with your approval as understood in the application form. *
是否參加農場提供之接駁服務(接駁地點中正紀念堂單趟費用每人400元) Chiang Kai-shek Memorial Hall (Exact entry will be advised)– NT$400/ per ride/person. *
您是否同意本農場將小孩子的活動照片上傳至網路上，以便家長於家中一起分享我們的快樂?During the camp we will take photos while your child doing activities, do you agree with us if we publish on our website. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms