2022 復刻南區社區考察計劃– 編織班報名表
蒲窩與藝術單位Breakthrough Art Studio合作舉辦《2022 復刻南區社區考察計劃 – 社區藝術工作坊(編織班)》,讓公眾參與社區導賞團,遊歷香港仔社區和了解香港仔故事,投票選擇你認為最能代表香港仔的象徵物如漁船、魚市場作為作品主角。然後以竹為原材料作編織,並以七巧板的形式合併成為最終作品。完成作品後更可以與藝術家在香港仔海濱公園即場佈置及展示作品,為身邊看似平平無奇的社區建立一個新形象!  
Sign in to Google to save your progress. Learn more
參加者基本資料
我將會出席社區編織工作坊的以下活動
*
Required
全名 Full Name *
稱呼 Nickname
聯絡電話 Contact Number (格式 format: 1234 5678)
*
電郵地址 Email Address
*
年齡 Age
*
性別 Gender
*
身份 Occupation 
*
居住地區 District of residence
*
學校名稱、科目及年級 或 職業
*
如你是學生,請填寫學校名稱、科目及年級;如你是在職,請填寫職業。
得知本計劃的渠道(*可選多於一項)
*
Required
參加者聲明 Declaration of Participant
本人同意參加上述活動,並願意遵守蒲窩青少年中心 (簡稱 “主辦機構”) 所訂的條文及規則,並同意以下各點:

1. 自願參加此活動和自願承擔各意外風險及責任,如因參加是項活動而引致任何損失及受傷,除非因主辦機構引致,否則主辦機構毋須負責;
2. 在此聲明參加者身體健康及有能力參加此活動;
3. 明白此活動的體能要求情況下報名參加;
4. 明白活動僅供主辦機構的會員參加;
5. 如參加者未持有主辦機構基本會籍或以上的身份,報名表格所填寫的個人資料將會用作登記會員即日通,並只限於出席活動時生效;
6. 聲明在報名表格上之資料確實無誤;
7. 同意及確認所有列明之重要事項、聲明及有關細則。


I agree to participate in the above activity and abide by the terms and conditions of The Warehouse Teenage Club (the organizer). I further confirm to the following:

1. I participate in in the above activity of my own will. I will bear my own risk of injury and loss, unless such injury or loss is caused by the organizer directly.
2. I am physically fit for the activity.
3. I understand the physical fitness requirements for the above activity when I submit this application.
4. I understand events organized by the organizer are eligible to members only.
5. If I have not registered the organizer’s basic membership or any degree of membership upgrade, my personal information provided will be used to register a temporary membership that is valid only during my presence at the activity.
6. The information on this application form is true and correct.
7. I agree and confirm all mentioned terms and conditions.
收集及使用個人資料聲明 Personal Information Collection Statement
(1) 蒲窩青少年中心 (簡稱 “主辦機構”) 會嚴格遵守《個人資料(私隱)條例》(第486章) 規定,並確保妥善儲存有關的個人資料及資料準確無誤。主辦機構只收集參加者資料作開立收據、聯絡、招募義工、宣傳活動/服務、進行問卷調查及收集意見之用途,本中心不會以任何形式出售、租借或轉讓予任何人士或組織。
(2) 主辦機構亦將會使用參加者於活動期間被攝錄之照片及錄像及其所攝錄之相片、錄像,以及所遞交的作品等作行政報告及相關宣傳之用。
(3) 根據《個人資料(私隱)條例》(第486章) 第18 條、第22條和附表1 內第6 原則的規定,閣下有權要求查閱和改正所提供的個人資料。

1. The Warehouse (the organizer) seeks to comply fully with the provisions of the Personal Data (Privacy) Ordinance (Cap. 486) when holding and processing such information. The collection of personal information serves the purposes of issuing invoices, receipts and related documents; contact; recruitment of volunteers, participants and instructors; promotion; fundraising; survey and similar uses. The collected information will not be disclosed to any third party.
2. The organizer will take video and photographs of the participants during the activities and will reserve the right to use the image, video and audio collected for administrative reports and other promotional materials.
3. According to the Personal Data (Privacy) Ordinance (Cap. 486) section 18, 22, Appendix I - Principle 6, members and participants are entitled to have access to and correct the personal information held by the organizer.
你是否已閱畢《參加者聲明》、《收集及使用個人資料聲明》? Have you read “Declaration of Participant” and “Personal Information Collection Statement”?
*
Required
備註:
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of The Warehouse Teenage Club Limited. Report Abuse