【Maxi27】2021 Summer Camp application form 暑期探索班報名表
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Chinese Name 中文姓名
English Name 英文姓名 *
Gender 性別 *
Date of Birth 出生日期 *
MM
/
DD
/
YYYY
Contact number 聯絡電話（我們會用此號碼與您聯絡） *
School 就讀學校 *
Emergency Contact Person 緊急聯絡人姓名 *
Emergency Contact Number 緊急聯絡人電話 *
Relationship with Emergency Contact 緊急聯絡人關係 *
Course(s) name 有意報讀之課程 (可多選) *
Required
Number of lesson (You may contact us to confirm) 堂數 (可聯絡我們確認資料) +852 55120992
Referral name (If applicable) 介紹人 (如適用)
Health declaration 健康申報
If the participant has special circumstances that require special treatment, such as physical (eg asthma, allergic) or psychological (eg hyperactive) conditions require staff attention, please clearly state:
如參加者有特殊情況需要特別處理，如身體(例如哮喘﹑過敏)或心理(例如過度活躍症)等狀況需要職員注意，請清楚列明︰
Health declaration 健康申報 *
Required
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