佛光西來學校義工報名表                                Buddha’s Light Hsi Lai School Volunteer  Application Form
​佛光西來學校
Buddha's Light Hsi Lai School
3130 Colima Rd
Hacienda Heights, CA 91745
Tel:(626) 956-5010

Website: www.blhls.org 
Facebook: https://www.facebook.com/blhls/
Youtube: https://www.youtube.com/channel/UCx0Mv1dAUPhIPNUAY6tS3VQ
In Google anmelden, um den Fortschritt zu speichern. Weitere Informationen
中文姓名: Chinese Name *
英文姓名: English Name *
出生日期:Date of Birth *
TT
.
MM
.
JJJJ
性別:Gender *
義工屬性 Type of Volunteer *
職  業:Occupation *
國  籍:Nationality *
地址:Address *
E-Mail: *
電話 (住宅):Tel (Home) *
電話 (手機):Tel (Cell)
電話 (公司) :  Tel (Work)
緊 急 聯 絡 人:Emergency Contact Person *
緊 急 聯 絡 人關 係:Emergency Contact Person Relationship *
緊 急 聯 絡 人電話:  Emergency Contact Person Tel *
學 歷 :  Education *
Pflichtfrage
工 作或義工經 驗 :  Work or Volunteer Experience *
語言 ; Language *
特殊專長 :  Specialty *
適當時間 : Preferable time *
在校學生姓名 : Current Student Name (僅家長義工需要填寫 Only for parents volunteer)
學生課程時段 : Student Class Section   (僅家長義工需要填寫 Only for parents volunteer)
學生班級 : Student Grade   (僅家長義工需要填寫 Only for parents volunteer)
是否有完成接種疫苗 Are you fully vaccinated? *
希望參與之義務工作 : I am interested to volunteer for: *
推薦人  Referee
備註欄 :  Remarks
EMERGENCY AUTHORIZATION & WAIVER OF CLAIMS 授權急救及免責聲明 : I am in good physical condition, but in case of illness or accident, BLHLS has my consent to secure necessary medical attention.  I, (above name),hereby release and discharge BLHLS, its directors, officers, teachers, instructors, staff members, and all other associated entities (the “Releasees”) from all claims, demands, costs, expenses, actions and causes of action, whether in law or equity, in respect to death, injury, loss or damage to my property however caused, arising out of my participation in activities at or related to the School, whether or not on the School’s premises.  I hereby indemnify and hold each of the Releasees harmless from any and all damages, costs, losses and expenses suffered by my arising out of such participation and activities. *
Pflichtfrage
CONSENT: I give my consent to Buddha’s Light Hsi Lai School to use any of the photos/videos taken during any of the activities of Hsi Lai School for the purpose of communicating, promoting, fundraising and, or other information about the class and the school as a whole. *
Pflichtfrage
Buddha’s Light Hsi Lai School (“BLHLS”) has put in place preventative measures to reduce the spread of COVID-19; however, BLHLS cannot guarantee that you or your child(ren) will not become infected with COVID-19. Further, attending BLHLS could increase your risk and your child(ren)’s risk of contracting COVID-19.By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected by COVID-19 by attending BLHLS and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at BLHLS may result from the actions, omissions, or negligence of myself and others, including, but not limited to, BLHLS employees, volunteers, and school participants and their families.I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at the BLHLS or participation in BLHLS’s programming (“Claims”). On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless the BLHLS, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the BLHLS, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any BLHLS programs. *
Pflichtfrage
簽名:Signature *
填表日期:Today’s Date *
TT
.
MM
.
JJJJ
Senden
Alle Eingaben löschen
Geben Sie niemals Passwörter über Google Formulare weiter.
Dieses Formular wurde bei blhls.org erstellt. Missbrauch melden