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Child / Family Information Sheet 儿童/家庭登记表
双城西区基督教 West Metro Chinese Church Address: 3695 County Road 101, Plymouth, MN 55446
Email: wmcc.children.ministry@gmail.com
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General Information基本信息
Name: Child#1 (First name, Last Name) #1 孩子姓名
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Birth Date: Child #1 孩子生日
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Gender : Child #1 孩子性别
F 女
M 男
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Name: Child#2 (First name, Last Name)孩子姓名
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Birth Date: Child #2 孩子生日
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DD
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YYYY
Gender : Child #2 孩子性别
F 女
M 男
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Name: Child#3 (First name, Last Name)孩子姓名
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Birth Date: Child #3 孩子生日
MM
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DD
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YYYY
Gender : Child #3 孩子性别
F 女
M 男
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Name: Child#4 (First name, Last Name)孩子姓名
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Birth Date: Child #4孩子生日
MM
/
DD
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YYYY
Gender : Child #4 孩子性别
F 女
M 男
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Name: Child#5 (First name, Last Name)孩子姓名
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Birth Date: Child #5孩子生日
MM
/
DD
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YYYY
Gender : Child #5 孩子性别
F 女
M 男
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Mom's Name (First name, Last Name)母亲名字
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Mom's Phone母亲手机号码
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Mom's email母亲邮件地址
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Dad's name (First name, Last Name)父亲姓名
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Dad's Phone父亲手机号码
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Dad's email父亲邮件地址
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Home Address家庭住址
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Volunteer Information, I am willing to assist with (check all that apply)志愿服务信息，我愿意做:
Being coordinator 班主任/协调人
Being a main teacher 任课老师
Being an assistant teacher 助教
Other special event assistance 其他活动的志愿者
Other:
Allergy Information. Please list any food or other allergies we should know about 孩子的过敏信息
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Emergency Contact 紧急联系人
If I cannot be reached in the event of emergency please contact: name, phone, relationship
Emergency Contact Name 紧急联系人姓名
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Emergency Contact Relationship与紧急联系人的关系
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Emergency Contact Phone number紧急联系人的电话
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Publicity Release 信息公开
I grant permission for WMCC’s to use photos of my child in its publications (e.g. newsletter, website, etc.) 我授权教会使用有我孩子在其中的照片/影片使用在教会网站等处。
Yes 同意
No 不同意
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Questions and comments 问题和建议
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