2020 VBS Registration 兒童聖經學校報名

Name of Child 孩子姓名 *

First Name

Last Name

Gender 性別 *

Male

Female

Birthday 孩子生日 *

MM

DD

YYYY

Grade 年級 *

preschool

kindergarten

1st grade

2nd grade

3rd grade

4th grade

5th grade

Was your child baptized?  孩子是否已經受洗？ *

yes

no

Dad's Full Name 父親姓名

First Name

Last Name

Mom's Full Name 母親姓名

First Name

Last Name

Address 住址 *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you currently attend our church? 您是否在羅蘭崗基督徒禮拜堂聚會？ *

yes

no

Phone 電話 *

(###)

###

####

Are you currently part of a fellowship? 您有參加團契嗎？ *

yes

no

Have you and your spouse been baptized? 請問您和您的配偶是否已受洗？ *

Both

Dad

Mom

Neither

Check if your child has any of the following 若您的孩子有任何以下任何情況，請勾選：

frequent, severe headaches 經常，嚴重的頭痛

ear, nose, or throat trouble 耳，鼻或喉嚨有問題

dizziness 眩暈

shortness of breath 呼吸急促

frequent colds 经常感冒

heart trouble 心臟疾病

asthma 氣喘

diabetes 糖尿病

other 其他