New Student
Registration

Student's Name 学生姓名 *

First Name

Last Name

Phone 电话 *

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Address 地址 *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Community Service

High School Students may earn Community Service hour serving in Charis programs. Please select:

Mission to the Homeless

Elderly Assistant

After School Tutoring

Academy Interest Classes

Summer Charis Camp

Fluency of Mandarin 中文听说读写程度 *

Non Speaker 基本不会说中文

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Speaker but Non Reader 能说但不会阅读

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Speak some + read 能说并且会一些阅读

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Advance Level 听说读写属较高水平

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

I want to join the ACT Prep Course

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

Contact #1: Name 联系人一：姓名 *

First Name

Last Name

Phone 电话 *

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Contact #2: Name 联系人二：姓名 *

First Name

Last Name

Phone 电话

(###)

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Release and Waiver 免责声明 *

I, the undersigned, hereby acknowledge that certain risks of injury are inherent to any program, including but not limited to participation in recreational activities, a child’s failure to follow instructions of supervisors, communicable illness, and independent acts of third parties not under the control of supervisors. I acknowledge that all risks cannot be prevented, and assume those beyond the control of the staff. These types of injuries may be minor or serious and may result from one’s actions, or the actions or inactions of others or a combination of both. I will take responsibility to see that I am prepared for all activities and am in good health each day of the session. I hereby assume all risks associated with participation in Charis Chinese Academy (CCA) and agree to hold harmless Charis Alive, the Church of the Servant (the Church), its directors, officers, employees, volunteers, et al, from and against any and all claims, damages, demands, action or right of action, losses or liability of any kind or nature which may arise in connection with injuries suffered to me while enrolled/participating in their program. I have read and understand the above informed consent agreement in its entirety and hereby give my consent to participate knowing all of the foregoing. 本人，以下签署人，特此承认，任何活动都存在一定的伤害风险，包括但不限于参与娱乐活动、儿童没有遵行监督者的指示、传染病以及不受监督者控制的第三方的独立行为。我承认，所有风险都是无法预防的，并承担那些员工无法控制的风险。这些类型的伤害可能是轻微的或严重的，可能是由于自己的行为，或他人的行为或不行为，或两者的结合。我将负责确保我为所有活动做好准备，并且在课程的每一天都保持健康。我在此承担所有与参加慈惠中文学校相关的风险，并同意使慈惠事工、仆人教会及其董事、官员、雇员、志愿者等不受任何和所有索赔、损害赔偿、要求、诉讼或诉讼权利、损失或任何类型或性质的责任的影响，这些风险可能与我在注册/参加其课程时遭受的伤害有关。我已阅读并理解上述知情同意协议的全部内容，并在此同意参与了解上述所有内容。

I AGREE to the Terms Above 我同意上述条款

Consent to Photo/Video Release 照片/视频发布同意书 *

I understand that CCA may produce promotional material relating to its activities. As a participant at CCA, I may be included in videotapes or photographs taken during the school. I grant to CCA the right to photograph and/or videotape me and to utilize such videotapes and photographs, my name, face likeness, voice and appearance as part of the program. 我了解慈惠中文学校可能会制作与其活动相关的宣传材料。作为慈惠中文学校参与者，我可能会出现在学校期间拍摄的视频或照片中。我授权慈惠中文学校对我进行拍照和/或录像，并利用这些录像和照片、我的姓名、脸部肖像、声音和外表作为活动的一部分。

I AGREE to the Terms Above 我同意上述条款

Transportation 交通接送 *

I certify and agree that I am to pick-up and drop-off my child only at the designated places and times. 我证明并同意，我会在指定的地点和时间接送我的孩子。

I AGREE to the terms above 我同意上述条款

Consent to Rules and Expectations *

I understand that my child must abide by the rules and behaviors expected to ensure everyone’s safety and enjoyment of CCS. Failure to comply with these rules may result in the child’s removal from CCS. I will notify the CCS Supervisors immediately of any injuries the child sustains, any inappropriate behavior, or of any incidents of sexual misconduct, harassment or assault. 我了解我的孩子必须遵守规则，以确保每个人的安全及享受慈惠中文学校。不遵守这些规则可能会导致孩子从慈惠中文学校中开除。如果孩子受到任何伤害、任何不当行为或任何不当性行为、骚扰或攻击事件，我将立即通知慈惠学校主管。

My child/children and I AGREE to the terms above. 我和我的孩子同意上述条款。

Disclaimer 免责声明 *

I have READ and WILL COMPLY with Charis Chinese Academy Rules and Regulations: I AGREE to abide with all the Rules and Regulations at Charis Chinese Academy. Failure to follow any of the rules posted above can lead to possible expulsion or disciplinary actions. I UNDERSTAND all fees paid are non-refundable. I UNDERSTAND Charis Chinese Academy is not responsible for any bodily injuries or for any lost personal belongings. 我已阅读并将遵守慈惠中文学校的规章制度：我同意遵守慈惠中文学校的所有规章制度。如果不遵守上面公布的任何规则，会导致被开除或受到纪律处分。 我了解所有已支付的费用均不予退还。 我了解慈惠中文学校不对任何人身伤害或任何个人物品丢失负责。

I Understand 我同意

I Understand 我同意