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HĐVN Đơn Ghi Danh Đoàn Sinh | Youth Registration Form
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11
Questions
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1
Tên Thành Viên | Registrant's Name
*
This field is required.
Tên Đoàn Sinh | Child's Name
Tên | First Name
Tên đệm | Middle Name
Họ | Last Name
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2
Ngày Sinh Của Thành Viên | Registrant's Birth Date
*
This field is required.
/
Date
Day
Month
Year
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3
Thông Tin Liên Lạc Thành Viên | Registrant's Contact Information
Địa Chỉ Nhà | Address
Thành phố | City
Please Select
Texas
Other
Please Select
Please Select
Texas
Other
Tiểu bang | State
Zip Code
Please Select
Male
Female
Other
Please Select
Please Select
Male
Female
Other
Giới tính | Gender
Số liên lạc thành viên | Registrant's contact number
Email của thành viên | Registrant's email
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4
Tên Phụ Huynh | Guardian's Name
*
This field is required.
Tên | First Name
Tên đệm | Middle Name
Họ | Last Name
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5
Thông Tin Liên Lạc Phụ Huynh | Guardian's Contact Information
Địa Chỉ Nhà | Address
Thành phố | City
Please Select
Texas
Other
Please Select
Please Select
Texas
Other
Tiểu bang | State
Zip Code
Please Select
Male
Female
Other
Please Select
Please Select
Male
Female
Other
Giới tính | Gender
Số liên lạc phụ huynh | Guardian's contact number
Email của phụ huynh | Guardian's email
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6
Xin vui lòng chọn Liên Đoàn để thanh viên ghi danh sinh hoạt
*
This field is required.
Please select the Lien Doan the registrant will participate in.
LĐ Biển Đông
LĐ Pháp Luân
LĐ Hùng Vương
Other
LĐ Biển Đông
LĐ Pháp Luân
LĐ Hùng Vương
Other
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7
Ngành Sinh Hoạt | Program
*
This field is required.
Vui lòng chọn theo độ tuổi | Please select according to age
Ấu Sinh (6-10)
Thiếu Sinh (11-14)
Thanh Sinh (15-17)
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8
Hold Harmless, Accident & Liability Waiver
*
This field is required.
As the parent/legal guardian of the registrant/child on this form, I hereby assume all risks and hazards of the registrant/child in Hướng Đạo Việt Nam (HĐVN) and/or Tinh Thần Hưng Đạo (TTHĐ) events/activities. I hereby do waive, release, absolve, and agree to indemnify and hold harmless the Hướng Đạo Việt Nam (HĐVN) and/or Tinh Thần Hưng Đạo (TTHĐ) Organizing Committee and staffs, units, leaders, volunteers, other participants, related parties or other organizations associated with the activity from any and all claims or liability arising out of any injury to myself, my son/daughter and/or other family members. I hereby expressly authorize and request the organizing committee and staffs, his/her unit leaders to use their best judgment in any emergency or injury to myself, my son/daughter and/or other family members requiring paraprofessional or professional medical attention or treatment. I understand that Hướng Đạo Việt Nam (HĐVN) and/or Tinh Thần Hưng Đạo (TTHĐ) provides basic accident medical expense and liability for related program activities. I understand I am still responsible for all medical expenses for myself, my son/daughter and/or other family members.
Waiver Agreement :
By checking this box, I agree to the terms on this hold harmless, accident & liability waiver.
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9
Consent For Use of Photographs
*
This field is required.
As the parent/legal guardian of the registrant/child on this form, I hereby authorize and give full consent to the Hướng Đạo Việt Nam (HĐVN) and/or Tinh Thần Hưng Đạo (TTHĐ) Organizing Committee to publish and copyright all photographs in which I, my son/daughter and/or other family members whom may appear at any given Tinh Thần Hưng Đạo (TTHĐ) events, programs and activities. I further agree that the Hướng Đạo Việt Nam (HĐVN) and/or Tinh Thần Hưng Đạo (TTHĐ) Organizing Committee may transfer, use or cause to be used, these photographs in brochures, websites, social media, newsletters, advertisings, posters, displays, slide shows, videotapes, catalogs, CD-ROMs, and like publications, literature or materials without limitations or reservations.
Consent Agreement *
By checking this box, I agree to the terms on this consent for use of photographs waiver.
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10
Ngày Ghi Danh | Date of Registration
/
Date
Month
Day
Year
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11
Chữ ký của phụ huynh | Guardian Signature
*
This field is required.
With this signature, I confirm the registration of my child to join Hướng Đạo Việt Nam (HĐVN) and Tinh Thần Hưng Đạo (TTHĐ)
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