You can always press Enter⏎ to continue
HĐVN Đơn Ghi Danh Người Lớn | Adult Registration Form
Hi there, please fill out and submit this form.
10
Questions
START
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
Previous
Next
Submit
Press
Enter
2
Ngày Sinh Của Thành Viên | Registrant's Birth Date
*
This field is required.
/
Date
Day
Month
Year
Previous
Next
Submit
Press
Enter
3
Thông Tin Liên Lạc Thành Viên | Registrant's Contact Information
Địa Chỉ Nhà | Address
Thành phố | City
Please Select
California
Virginia
Massachusetts
Michigan
Oregon
Texas
Washington
Other
Please Select
Please Select
California
Virginia
Massachusetts
Michigan
Oregon
Texas
Washington
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
Previous
Next
Submit
Press
Enter
4
Xin vui lòng chọn Liên Đoàn/Bách Hợp để thanh viên ghi danh sinh hoạt
*
This field is required.
Please select the Lien Doan/Bách Hợp the registrant will participate in.
LĐ Biển Đông
LĐ Pháp Luân
LĐ Hùng Vương
Xóm BH Bạch Mã TX
HDVN Staff
Other
LĐ Biển Đông
LĐ Pháp Luân
LĐ Hùng Vương
Xóm BH Bạch Mã TX
HDVN Staff
Other
Previous
Next
Submit
Press
Enter
5
Ngành Sinh Hoạt | Leader Program
*
This field is required.
Vui lòng chọn theo độ tuổi | Please select according to age group you wish to be a leader
Thanh Sinh (18)
Trưởng Ngành Ấu - Ấu Leader (21-99)
Trưởng Ngành Thiếu - Thiếu Leader (21-99)
Trưởng Ngành Thanh - Thanh Leader (21-99)
Ngành Tráng- HDVN Rover (21-99)
Trưởng Niên - HDVN Elder (21-99)
Cố Vấn (Advisor)
HDVN Staff
Tình Nguyện Viên (Volunteer)
Previous
Next
Submit
Press
Enter
6
Tên Rừng | Jungle Name
Xin vui lòng điền nếu bạn có | Please fill if you have one, or click next
Previous
Next
Submit
Press
Enter
7
Hold Harmless, Accident & Liability Waiver
*
This field is required.
I hereby assume all risks and hazards of myself 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 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.
Previous
Next
Submit
Press
Enter
8
Consent For Use of Photographs
*
This field is required.
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.
Previous
Next
Submit
Press
Enter
9
Ngày Ghi Danh | Date of Registration
/
Date
Month
Day
Year
Previous
Next
Submit
Press
Enter
10
Chữ ký | Signature
*
This field is required.
With this signature, I confirm my registration to join Hướng Đạo Việt Nam (HĐVN) and Tinh Thần Hưng Đạo (TTHĐ). The registration fee of $25 will be collected by your Liên Đoàn/Bách Hợp representative.
Clear
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
10
See All
Go Back
Submit