Program Registration Form 課程報名表
Student Name 學生姓名
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First Name 姓
Last Name 名字
Birth Date 出生日期
*
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Year
Gender 性別
*
Please Select
Male 男
Female 女
Age 歲數
*
Height 高度
*
Weight 重量
*
Address 地址
Street Address Line 1 地址行1
Street Address Line 2 地址行2
City
State 地區
Zip Code
School Attending 現就讀學校
E-mail 電郵
*
Phone Number 聯絡電話
*
-
Courses 課程
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Shaheen Mini Hockey Development Program 沙鷹青苗曲棍球訓練班(Summer Program暑期班)
Shaheen Youth Hockey Development Program 沙鷹青少年曲棍球訓練班(Summer Program暑期班)
Shaheen Adult Hockey Development Program 沙鷹成人曲棍球訓練班曲棍球訓練班 - 成人班(Summer Program暑期班)
曲棍球訓練班 - 青苗班(5-6月)
體適能訓練班 - 成人班(5-6月)
體適能訓練班 - 青苗班(5-6月)
體美瑜珈班
Beginner 初學者
*
Yes 是
No 否
Emergency Contact Person 緊急聯絡人
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Name 姓名
Emergency Contact Number 緊急聯絡人電話
*
Phone Number 聯絡電話
Additional Comments 其他意見
Payment Method 付款方法
*
Cash 現金 (No. 86 Woo Sung Street, Yau Ma Tei, Kowloon, Hong Kong 九龍油麻地吳松街86號地下)
Cheque 支票 (Payable to “Shaheen Sports Club” and send to No. 86 Woo Sung Street, Yau Ma Tei, Kowloon, Hong Kong 枱上請寫上「Shaheen Sports Club」並郵寄到「九龍油麻地吳松街86號地下」)
ATM 自動櫃員機 (Hang Seng Bank Account 恒生銀行戶口 264-092412-001)
Other
Receipt Upload 上載收據
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Are you interest to join Newly Sports in the future. If Yes, please choose the following sports you may interest 請問您在未來有興趣參加新興運動嗎?如是,請在下列選擇中選取您有興趣的新興運動 :
*
No 沒有興趣
Dogeball 閃避球
Floorcurling 地壼球
Physical Fitness 體適能
Flyball 旋風球
Kinball 健球
Lacrosse 網棍球
Spartan 斯巴達
Petanque Balls 地擲球
Floor ball 地板球
Declaration 免責條款
*
I certify that I am/participant is physically fit and sufficiently trained, and have not been otherwise advised by a qualified medical practitioner in the course. I/participants understand that I am / participating in the event at own risk and responsibility. I hereby explicitly agree to abide by all rules and conditions of the Organizer. I hereby discharge the organizer and any other individuals or organization connected directly or indirectly with this course from my responsibility in the course of loss of property, injury or death incurred during, as a consequence of or while travelling to or from the course. 這證明本人/參加者是自願參加此活動, 身體狀況良好, 並願意自己承擔所有責任. 本人/參加者亦會謹遵主辦機構之一切活動規則及決定. 參加者一旦因活動過程中受到任何財物損失, 受傷或致死亡時, 主辦機構及有關協辦機構均毋需負上任何責任. 本人/參加者亦願意授權予主辦機構在毋需經審查而可使用參加者之肖像作為日後活動籌辦及推廣之用.
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