Picnic At The Park 2022

Picnic at the Park 2022 Registration

Orange County Community Christian Church

4421 Cerritos Ave., Cypress, CA 90630, 714- 826-5667

Sr. Pastor Dr. Carl Che www.oc4.land

Minister Yeh, 714-553-9602

Date 日期: July 2nd, 10AM – 12PM

El Dorado East Regional Park 7550

E. Spring St, Long Beach, CA 90815

Full Name 全名

Age 年齡

Date of Birth 生日

Allergies/Other Medications 過敏藥物

Street Address 地址

City 城市

Zip Code 邮政编码

Parent Name(s) 父母名字 * *

* * If you would like to volunteer for the Picnic at the Park event, please include your email on this field.

* *如果您想自愿参加我们在公园里的野餐，请在此字段中包含您的电子邮件。

Parent Contact and Phone Number (During Event) 活动期间的联系方式和电话号码

Emergency Contact and Phone Number 紧急联络号码

Parking Admission Needed?

Yes

Items to bring 攜帶物品: Bible 聖經

Thank you for submitting your form.

谢谢!

*For Part 2, please read and fill out the release form located below.

对于第二部分，请阅读并填写下面的 RELEASE 表格。

ORANGE COUNTY

COMMUNITY CHRISTIAN

CHURCH PERMISSION

AND RELEASE FORM

致橙縣基督教會允准及授權狀

Please put the date. This release form will be valid from January 1 to December 31 of the CURRENT year.

hereby grant permission for the following:

to participate in activities with Orange County Community Christian Church (OC4) and hereby release OC4, its staff, employees, and helpers from any and all liabilities connected with said activities, including his/her/their transportation during participation in activities with OC4.

我，_____ 特允准參加橙縣基督教會的各種活動，並謹此豁免橙縣基督教會的職員，服務人員承擔上述人員在參加教會活動中，包括交通中所產生的所有的相關索賠及責任。

Name (First, Middle Initial, Last)

Minor 1: (First, Middle Initial, Last)

Minor 2: (First, Middle Initial, Last)

Minor 3: (First, Middle Initial, Last)

Minor 4: (First, Middle Initial, Last)

Please remember that your name will serve as a legally binding signature.

Insurance Co, Policy #: (PLEASE INCLUDE BOTH)

Allergies/Medical Conditions (Include Name(s) of the Individual(s))

Signature of: (授權人簽名)

Self

Parent

Guardian

By clicking this box, you agree to the terms listed in this form. 单击此框，即表示您同意此表格中列出的条款。

* * *If you would like to volunteer for the Picnic at the Park event, please include your email on this field. * * *如果您想自愿参加我们在公园里的野餐，请在此字段中包含您的电子邮件。

* * If you would like to volunteer for the Picnic at the Park event, please include your email on this field.

* *如果您想自愿参加我们在公园里的野餐，请在此字段中包含您的电子邮件。