2023: Picnic At The Park

Picnic at the Park: 2023 Online Registration

Orange County Community Christian Church

4421 Cerritos Ave., Cypress, CA 90630, www.oc4.land

Sr. Pastor Dr. Carl Che, 714-826-5667

Minister Yeh, 714-553-9602

Date 日期: June 24, 10AM – 1PM

El Dorado East Regional Park 7550 E. Spring St, Long Beach, CA 90815

To register your child (K-6) for our Kids Program & Activities, please complete BOTH Part 1 and Part 2.

*For Part 1, please fill out the form below.

对于第 1 部分，请填写下表。

Child's Full Name 全名

Child's Age 年齡

Child's Date of Birth 生日

Child's 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

Park Entrance Fee Reimbursement? (Receipt Needed)

Yes

Items to bring 攜帶物品: Bible 聖經

Thank you for submitting Part 1. Please proceed to Part 2.

谢谢! 请继续第 2 部分。

ORANGE COUNTY COMMUNITY CHRISTIAN

CHURCH PERMISSION AND RELEASE FORM

致橙縣基督教會允准及授權狀

*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。

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，(姓名) 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 are agreeing 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。