Microsoft Word CYC Camper_package

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1 2013 年達福地區華裔青少年夏令營學員報名表日期 :06/30/ /6/2013 主辦 : 達拉斯華人活動中心 Dallas Chinese Community Center 地點 :University of Texas Arlington 300 W. First St. Arlington TX

2 時地 2013 年達福地區華裔青少年夏令營簡介間 :2013 年 6 月 30 日 ( 星期日 ) 下午三點至 7 月 6 日 ( 星期六 ) 下午五點點 :University of Texas - Arlington 資格 : 1. 八歲以上 ( 必須於 08/31/2013 前滿八歲者 ) 2. 身體健康無傳染性疾病或需特殊照顧者 3. 過去參與夏令營無不良記錄者報名時間 : 學員 :3 月 2 日至 5 月 31 日, ( 請至達拉斯華人活動中心領取報名表或上網下載 ) 報名地點 : 達拉斯華人活動中心 Dallas Chinese Community Activity Center 400 N. Greenville Avenue, Suite 12 Richardson, TX 或郵寄至 Julie Hung 4445 Fairway Dr., Carrollton, TX ** 有疑問請與註冊組洪小惠老師 (972) 或王曙蒨老師 ( ) 連絡營區費用 : 每人 $ ( 包含報名費 $20; 請在支票上註明學生姓名 ) 同一家庭第ニ名子女 $ 第三名子女 $ 為了便於分班及文書作業 ; 凡是於 5 月 1 日以前報名者, 每一人可減免 $10 元 ( 包含正副輔導員 ) ** 在 6 月 1 日至 6 月 9 日報名者加收 50 元手續費 (Late Registration fee $50 from 6/1 to 6/9) 保證金 : 每人 $50.00 ( 學員遵守營規及宿舍潔淨者, 保證金於結營後三星期內退回 ) 支票抬頭 : DCCC (Dallas Chinese Community Center) 營區費用 ( 含報名費 ) 與保證金須分開支付, 限用 Money Order 或私人支票 ( 遭退票者取消報名資格, 原件退回 ) 支票上請註明學生中英文姓名及在學的中文學校夏令營課程 : 1. 中華文化簡介, 包括民俗藝術舞蹈美勞書法民俗體育等輔導老師 : 2. 團體活動, 包括體育游泳團體遊戲趣味競賽等 3. 另有功夫國畫街舞及今年新增的電影製作邀請各項專才老師教導課程, 各班有導師, 助理老師及正副輔導員照顧起居, 營區有各組工作人員維持秩序安全及整潔主辦單位 : 達拉斯華人活動中心協辦單位 : 中華民國僑務委員會贊助單位 : 網址臉書美洲中國工程師協會達福分會 CIE/USA-DFW College Leadership Training Program 美國聮信銀行 Comerica Bank 2

過去參與夏令營無不良記錄者報名時間 : 學員 :3 月 2 日至 5 月 31 日, ( 請至達拉斯華人活動中心領取報名表或上網下載 ) 報名地點 : 達拉斯華人活動中心 Dallas Chinese Community Activity Center 400 N.

3 2013 Dallas/Ft. Worth Chinese Youth Camp Date: Sunday June 30, 2013 to Saturday July 6, 2013 Camp Site: University of Texas Arlington Check-in Time: 3:00 P.M. on June 30, 2013 Check-in Site : University of Texas at Arlington. The camp will send out notice 2 weeks before camp Eligibility for campers: 8 yrs old before August 31, 2013 Registration period for campers: March 2 to May 31, additional charges of $50 would be added if registered after May 31. Camp Fee: $395 (includes a non-refundable $20.00 registration fee) Save $10 for each camper if registration is completed before May 1, 2013 Save $10 on each additional child in the same family. Mail completed registration forms to Chinese Youth Camp - Julie Hung 4445 Fairway Drive, Carrolton, TX Camp Experience: Camp Activities: 1. Introduction to Chinese culture: folk dancing, arts and crafts, painting, calligraphy, Chinese yo-yo, kung-fu, and various other folk activities. 2. Additional activities include: filmography (*NEW*), street dance, basketball, group games, volleyball, and more. 3. Banquet, talent show, leadership training, and more. Our camp is unique in the range of classes/activities we offer and the diverse makeup of our camp staff. Each year, we invite 3 teachers from Taiwan to join our camp to teach 3 core Chinese cultural classes. Each teacher is a master in his respective cultural subject and adds a tremendous dynamic to camp curriculum, delivering a more enhanced learning experience to our campers. Additionally, we have available to us locally, a pool of talented teachers, who to teach classes such as street dance, kung-fu, leadership, and etiquette. Every group is assigned a strong team of trained counselors and assistant counselors and an adult chaperone lead and monitor the campers throughout the day. For more information about the camp and to download the registration form, please visit: CYC Website: Find us on Facebook: If you have any questions, please contact the Camp Director, Tingwhai Lee, at (817)

The camp will send out notice 2 weeks before camp Eligibility for campers: 8 yrs old before August 31, 2013 Registration period for campers: March 2 to May 31, additional charges of $50 would be

4 請注意 : 務必將此表格填寫完整, 否則將不接受報名年齡 : 必須年滿 8 歲 (08/31/2013), 若有違規者, 本營有權要求貴子弟退營, 營費恕不退還註冊組專用 For office use only 學號 Student # 班級 Class # 寢室 Room # 學生姓名 ( 中文 ): 2013 年達福地區華裔青少年夏令營報名表 2013 DFW Chinese Youth Camp English Name: 年齡 (Age): 性別 (Sex): 出生日期 (Birth date): 2013 秋季班就讀美國學校年級 (Grade): 通訊處 Parent's Address Camper's 家長姓名 ( 中文 ): Parent Name: 電話 (H): Tel (W): (M) 制服尺寸 Uniform Size: (Adult) ( )XL 特大 ( ) L 大 ( ) M 中 ( )S 小, Youth ( ) M 中在緊急情況下而聯絡不到家長時, 可與下列親友聯絡 Emergency Contact: 姓名 (Name): 電話 (Tel): (M) 關係 (Relationship): 希望同寢室的朋友 ( 年齡相近 ) Preferred roommate 中文姓名 Name: 現就讀中文學校名稱 (Current Chinese School attending): 保健資料 Health Information 醫療保險 Medical Insurance 保險公司 Insurance Co: 保險卡號碼 Insurance #: 無醫療保險學員住營期間如有醫療需要, 家長將自行家長簽名 No medical Insurance 負責醫療費用過敏 Allergy 對何種藥物 Medicine: 對何種食物 Food: 身體狀況 ( ) 很好 ( ) 好註 : 需要特殊照顧者, 因人力及設施限制, Health Very Good Good 故無法接受報名, 請見諒其他 : 1. 有特殊事故要求退費時, 必須以書面申請, 除報名費不退以外, 營區費用於 6/01/13 前可退全費, 6/10/13-6/22/13 僅退半費, 6/23/13 以後, 恕不退費. 保證金則全退. Check payable to DCCC. 2. 如以上資料有不實者, 本營有權退件 * 繳費記錄 : 1. 費用 $395.00/385.00/ 保證金 $50.00 支票號碼 : 月 1 日前報名減免 :$10/ 人 5 月 31 日後報名另加 $50/ 人 $10/person discount if enrolled before 05/1/13 $50/person Late registration fee after 5/31/13 Please complete the following survey question so we can improve our camp: How do you know this camp? 1. From Chinese School. 2. From Local Chinese Newspaper. 3. From friends, (name up to 5)

Parent's E-mail: Address Camper's E-mail: 家長姓名 ( 中文 ): Parent Name: 電話 (H): Tel (W): (M) 制服尺寸 Uniform Size: (Adult) ( )XL 特大 ( ) L 大 ( ) M 中 ( )S 小, Youth ( ) M 中在緊急情況下而聯絡不到家長

5 2013 DFW Chinese Youth Camp Activity Permission slip My child has my permission to participate in the 2013 DFW Chinese Youth Camp at University of Texas at Arlington. My child has my permission to participate in bowling activities in the 2013 DFW Chinese Youth Camp at University of Texas at Arlington. The undersigned as legal guardian of the student do hereby grant to the staff of the DFW Chinese Youth Camp in my absence, the authority to render a judgement concerning medical assistance in the event of an accident. I do not hold the DFW Chinese Youth Camp, its teachers, staff, and school responsible for any and all injuries that may occur during the acitivities, including the transportation provided by the DFW Chinese Youth Camp, and I so signify by signature below: SIGNED: DATE: 2013 DFW Chinese Youth Camp Medical Release Form This is to certify that I grant permission for my dependent child, (Chinese name) (English name), to receive medical treatment by university physicians, while attending DFW Chinese Youth Camp at University of Texas at Arlington. I further authorize treatment at local hospitals by physicians at those facilities, should such treatment be required. I understand that I will be responsible for any and all medical charges or fees. SIGNED: DATE: ADDRESS: PHONE: (Work) (Home) My medical insurance company is My policy number is (Please attach a copy of your medical insurance card) 5

The undersigned as legal guardian of the student do hereby grant to the staff of the DFW Chinese Youth Camp in my absence, the authority to render a judgement concerning medical assistance in the

6 DFW CHINESE YOUTH CAMP RULES General Rules: 1. The camp director reserves the right to reprimand any violators 2. Follow campus policies and follow instructions given by camp staff 3. Be prompt and present at all scheduled camp activities 4. Stay within the camp site or assigned places. Do not leave from camp without written consent from the camp staff 5. Wear camp provided t-shirt at all times. No alterations or markings to t-shirts are allowed 6. Smoking, consumption of alcoholic beverages, and drugs are strictly prohibited 7. Absolutely no gambling, fighting, or carrying of dangerous objects (such as fireworks, firearms, and knives) are permitted 8. In case of emergency, report to staff immediately 9. All trash must be disposed of properly 10. No gum chewing allowed at this camp 11. Counselors, assistant counselors and campers may bring cell phones to use during break time, but CYC is not responsible for any lost and/or damaged cell phones. 12. Any valuable items you bring are your responsibility. CYC is not responsible for any lost and/or damaged belongings that may occur during CYC. Dormitory Rules: 13. Keep room and facilities clean and tidy. Adult camp staff will conduct daily inspections. 14. Curfew is strictly observed. Room checks will be conducted by adult staff after 10 pm 15. No visitations by campers of the opposite sex are permitted 16. Absolutely no room switching 17. Be considerate. Do not create noise Classroom rules: 18. Be respectful to each other and to the teacher 19. Follow the teachers rules 20. Keep classrooms clean 21. Be respectful of others as you walk from class to class Dining Hall Rules: 22. Stay in line to receive food. Be courteous and helpful to younger campers 23. Only take what you can eat and eat what you take 24. Keep dining hall absolutely clean Check-Out Rules: 25. Parents will be responsible for picking up their camper who becomes ill, injured, has problem adjusting to camp life, or violates camp rules and is dismissed by the camp authorities. If, for any reason, a child must be picked up during camp, there will be no refund. 26. Except for the above conditions, no early dismissal is allowed. All campers are required to attend the closing ceremony 27. Campers may check out only upon presenting check-out slip, authorized by camp staff, to staff at his/her dorm exit door 28. Parents will be liable for any damages caused by their camper I have read and understand the above Chinese Youth Camp rules and I agree to follow them. SIGNED (CAMPER): DATE: SIGNED (PARENT): DATE: 6

Wear camp provided t-shirt at all times. No alterations or markings to t-shirts are allowed 6. Smoking, consumption of alcoholic beverages, and drugs are strictly prohibited 7.

7 2013 達福地區華裔青少年夏令營營規以下列營規, 若違反其中任何一項, 本營有權通知父母接走學員, 且概不退費一般規則 : 任何參加夏令營的學員或正副輔導員, 需由家長或監護人陪同報到, 為避免學員駐營期間擅自開車外出, 駐營期間請勿將車輛停至營區內報到當天, 身體不適者, 不可入營, 經醫生證明, 可全額退營區費遵守 University of Texas- Arlington 校園規則聽從工作人員指導, 醫師處方藥物需由營方管理準時參加營區各項活動僅在營區內或指定地區活動, 絕對禁止外出在營期間必須穿著夏令營 T 恤, 不可修改或塗畫禁止抽煙飲酒或吸用藥物營區內禁嚼口香糖禁止賭博打架或攜帶危險物品 ( 如鞭炮槍械小刀 ) 如有緊急狀況, 速報工作人員正副輔導員可攜帶手機入營, 在休息時間作聯係用 CYC 不鼓勵學員們攜帶手機入營, 但上課期間禁止使用手機或任何其他貴重物品遺失,CYC 概不負責宿舍規則 : 保持房間及設備乾淨整齊, 工作人員將每日檢查, 對違反規定者, 將予通知警告宵禁將嚴格執行, 每晚 10 點 30 分後, 輔導人員將逐間查房禁止異性至房間拜訪禁止隨便更換寢室保持宿舍安靜教室規則 : 保持秩序, 聽老師指導保持教室整潔走廊禁止喧嘩餐廳規則 : 排隊取食, 要禮讓及幫忙幼小者取己所需, 勿浪費食物保持餐廳整潔結營規則 : 於下列情形下, 本營有權通知父母負責接走學員, 概不退費 : (1) 生病 (2) 受傷 (3) 無法適應團體生活 (4) 違反營規, 如父母不接走學員, 本營有權保留 $50 保證金除上列原因以外, 所有學員概須參加結業典禮, 不可提前離營否則本營將保留 $50 保證金學員須於各宿舍出口, 交予工作人員, 離營許可證後, 始可離營父母對子弟所破壞物品須負責賠償我及我的父母同意以上各項營規, 我願全部遵行, 簽署同意如下 :, 學員姓名日期父母或監護人姓名日期 7

地區活動, 絕對禁止外出在營期間必須穿著夏令營 T 恤, 不可修改或塗畫禁止抽煙飲酒或吸用藥物營區內禁嚼口香糖禁止賭博打架或攜帶危險物品 ( 如鞭炮槍械小刀 ) 如有緊急狀況, 速報工作人員正副輔導員可攜帶手機入營, 在休息

8 2013 年達福地區華裔青少年夏令營註冊必備資料 * 註冊必備資料缺一原件退回, 補交而有擔誤, 營區概不負責, 報名前請仔細核對學員名額有限, 依完成報名先後決定 1. 報名表 2. Health Insurance 資料影印本 3. Medical Release Form 4. Activity and Permission Slip 5. 費用 $395.00( 含報名費 $20.00, 同一家庭第ニ名子女 $385.00, 第三名子女 $375.00), 保證金 $50.00( 學員遵守營規, 無違反營區紀律事故者, 保證金於結營後退回現讀中文學校 ) 費用須以 Money Order 或私人支票支付 ( 遭退費者, 取消報名資格, 原件退回 ) 營區費用 ( 含報名費 ) 及保證金分二張支票支付 ( 支票上請註明學員中英文姓名, 就讀中文學校 ) 凡是於 5 月 1 日以前報名者, 每一人可減免 $10 元 ( 包含正副輔導員 ) 在 6 月 1 日至 6 月 9 日報名者加收 50 元手續費 6. 營區規則 Camp Rule ( 中文英文版各一份, 學員及家長皆須閱後簽名 ) 7. If you are applying for a counselor/assistant counselor s position, please turn in all items above as well as the Counselor/Assistant Counselor s Application and Requirement forms. 報名表填寫有任何疑問, 請聯絡夏令營註冊組洪小惠王曙蒨營長李庭槐副營長王嘉玲 Our website is: You can be a friend of our Facebook for all the camp information. 8

00( 學員遵守營規, 無違反營區紀律事故者, 保證金於結營後退回現讀中文學校 ) 費用須以 Money Order 或私人支票支付 ( 遭退費者, 取消報名資格, 原件退回 ) 營區費用 ( 含報名費 ) 及保證金分二張支票支付 ( 支票上請註明學員中

9 2013 CYC Registration Checklist Registration will be returned if any of the required documents is missing. CYC will not be responsible for the delaying of the enrollment process due to missing documentation. Therefore, please check your registration form carefully. Remember the number of enrollment is limited and is based on a first come first serve policy. Registration Form Copy of Health Insurance Information Medical Release Form Activity Permission Slip *Check for camp fee $ (Includes a non-refundable $20.00 registration fee). The price is $ for the second child in the same family, and $ for the third child in the same family. Separate check of $50.00 for security deposit (CYC will not deposit this check unless any property is damaged by the camper. This check will be returned to you at reunion).** Camp Rules Form (Both Chinese & English version), signed by parent and camper. If you are applying for a counselor/assistant counselor s position, please turn in all items above as well as the Counselor/Assistant Counselor s Application and Requirement forms. If you have any questions, please contact us: Administration: Julie Hung (972) Shu Lam (972) Camp Director: Tingwhai Lee (817) Deputy Director: Chialing Chung (972) CYC Website: CYC Facebook: * CYC only accepts checks or money orders. Save $10 for each camper (including counselors and assistant counselors) if registration is completed before May 1, A late registration fee of $50 for each person will be charged if enrolled from 6/1/13 to 6/9/13. ** Please write separate checks for camp fee and deposit check. If you have more than one child attending the camp, you can use one check for each. Write down your child s name on each check. 9

Remember the number of enrollment is limited and is based on a first come first serve policy.

Microsoft Word - 2013 CYC Counselor_package - Jessica's revisions

Microsoft Word - 2013 CYC Counselor_package - Jessica's revisions 2013 年達福地區華裔青少年夏令營輔導員報名表日期 :07/1/2013 07/6/2013 主辦 : 達拉斯華人活動中心 DFW Chinese Community Center 地點 :University of Texas Arlington 300 W. First St. Arlington TX 76019 1 時地 2013