2019 AGAPE Winter Retreat Student Registration

December 26 - 28, 2019 | 4-H Conference Center
600 4h Center Dr, Front Royal, VA 22630
https://www.nova4h.com

Registration Fee:
Early: $110 (12월 1일 까지 등록)
Regular: $125 (12월 8일 까지)
Late: $135 (12월 22일 까지)
PK/MK: $60
Sibling discount: 2nd: $90, 3rd: $60 

*신청비는 학생을 통해 소그룹 선생님에게 Check, Cash 또는 Venmo ID: @Annabellecse 로 보내주시기 바랍니다.
Note: Please make checks payable to "KCPC". Also, include the student's name and grade.
학생 정보 (Student Information)

 
 
 
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Medical Information

 
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비상 연락처 (Emergency Contact)

 
 
 
학부모 동의 내용

본인은 참가 학생의 보호자로서  학생이 와싱톤중앙장로교회 아가페 중고등부에서 주최하는 수양회에 참가하는 것을 허락하며참가하는 학생이 교역자와 교사들의 지도에 순종하며 규칙에 따를 것을 약속합니다



I, legal guardian of the above named student, give permission for my child to participate in KCPC's retreat program and promise that the student will obey rules and the guidance of the leaders.  


나는 자녀가 교회나 리더가 지정한 교통수단와 교회와 리더가 지정한 운전사가 운전하는 교통수단을 이용할 있도록 허락합니다나는 자녀가 행사에 참여하거나 참석하기 위해 교회나 리더가 지정한 교통수단을 이용하는 것에 대해 교회가 어떠한 책임이나 의무가 없음을 허락합니다


I give permission for the Child to ride in the vehicle designated by the Church or leader(s), operated by a driver designated by the Church or leader(s). A I am neither obligated nor required to have the Child ride in the vehicle designated by the Church or leader(s) in order for the Child to participate or attend the Event.


나는 응급상황에 리더가 본인이나 비상연락망에 있는 사람에게 연락할 것을 이해합니다만약 본인이나 비상연락망에 있는 사람에게 연락이 되지 않을 경우리더가 적합하고 이유있는 행동을 하여  자녀를 보호하는것을 허락합니다이것은 자녀를 인근 병원이나 응급실로 옮기는 것도 포함됩니다학생이 수양회 기간  아프거나 개인적인 이유로 집에 일찍 돌아가야   보호자가 학생을 픽업해야 하는것을 이해 합니다.


I understand that, in case of an emergency, the leader(s) will contact either myself or the emergency contact person listed below. A If neither parent nor the emergency contact person can be located or contacted, the leader will take appropriate and reasonable actions to give care to the Child, including visitation to the hospital emergency room, if deemed reasonably necessary in the discretion of the leader or Church. In non-emergency situation, I understand that I have to pick-up child from the retreat center if the child is mildly sick or needs to leave for personal reasons. 


나는 행사를 통해서나 행사로 인해서 발생하게 되는 어떠한 인명피해나 재산피해에 대해서  교회리더스태프교사보조교사  자원봉사자(사례를 받는 자나 안받는  모두를 포함)에게 책임을 묻지 않을 것을 동의합니다


I hereby release and agree to hold harmless the Church and its designated leader(s), staff, teachers, teaching assistants, and volunteers, paid or unpaid, from all liability for damages or injuries arising from, in, before, and after the Event. 


또한 만약 등록을 취소할 경우에만 등록비 환불이 되지 않음을 인정합니다


I also understand that in case I need to cancel my child's registration, I will not be refunded.

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Required Waiver Forms

Please download and fill out the required waiver forms. Once you have filled them out, please upload them to their respective fields.

KCPC Agape Waiver Form

Description

December 26 - 28, 2019
4-H Conference Center
600 4h Center Dr, Front Royal, VA 22630
https://www.nova4h.com

Registration Fee:
Early: $110 (12월 1일 까지 등록)
Regular: $125 (12월 8일 까지)
Late: $135 (12월 22일 까지)
PK/MK: $60
Sibling discount: 2nd: $90, 3rd: $60 

*신청비는 학생을 통해 소그룹 선생님에게 Check, Cash 또는 Venmo ID: @Annabellecse 로 보내주시기 바랍니다.
Note: Please make checks payable to "KCPC". Also, include the student's name and grade.