Student_Profile_学生个人及健康情况.docVIP

Student Profile/学生情况 Name/姓名: Li Chunfeng Gender/性别: Male Grade/年级: High grade One School/学校: The 39 Middle School Phone /电话: 1座机电话号码85 Emergency Contact /紧急电话: 1座机电话号码85 Email/邮箱: 座机电话号码6@ Home Address/家庭住址: Houluoquan bystreet,Xicheng District,Beijing Tell us a little about yourself, such as your hobby, family etc/说说你自己，包括你的爱好、家庭等: My name is Li Chunfeng, I am 15 years old. I like sing song, play basketball and play computer games. I am like talk about with friends ,too . What do you hope to gain from the experience/你希望从这次活动中收获什么？: I hope to learn each other and open my field of vision . 请家长圈出适当的选项： Yes No I give permission for samples of my child’s work poetry, short stories, drawings, etc. to appear on school sponsored websites for educational purposes. Only my child’s first name will appear next to such samples. 我允许自己或小孩的作业（诗歌、故事、绘画等）因教育原因而作为案例出现在学校赞助的网站上，且案例后只署上姓氏。 Yes No I give permission to have my child’s picture appear on school bulletin boards, in school publications yearbooks, playbills class list, etc. , in video productions and in local newspapers in conjunction with school projects.我允许小孩的照片出现在校布告栏、校出版物（如校历、海报、班级名册等）中。 Yes No I give permission for photographs of my child to appear on school sponsored websites. Only child’s first name will appear next to such photos.我允许小孩的照片出现在学校赞助的网站上，且照片后只署上姓氏。 Yes No I give permission for my child to have a cell phone on school property provided that he/she abides by the school rules for cell phone use. 如果小孩遵守学校关于手机使用的制度，我允许小孩在校内使用手机。 Yes No I give permission to use my email for distribution of newsletters, school notices, general correspondence, etc. If you prefer to receive paper copies, circle No. 我允许使用邮箱来接受新闻、学校通知及一般的通信等。如果您更希望收到纸质材料，请选NO。 Student Picture/学生照片: Parent Signature/家长签字 Student Signature/学生签字: Medical Questions/健康信息 请家长圈出适当的选项或作答： 1. Does your child have any allergies? 您的小孩有任何的过敏吗？ 是否有宠物过敏？ Yes or No If yes, what? 如有，请说明：_________________________________________