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1、最新Student_Profile_学生个人及健康情况Student Profile/学生情况Name/姓名:Li ChunfengGender/性别:MaleGrade/年级:High grade OneSchool/学校:The 39 Middle School Phone / :Emergency Contact /紧急 :Email/邮箱:Home Address/家庭住址:Houluoquan bystreet,Xicheng District,BeijingTell us a little about yourself, such as your hobby, family etc
2、/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：YesNoI give
3、 permission for samples of my childs work (poetry, short stories, drawings, etc.) to appear on school sponsored websites for educational purposes. Only my childs 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。YesNoI give permission to have my childs
4、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。YesNoI give permission for photographs of my child to appear on school sponso
5、red websites. Only childs 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。YesNoI 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 使用的制度，我允许小孩在校内使用 。YesNoI give permission to us
6、e 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 chil
7、d have any allergies?您的小孩有任何的过敏吗？是否有宠物过敏？Yes or NoIf yes, what? 如有，请说明：_2. I give permission for the school nurse to give my child Tylenol or Ibuprofen (Advil, Motrin) as a pain reliever when needed.如需要，我允许校医对小孩使用泰诺或布洛芬止痛药，美林等药止痛。 Yes or No3. Does your child have any physical limitations that preven
8、t participation in any school programs? 您小孩有任何身体不适而不能参加学校的某个/些活动吗？Yes or NoIf yes, what? 如有，请说明：_4. Does your child take any medication?您的小孩在吃任何药物吗？Yes or NoIf yes, what? 如有，请说明：_When is the medication taken? 药物应何时服用？ _In case of emergency, if your emergency contacts cannot be reached, your child will be taken to a hospital or emergency treatment facility by ambulance.如果出现紧急情况，而您的紧急联系方式又不能联系上您时，您的小孩将被送往医院或救护车送往紧急治疗机构。 Please sign and date below that the information on this Medical Information Page is correct. 假设上述信息正确无误，请在下面签上您的姓名和时间。Parents/Guardian Signature家长/监护人 签名：_Date日期：_
