Trường Việt Ngữ Thăng Long
Thang Long Vietnamese Language School
www.tvnthanglong.org - tvnthanglong@yahoo.com
Mail Address: 4901 Powell Road, Fairfax, VA 22032 - (703) 764-1916
Volunteer Form
(Waiver Form for Thang Long Vietnamese Language School)
Full Name/Họ và Tên: _____________________________________________________________________
Date of Birth/Ngày Sinh:_____________________________________________________________________
Addess: ______________________________________________________________________________
Home Phone/Số Điện Thoại Nhà: _______________________ Cell phone/Số cầm tay: ________________
E-mail/Điện Thư: __________________________________________________________________________
Volunteer for (Please circle): 1. Teacher 2. Teacher Assistant 3. Party Organizer: Ban Ẩm Thực 4. Photographer, Video: Ban Nhiếp Ảnh 5. Security: Ban Trật Tự 6. Teach singning.
Địa Điểm & Giờ Giấc Sinh Hoạt (Place & Hours of Operation)
Grace Evangelical Lutheran Church
3233 Annandale Road
Falls Church, VA 22042
9:30 sáng - 12:30 trưa mỗi Thứ Bảy (Every Saturday from 9:30A.M to 12:30 Noon)
Agreement, Waiver & Release of Liability
I, the undersigned, permit my child to participate in all school activities organized by the Thang Long Vietnamese Language School. I understand that there are unforeseeable risks. Neither Thang Long Vietnamese Language School, Viet Nam Center will provide any insurance coverage for my child and his parents/guardians while being at/around the church property. I am completely responsible for the safety of my child and myself.
I hereby release and agree to indemnify and hold harmless Thang Long Vietnamese Language School, the Viet Nam Center, their employees, officers, volunteers and affiliates, all of whom hereinafter will be referred to as releases - ad infinitum from any and all damages, claims, actions, liability and expenses (including costs of judgments, settlements, court costs, and attorney's fees), regardless of the outcome of such claims or actions, arising out of my and my child’s participation in the foresaid activities, notwithstanding liability may result from the negligence of the releases. This Release shall be binding upon not just myself but also any person suing on my behalf and/or my child’s behalf.
_________________________________________________________
Signature Date Signed
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