Shaolin-
land of legends - Application form
1. Parent / Guardian: A Father Surname ……………………………………..
First name ……………………………………..
Passport number…………………………….
Stature (in cms) ……………………………….
Date of birth:
/
/
Nationality …………………………………….
B. Mother Surname ……………………………………..
First name ……………………………………..
Passport number …………………………....
Stature (in cms) ……………………………….
Date of birth:
/
/
Nationality …………………………………….
2. Children: A. Surname …………………………………..
First name……………………………………..
Passport number ……………………………
Stature (in cms) ………………………………
Date of birth:
/
/
Nationality …………………………………….
B. Surname ……………………………………
First name ……………………………………..
Passport number ……………………………..
Stature (in cms) ………………………………..
Date of birth:
/
/
Nationality …………………………………….
C. Surname…………………………………….
First name ……………………………………
Passport number ……………………………...
Stature (in cms) ………………………………
Date of birth:
/
/
Nationality …………………………………….
Home address in Beijing / China ……………………………………………………………………….... Email address …………………………………………………………. Telephone …………………………………………..
Mobile ………………………………………..
Please specify any needs or requests ……………………………………………………………………… …………………………………………………………………………………………………………………. Do you have any health problems that we should be aware of . . …………………………………….... …………………………………………………………………………………………………………………. Do you have any allergies …………………………………………………………………………………. Comments ………………………………………………………………………………………………….. …………………………………………………………………………………………………………………. ………………………………………………………………………………………………………………….