synergy registration form

2

Click here to load reader

Upload: serenethunder

Post on 31-May-2015

744 views

Category:

Documents


1 download

TRANSCRIPT

Page 1: Synergy registration form

THE AKSIS 101 CULMINATING ACTIVITY and CAMP 2011

November 5-6, 2011 at Camp Explore, Antipolo, Rizal

Dear AKSIS Member,

With a big smile, we proudly present you SYNERGY, the Culminating Activity for the first semester’s AKSIS

101. We thank you for expressing your interest in participating to this event. We will be formally welcoming the

new members to the club, and strengthen the bonds between members. By the end of this activity, you’ll find

yourself well-acquainted with your club mates, your officers, and most importantly, with the AKSIS family.

For November 5-6, 2011, we will be at the Camp Explore’s Forest Camp, surrounded by the Sierra Madre

Mountains and Marikina Watershed of Mt.Purro, Nature Reserve. With nature at its purest, the participants are

expected to have a weekend well-spent for we have prepared a multitude of fun and engaging activities that at the

same time will help them accomplish the objectives of this activity. Feel free to learn more about the venue

through their website: http://mycampexplore.com/

In your hands is the registration packet. To reserve your slot, kindly accomplish the form and pay the

registration fee of P1,300 (inclusive of transportation, three meals and two snacks, and cottage style lodging) to

the AKSIS core team on October 26 (4:30-5:30PM) or October 27 (3:30-5:30PM) at the PSHS-MC, back lobby area

(near the cafeteria). Our team will be there to entertain further questions and present you with the final briefing

and guidelines upon payment. If you will be unable to pay the full amount right away, you may pay half (P650 -

P700) to reserve and the balance on November 5. Please make all checks payable to cash.

Thank you for your unwavering support. We hope to have your presence in this forthcoming activity, as

we build towards a meaningful and fun-packed second semester of the school year.

Ryan B. Misola

AKSIS President

Noted by:

Vladimir S. Lopez

AKSIS Adviser

For questions and clarifications, you may contact the following:

MR. VLADIMIR LOPEZ (Adviser) – 0917-986-8664, [email protected]

RYAN MISOLA (AKSIS President) – 09056792800, [email protected]

NICOLE ROCAFORT (AKSIS SECRETARY, Committee Head) – 0906-297-3043

Or post in our AKSIS s/y 2011-2012 Facebook Group

Page 2: Synergy registration form

REGISTRATION FORM

(Print out. Fill up. Submit on October 26 or 27, along with your payment. )

FIRST THINGS FIRST

Full Name

Nickname Year and Section

Mobile Number Email Address

Home Address, Landline

OLD MEMBERS

Duration (SINCE WHEN WERE YOU A MEMBER?)

Participation* ARM

Rate the Club’s Activity* SWITCH ARMS? (IF YES, TO WHICH ARM?)

NEW MEMBERS – WELCOME TO AKSIS!

Rate the Club’s Activity* Preferred Arm

List of AKSIS Friends

Expectations this S/Y *For Participation: VA (very active), SA (somewhat active), SI (somewhat inactive), VI (very inactive)

Parent’s Permit I hereby allow my son/daughter to participate in SYNERGY this November 5-6, 2011 at Camp Explore, Antipolo, Rizal, to be hosted by AKSIS, the social science club of the PSHS. I also certify that my son/daughter is physically fit and ready to join a summer camp and participate in all its outdoor activities that will include challenging terrain, obstacle courses, slippery surfaces, mud, and water. I will also be my son’s/daughter’s emergency contact. My details (mobile/landline/e-mail) are __________________________________________________________________________________________.

Duly signed, ______________________________________ (printed name and signature)

------------------------------------------------------------------------------------------------------------------------------------------EMERGENCY CONTACT INFORMATION (feel free to tear off this portion)

Dr. Cristina Cristobal (SSD Chief) – (02)9240661

Mr. Vladimir Lopez (AKSIS Adviser) – 017-986-8664

Ryan Misola (AKSIS President) – 0905-679-2800

Nicole Rocafort (AKSIS Sec., Program Head) – 0906-297-3043

Ms. Kit Malvar Llamas (Camp Director) – 0917-898-2155