本人確認以上所有由本人提供的資料乃正確無誤,並承擔因虛假資料而產生的任何後果和責任。
I confirmed that all the information I provided was accurate, and I bear any consequence and responsibility that cause by false information.

*煩請於學生上課當天填妥以上申報表

*Please kindly fill in the above health declaration form before student attending the class .

**未滿18歲之學生必須由家長或監護人填寫

**If you are under 18 years old, the form should be filled by parents or guardians