Student Information

How many children are you registering? *

1 child

2 or more children

*If registering more than 2 children, please complete and submit form for each additional child.

New Student or Returning? *

New Student

Returning

Home School Organization Name if applicable

Child Name *

Birthdate *

Age (Session Start) *

Language *

Spanish

Mandarin Chinese

Class day of week and time *

Any medical conditions of the child that we should be aware of? If none, please write none. *

Please use this space to tell us what activities your child enjoys/does not enjoy doing.

Photo Permission *

Yes

Do you authorize the use of images of your child to be used on the FwFL website, FB, or other online outlets or in printed materials? Additional permission to include child's name will be obtained when applicable

Video Permission *

Yes

Do you authorize the use of video of your child to be used for FwFL teacher training purposes? Please note...If a promotional video is being done, you will be asked to sign a separate permission form granting permission to use image or video of your child

Home School Organization Name if applicable

Child 2 Name *

New Student or Returning Child 2 *

New Student

Returning

Birthdate Child 2 *

Child 2 Age (Session Start) *

Language Child 2 *

Spanish

Mandarin Chinese

Class day of week and time Child 2 *

Child 2: Any medical conditions of the child that we should be aware of? If none, please write none. *

Child 2: Please use this space to tell us what activities your child enjoys/does not enjoy doing.

Photo Permission Child 2

Yes

Video Permission Child 2 *

Yes

Do you authorize the use of video of your child to be used only for FwFL teacher training purposes? Please note...If a promotional video is being done, you will be asked to sign a separate permission form granting permission to use image or video of your child

Parent Information

Parent(s)/Guardian(s) Name *

Address *

Country

City

State

Zip code

Mobile Number *

Alternate Number *

Email--please provide an address that is checked often. *

How did you hear about us? If you were referred, please list referrer's name.

Username and Password

Create Username and Password

If you have not already done so, please create a login by registering your account This login will provide you with access to the Current Families section of the website which has the class lesson’s activity sheets and audio, pronunciation guides, as well as other useful information. After your payment is received, your account registration will be approved and you will have access to Current Families.

Help To Promote Our Program

Enrolling More Than 2 Children

If enrolling more than two children, please submit another form for each additional sibling. If parent(s)/guardian(s) information is the same for additional sibling please note same.

Liability Agreement/Review of Policies

Signature *

Date

Please read below

Liability Agreement: I agree that I will not hold a faculty member or an employee of Fun with Foreign Language (FwFL) liable for injuries sustained or for illnesses contracted by me/my child/my children while a student/participant at FwFL. I agree to indemnify FwFL and its faculty for all liabilities, costs, and judgements arising for acts of omissions of the undersigned, which result in injury or damage to any person or party . I further agree that I will not hold FwFL or any faculty member responsible for the loss or damage of personal property during participation.

Returned Check Policy: The fee for a returned check is $35.

I have read and understand the policies above and waive all claims of liability.

Signature *

Date

Payment Options

Please select one of the following: *

Captcha *

reCAPTCHA is required.

Home School Student Registration