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Online Registration
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Indicates required field
Registration Term
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Whole Year
Fall Semester
Spring Semester
Early Bird Discount Deadline:
5/31/2015 for currently enrolled students
8/15/2015 for new students
Student and Class Information
English Name of 1st Student
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First
Last
Chinese Name
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Birthday (mm/dd/yyyy)
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Language Class
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Select One
Pre-K
Kindergarten
Traditional 1st Grade
Traditional 2nd Grade
Traditional 3rd Grade
Traditional 4th Grade
Traditional 5th Grade
Traditional 6th Grade
Traditional 7th Grade
Traditional 8th Grade
Traditional 9th Grade
CSL Children Level 1
CSL Children Level 2
CSL Children Level 3
CSL Adult Level 1
CSL Adult Level 2
Cultural Class
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Select One
Chinese Watercolor Painting
Chinese Calligraphy
Adult Aerobics
English Name of 2nd Student
*
First
Last
Chinese Name
*
Birthday (mm/dd/yyyy)
*
Language Class
*
Select One
Pre-K
Kindergarten
Traditional 1st Grade
Traditional 2nd Grade
Traditional 3rd Grade
Traditional 4th Grade
Traditional 5th Grade
Traditional 6th Grade
Traditional 7th Grade
Traditional 8th Grade
Traditional 9th Grade
CSL Children Level 1
CSL Children Level 2
CSL Children Level 3
CSL Adult Level 1
CSL Adult Level 2
Cultural Class
*
Select One
Chinese Calligraphy
Chinese Watercolor Painting
Adult Aerobics
English Name of 3rd Student
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First
Last
Chinese Name
*
Birthday (mm/dd/yyyy)
*
Language Class
*
Select One
Pre-K
Kindergarten
Traditional 1st Grade
Traditional 2nd Grade
Traditional 3rd Grade
Traditional 4th Grade
Traditional 5th Grade
Traditional 6th Grade
Traditional 7th Grade
Traditional 8th Grade
Traditional 9th Grade
CSL Children Level 1
CSL Children Level 2
CSL Children Level 3
CSL Adult Level 1
CSL Adult Level 2
Cultural Class
*
Select One
Chinese Calligraphy
Chinese Watercolor Painting
Adult Aerobics
Family Contact Information
Mother or Female Guardian (only if student is a minor)
*
First
Last
Father or Male Guardian (only if student is a minor)
*
First
Last
Email
*
Email
*
Phone Number
*
Phone Number
*
Home Address
*
Same home address as last year
New Address or address for new family
*
Line 1
Line 2
City
State
Zip Code
Country
Emergency Contact Name
*
First
Last
Emergency Contact Phone Number
*
Important Statements and Signature
Refund Policy Agreement
*
I hereby confirm that I agree to abide by the school refund policies stated in the Registration Information
Electronic Signature
*
I understand that checking this box and type my name below, I am electronically signing my name on this registration form.
Type your first name and last name
*
Date
*
Special Note. If your child has any allergy or special medical situation, please inform us as soon as possible.
Comment
*
CAoC Waiver Statements
*
I hereby to sign CAoC Waiver Statemetns
I do not wish to sign CAoC Waiver Statements
If you choose not to sign CAoC Waiver Statements, please initial each of the follow boxes.
*
We/I hereby release, discharge and agree to hold harmless Chinese Academy of Cleveland, its board members and staff, as well as Shaker Heights School and its staff and all persons acting under the permission or authority, from a liability whatsoever for any and all claims of any nature which may raise out of our/my attendance at the Chinese Academy of Cleveland, and/or purchase and / or consumption of food and / or snacks offered through the Chinese Academy of Cleveland during snack time, special luncheon, and special events sponsored by the Chinese Academy of Cleveland such as Chinese New Year celebration, outdoor picnic, and end-of-year luncheon. This release covers us/me and any minor members of our/my family.
We/I hereby also agree on behalf of ourselves / myself and any minor members of our / my family to allow the staffs and board members of the Chinese Academy of Cleveland to release electronic or paper photographs of us / me and any minor members of our/ my family on published materials including newspaper articles, internet websites, and video / radio productions associated with the reporting and promotion of activities associated with the missions, actions, and activities of the Chinese Academy of Cleveland.
Furthermore, in case of emergency and my designated emergency contact cannot be reached, permission is granted to have my child treated by doctor or hospital appointed by the Chinese Academy of Cleveland or its authorized personnel."
If you do not wish to sign the waiver, please initial each statement below.
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