Student Information

Student Name *

Age (Session Start) *

Birthdate

Language *

Spanish

Mandarin Chinese

Please provide possible options for day of week and time for private classes. *

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

Please use this space to tell us if the student has had any exposure to the foreign language. If so, please indicate how many years. If student is enrolled in a language class in school, please indicate which level.

Please use this space to tell us what outcome you are expecting at the completion of the tutoring sessions. *

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.

Liability Agreement/Review of Policies

COVID-19 Acknowledgement

Please read and review the COVID-19 information for in-person students only here.

I, the undersigned parent or guardian of the student named above, am aware of the health and safety protocols being implemented by FwFL and I agree that the student named above may participate in the FwFL program despite the risk of exposure to COVID-19. The student or family member will report any symptoms of illness to FwFL staff and I agree to do the same. Either I, or the student, shall report to FwFL staff if the student has any contact or exposure to COVID-19. I acknowledge that the FwFL Director retains the right to cancel or interrupt or postpone a class when in the judgment of the FwFL Director, such act is necessary for the health, safety and welfare of the students and staff of FwFL.

I have been advised of the risks of participation. I, the undersigned parent or guardian of the below named student, am aware of the health and safety protocols being implemented by FwFL and I agree that the below named student may participate in the FwFL program despite the risk of exposure to COVID-19.

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. I understand that I am expected to read the private class policies by clicking here for all other policies.

Signature *

Date *

Payment Information

How Would You Like to Pay

(please select one of the following) First monthly payment must be made prior to the start of services. Subsequent payments must be made monthly prior to the 1st week of each month.

Payment Options

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Private Student Registration

Student Information

Liability Agreement/Review of Policies

Payment Information