Students Registration Form

Students Registration Form

XIAO XUE BA Chinese Enrichment

by A*SPEECH
- Parent Full Name*
  
  First NameLast Name
- Child's Full Name*
  
  First NameLast Name
- Birth Date*
  
  MonthDayYear
- E-mail*
- Year Level of Signup*
- Day/Time of Signup*
- Mobile Number*
- Telephone Number
- Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Person to contact in case of emergency:*
  Parent/Guardian
- Relationship*
  ex. Father, Mother, etc.
- Payment Method
  
  CashNets
- Terms and Conditions:
  1. Make-up class will be provided for one lesson missed in the week.
  2. Full payment for a term is required upon signup. Any payment not received in full may void the child's registration for the class.
  3. Slots for all classes are on a first come first serve basis.
  4. The Centre reserves the right to postpone commencement or cancellation of a class due to insufficient signups. Payment will be refunded in full in the event of cancellation.
  5. Photo materials and media of your child may be used for marketing and event purposes. If you do not wish to participate, kindly email to hello@xueba.com.sg.
  By submitting, I agree to all terms and conditions for the sign up of my child:
- Signature
  
  Clear
- Should be Empty: