圣地亚哥华夏中文学校2020-21春学期才艺课注册表

圣地亚哥华夏中文学校2020-21春学期才艺课注册表

2020-21 San Diego Hua Xia Chinese School Spring Semester Enrichment Program Registration Form
1. 此注册表仅供未注册中文课的学生使用，在校生请至http://courses.sdhxcs.org登录注册。This form is for students Not enrolled in any Chinese programs. Current students (enrolled in Chinese Program) please log onto your student account at http://courses.sdhxcs.org and complete your self enrollment.

To prevent initiating multiple payment requests, please DO NOT refresh the page or go back to the previous page when the submission is being processed even if the system is not responding. For any technical difficulties, please contact system admin at enroll@sdhxcs.org.
2. 请提供家长/监护人直接、有效联系方式 Please provide parent/guardian's most recently updated info and immediate contact
家长/监护人英文姓名 Parent/Guardian English Name *

First Name Middle Name Last Name
家长/监护人中文姓名 Parent/Guardian Chinese Name

姓名
家庭住址 Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
家庭电话 Home Phone *

Area Code Phone Number
家长/监护人电子邮址 Parent/Guardian Email *

Confirmation Email
家长/监护人手机 Parent/Guardian Cell Phone *

Area Code Phone Number
3. 请提供学生注册信息 (成人才艺课程免填) Please provide student information (Not Required for Adult Programs)
Student English Name

First Name Middle Name Last Name
学生中文姓名 Student Chinese Name

姓名
出生日期 Date of Birth

Month Day Year
性别 Gender
学生电子邮址 Student Email

Confirmation Email
4. 请提供其它重要注册信息 Please provide other important information
紧急事故联络人 Emergency Contact Name *
联络人电话 Phone Number *

Area Code Phone Number
除家长外紧急事故联络人 Emergency Contact other than Parent *
除家长外联络人电话 Phone Number *

Area Code Phone Number
家庭医生姓名 Family Physician Name *
家庭医生电话 Phone Number *

Area Code Phone Number
医疗保险公司 Insurance Company *
保单号码 Policy Number *

Please select the enrichment course for enrollment, click here to have more details about the Enrichment Program in 2020-21 Spring Semester.

Credit Card Payment 信用卡付款信息 *

Adult Latin Dance Aerobic for Parents $ 80.00

Adult Yoga for Parents $ 120.00

Chinese Folk Dance AM 6 yrs+ $ 200.00

English Writing AM 8 yrs+ $ 200.00

Happy Do Arts PM 5 yrs+ $ 200.00

Intermediate & Advanced Chess PM $ 225.00

Beginner Skill Required

Intermediate Drawing AM $ 200.00

Intermediate Vocal AM 6 yrs+ $ 200.00

Total $ 0.00

Visa / MasterCard Payment
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

5. 请仔细阅读各项条款，提交注册表后即视为接受本校规章制度 Please read Terms & Conditions. By click on "Submit", I acknowledge that I accept the Terms & Conditions.
Note:

- An auto receipt will be sent to your email address. Please save and keep it till the end of the school year.

- Important! Please only click the "Submit" button ONCE. Do NOT click more than once as you will be double billed if you do so. Please be patient as this process can take up to a minute.
Date

Month Day Year
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