Lets Play in Italian Registration - Preschool & Language Builders

Enrichment Class Registration Form

Please fill out the information below to register your child for iLingo Academy Enrichment Classes
Please complete all information below:
Todays Date

MonthDayYear
Students First Name*
Last Name*
Date of Birth
Age
Address*

Street Address

CityState

Zip codeCountry
Mother's Full Name
Father's Full Name
Guardian Name
Mobile*

Area CodePhone Number
Emergency Phone*

Area CodePhone Number
E-mail:*
Class Location*
Class Name*
Choose your schedule - Coccinelli / Api*
Choose your schedule - Coccodrilli*
Choose your days - Language Builders*
Choose your time*
Choose your time - Language Builders*
Phone

Area CodePhone Number
Below is required for all adult classes and private lessons
Class Start Date
Class Time
Class End Date
Class Location
- Name of adult that maybe attending the class with the child
- Relationship
- 2nd Childs Full Name
- Date of Birth
- Age
- Class Location
- Class Name
- Choose your schedule - Coccinelli / Api*
- Choose your schedule - Coccodrilli*
- Choose your days - Language Builders*
- Choose your time - Language Builders*
- Choose your days
- Choose your days - Language Builders
- Choose your time
- Choose your time - Language Builders
- Class Time
- Class End Date
- Class Start Date
- 3rd Childs Full Name
- Age
- Date of Birth
- Class Location
- Class Name
- Choose your schedule - Coccinelli / Api*
- Choose your schedule - Coccodrilli*
- Choose your days - Language Builders*
- Choose your time - Language Builders*
- Choose your days
- Choose your days - Language Builders
- Choose your time
- Choose your time - Language Builders
- How did you hear about our program?
- Voucher or Promo Code
- Let’s Play in Italian, LLC Terms and Conditions
  
  These Terms and Conditions are entered into and agreed as of the date stated above (the "Effective Date"), by the Let’s Play in Italian, LLC ("Program"), located at 551 Park Avenue, Suite 6, Scotch Plains, Nutley, Hoboken New Jersey and the Parent or Guardian ("Guardian") named at the end of this agreement (the "Agreement").
  
  Payment and Refunds.
  
  a.      Payment. Monthly payments are due on the first of the month.
  
  b.      Refunds. The Program shall provide a prorated refund during the first week of class only.
  
  c.      Missed Classes. The Program shall provide one make-up class per session; however such make-up class must be taken during the same session Program class was missed.
  
  Permission to Secure Treatment. Guardian agrees to provide, in writing, any pre-existing medical condition or allergy Program participant may experience.   In the event of an emergency, Guardian authorizes Program and its directors, officers, employees and volunteers, to secure treatment from any licensed hospital, physician, or medical personnel, deemed necessary for the well-being of the child. Guardian agrees to assume fully responsibility for payment of all fees associated with medical services rendered.
  
  Photo Release. Program may from time to time take photographs or videos of participants for marketing or training purposes. Guardian/student agrees Program may use such photographs or videos for any lawful purpose, including publicity, illustration, advertising, and Web content.
  
  Limitation of on Warranties. This is a service Agreement. The Program warrants that it will perform services hereunder in good faith and in a professional manner. The Program disclaims all other warranties, express, implied or statutory, including, without limitation, warranties of merchantability and fitness for a particular purpose. Guardian’s only remedy for any breach of this warranty shall be the return of all payments paid to the Program hereunder with respect to the services giving rise to such breach.
  
  Limitation on Liability. The Program, its directors, officers, employees, and volunteers shall not be liable for any actions, damages, claims, liabilities, costs, expenses, or losses in any way arising out of or relating to the services performed pursuant to this Agreement in an amount in excess of the total payments made to the Program under this Agreement.
- *This electronic registration will hold your spot for 5 days until your payment can be received.
  
  *There is a one time regerstation fee per family of $60 please include this in your tuition if you are a new member.
  
  Once your application is reviewed and accepted, you will recieve an email from Brightwheel to set up your child's account and pay to secure your spot.
  
  We are here to help please call us at (908)322-KIDZ (5439) or email us at info@letsplayinitalian.com
- I agree to the terms and condition above
- Please verify that you are human*
- Should be Empty:

Enrichment Class Registration Form

Please complete all information below:

Below is required for all adult classes and private lessons