CSGW 2023-2024 Registration Form (Cash / Check)

Registration Form (Cash / Check)

2023-2024 School Year
This form can be used to register for the 2023-2024 school year when paying by cash or check. If you would like to pay by credit card, please use this form. Note that there is a surcharge for paying by credit card to cover card processing fees.

For further information on registration or specific school programs, please contact:
- School email: admin@csgw.org
- School website: https://csgw.org
- School phone: (301) 288-1039
- School mailing address:
  9710 Traville Gateway Dr. #132
  Rockville, MD 20850
Pricing

Save on tuition by registering for the full year! We also offer discounts for families that enroll multiple students.

# of Students	Full Year Tuition & Fees	Fall Semester Tuition & Fees
1	$770	$400
2	$1,510	$775
3	$2,240	$1,145
4	$2,970	$1,515
5	$3,700	$1,885
6	$4,430	$2,255

Family Information / 家庭資料
Parent Name*

First NameLast Name
Parent Chinese Name
(optional)
Parent Email*
example@example.com
Parent Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent Phone Number*
Please enter a valid phone number.
Parent #2 Name

First NameLast Name
Parent #2 Chinese Name
(optional)
Parent #2 Email
example@example.com
Same address / phone number as above?

Yes
Parent #2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent #2 Phone Number
Please enter a valid phone number.

Student Information / 學生資料
How many students are you registering?*
Student #1*

First NameLast Name
Student #1 Chinese Name
(optional)
Student #1 Birthdate*

MonthDayYear
Is Student #1 a New Student?

Yes
Student #1 Health Information
Please explain any medications, dietary restrictions, allergies, special needs, or health conditions of any kind (including physical, psychiatric, and behavioral) of which we should be aware for Student #1.
Student #2

First NameLast Name
Student #2 Chinese Name
(optional)
Student #2 Birthdate

MonthDayYear
Is Student #2 a New Student?

Yes
Student #2 Health Information
Please explain any medications, dietary restrictions, allergies, special needs, or health conditions of any kind (including physical, psychiatric, and behavioral) of which we should be aware for Student #1.
Student #3

First NameLast Name
Student #3 Chinese Name
(optional)
Student #3 Birthdate

MonthDayYear
Is Student #3 a New Student?

Yes
Student #3 Health Information
Please explain any medications, dietary restrictions, allergies, special needs, or health conditions of any kind (including physical, psychiatric, and behavioral) of which we should be aware for Student #1.
Student #4

First NameLast Name
Student #4 Chinese Name
(optional)
Student #4 Birthdate

MonthDayYear
Is Student #4 a New Student?

Yes
Student #4 Health Information
Please explain any medications, dietary restrictions, allergies, special needs, or health conditions of any kind (including physical, psychiatric, and behavioral) of which we should be aware for Student #1.
Student #5

First NameLast Name
Student #5 Chinese Name
(optional)
Student #5 Birthdate

MonthDayYear
Is Student #5 a New Student?

Yes
Student #5 Health Information
Please explain any medications, dietary restrictions, allergies, special needs, or health conditions of any kind (including physical, psychiatric, and behavioral) of which we should be aware for Student #1.
Student #6

First NameLast Name
Student #6 Chinese Name
(optional)
Student #6 Birthdate

MonthDayYear
Is Student #6 a New Student?

Yes
Student #6 Health Information
Please explain any medications, dietary restrictions, allergies, special needs, or health conditions of any kind (including physical, psychiatric, and behavioral) of which we should be aware for Student #1.

Emergency Information / 學生安全資料
Family Physician*

First NameLast Name
Family Physician's Phone Number*
Please enter a valid phone number.
Emergency Contact*

First NameLast Name
Emergency Contact's Phone Number*
Please enter a valid phone number.

Liability Waiver / 免責聲明

Terms & Conditions
1. I agree to take full responsibility for the safety of myself and all members of my family while attending CSGW. I will not hold CSGW liable for any personal injury or any personal property damage, which may occur on the premise during school time.
2. I agree to take full responsibility for any damage caused by me, or by any member of my family to the facilities used by CSGW during school time.
3. I agree to take full responsibility for my child/children to obey CSGW rules during school time.
4. If necessary, I authorize CSGW to seek emergency medical treatment for my child at an available medical facility at my own expense.
5. I grant the school permission to take photographs of my child/children/family for use in CSGW publications and online sites.
6. I agree that I shall not hold CSGW and/or its instructors liable for any injuries incurred during all school activities.
7. I agree than I nor my representatives shall take any civil legal action, shall not sue, and shall hold harmless CSGW, the board, teachers, and volunteers.
8. I understand that I will be assigned a family job role to support CSGW as part of CSGW's community objective – operation participation (co-op) model.
9. I hereby certify that I am the parent or guardian of the student(s) named above in this form and do hereby give my consent without reservation to the foregoing on behalf of those individuals.
10. I agree to maintain the privacy of all Student information within the school.
Health & Safety Protocol
The health and safety of your student(s) is important to all of us. To maintain a positive learning environment requires the full cooperation of all CSGW participants. COVID-19 is still a very real threat. As such, we will follow Montgomery County Health and Safety guidelines. We require:
1. Masks are currently optional. However, the Administrative Director may require all students, parents and teachers to wear masks in classrooms and all indoor spaces in the event of a spike in local COVID cases, during periods of high transmission, or for other reasons at their discretion.
2. All students and parents sanitize their hands every time they come into the classroom.
3. If you or your student(s) are sick (e.g., cold, flu, COVID), or have tested positive for COVID, we ask that you stay home, recover, and that you do not come to school until you and/or your child/children has recovered and can no longer infect others.
4. If you or your student(s) are sick, please notify the CSGW staff that you student(s) will not be in attendance.
Signature*

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Tuition
Registration is on a first-come, first-serve basis. Your registration will NOT be confirmed until payment is received.

An online payment surcharge of 3% covers our cost to process credit card transactions and are non-refundable.

Note: Please make sure to choose {numberStudents} student(s) in the Fees section below to match the student information you've already submitted. Incorrect or inconsistent submissions may be canceled at the discretion of CSGW.
Payment Method*
If paying by cash:
- Note: Cash is only accepted in-person during registration events or regular class time
- Please do NOT mail cash!
If paying by check:
- Note: There will be a $35 fee for any returned check.
- Please add your child's/children's name and the year of the registration in the check memo.
- Please make your check payable to "CSGW”
- Please mail your check to: 9710 Traville Gateway Dr. #132, Rockville, MD 20850
Pricing

Save on tuition by registering for the full year! We also offer discounts for families that enroll multiple students.

# of Students	Full Year Tuition & Fees	Fall Semester Tuition & Fees
1	$770	$400
2	$1,510	$775
3	$2,240	$1,145
4	$2,970	$1,515
5	$3,700	$1,885
6	$4,430	$2,255

Fees*

Full Year Tuition & FeesIncludes tuition, registration, textbooks, supplies, and materials for both fall and spring semesters. Save on tuition by registering for the full year!

$770.00 Students

Fall Semester TuitionIncludes tuition, registration, textbooks, supplies and materials for fall semester only. Spring semester fees will be due prior to the start of spring semester.

$400.00 Students

Enter coupon

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Should be Empty:

Registration Form (Cash / Check)

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Family Information / 家庭資料

Student Information / 學生資料

Emergency Information / 學生安全資料

Liability Waiver / 免責聲明

Health & Safety Protocol

Tuition

Pricing