Enrollment Saturday School 2023-2024 with PayPal including Semester Option v2

Enrollment Saturday School
School Year*
School Campus*
Name of Parent / Guardian*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Name(s) of student(s):
First Name*   Last Name*
*
DOB*Place of birth*

First Name   Last Name

DOBPlace of birth

First Name   Last Name

DOBPlace of birth

First Name   Last Name

DOBPlace of birth
- I Do I Do not authorize GASA to use my child's/children's photograph for reproduction and publication in literature, advertising and display.
German/Swiss/Austrian heritage:
- One Parent Both Parents Grandparents None
Ethnic composition of student(s):
- Hispanic Caucasian African American Asian Arabic Other (please specify)
How did you hear about us?

From a FriendConsulateWebsiteFacebookGoogleInstagramOther
Tuition for the 2023/2024 School Year:
NO REFUND OF TUITION.

A fee of $ 25.00 will be charged for all returned credit card payments.
Signature of Parent/Guardian: *

Clear
Date

MonthDayYear
Date
Parent and Student Responsibilities
1. The German American School Association is a nonprofit educational organization that does not discriminate on the basis of race, color, religious beliefs, sex, age, national origin, disability or any other classification protected by applicable law.
2. Classes will take place at different locations.
3. Return check policy: $ 25.00 will be charged for all returned checks and declined credit cards.
4. In the Saturday Schools, students under 4 years of age can only be accepted after a 4 week trial period following enrollment. The fee for the trial is $ 140.00 which will be applied to the tuition, if the student is fully enrolled.
5. The German American School Association has the responsibility to provide appropriate educational instruction for all students. Only for in house instruction classes are from 9:00 a.m. to 12:00 noon. Students are expected to be at school, prepared for class, at 8:50 a.m. Students must be picked up no later than 10 minutes after the end of classes. The German American School Association is not responsible for the students after their scheduled classes.
6. With the application for membership and enrollment, parents may request the by-laws of the German American School Association.
7. The German American School Association is committed to providing a safe learning and working environment and expects everyone to conduct themselves in a manner that shows respect of self, respect of others and respect of property. Any behavior that is disruptive to a good learning environment or any behavior that infringes on the safety or well-being of students, employees, or any other persons within the school’s jurisdiction will not be tolerated.
  Disruptive behavior includes, but is not limited to:
  Fighting, bullying, teasing, use or possession of controlled substances and/or weapons, including replicas and toy weapons, and other dangerous objects, defiance and class disruption, inappropriate language, spoken and/or written, theft and damaging school or private property.
  Any disruptive behavior will result in a warning and/or possible immediate or subsequent suspension or expulsion from school. Parents will be held liable for any damages.
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
Parent/Guardian Name*
Emergency Information
Same as Parent?

Yes
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number 1*
Telephone number/numbers where parent/guardian can be reached on Saturday morning:
Phone Number 2
Telephone number/numbers where parent/guardian can be reached on Saturday morning:
Phone Number 3
Telephone number/numbers where parent/guardian can be reached on Saturday morning:
Student-1*

First NameLast Name
Child’s known allergies
Current Medications:
Child’s physician
Physician's Phone Number
Please enter a valid phone number.
The above child can be released after school to the following persons: *
Student-2

First NameLast Name
Child’s known allergies
Current Medications:
Child’s physician
Phone Number
Please enter a valid phone number.
Parent/GuardianThe above child can be released after school to the following persons:
Student-3

First NameLast Name
Child’s known allergies
Current Medications:
Child’s physician
Phone Number
Please enter a valid phone number.
The above child can be released after school to the following persons:
Signature of parent or legal guardian*

Clear
Date*

MonthDayYear
Date
Parents and Students Responsibilities

13601 Whittier Boulevard, Suite 400 * Whittier, California 90605
(562) 693-0223 *
FAX (562)693-3753 *
office@gasaschool.org
www.Germanschool4kids.org
A Non-Profit Corporation (Tax ID 95-2259663)
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Enrollment Type*

Full YearFall SemesterSpring Semester
Enrollment - Full Year
Enrollment - One Semester
Total Amount
Amount Due*

prevnext( X )
USD(Same as Total Enrollment)

Payment Methods

First Name

Last Name

Credit Card Number

Security Code

Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

Name(s) of student(s):

Tuition for the 2023/2024 School Year:

Parent and Student Responsibilities

Emergency Information