G & P Afterschool Registration Form

G&P After School Registration Form

방과후 학교 등록 양식
CHILD INFORMATION:

자녀 정보
How many children would you like to register? (등록 자녀 숫자)*

1234
1) Child Name*

First NameLast Name
Birth Date*

MonthDayYear
Current Grade*
Name of School*
2) Child Name

First NameLast Name
Birth Date

MonthDayYear
Name of School
Current Grade
3) Child Name

First NameLast Name
Birth Date

MonthDayYear
Name of School
Current Grade
4) Child Name

First NameLast Name
Birth Date

MonthDayYear
Name of School
Current Grade
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
MEDICAL INFORMATION
If your child presently being treated for an injury, illness or taking any for of medication? If yes, explain.
Does your child require a special diet or have any allegies? If yes, please explain.
Emergency Contact
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email
example@example.com
Relationship with Child(ren)*
Not including the parent/guardian listed above, please list any additional persons permitted to pick up your child(ren).
Payment

등록안내

* 등록은 선착순이며, 자리가 차면 대기자 명단으로 넘어갑니다.

* Payment 방법: Check or Cash

* 체크는 Grace & Peace Church로 발행해 주세요

* 체크 메로란에 학생 이름(영어)과 학년을 꼭 적어 주세요.

* 등록비는 환불이 불가하며 등록비를 먼저 납부할 경우 등록이 확정됩니다.

1. 프로그램 등록비 (Registration Fee)

* 1회 등록비(Registration Fee): $50 (One-Time, Non-Refundable)

2. 수업료 (Tuition, Monthly) *Extra Discount for GPRC Members

3. 추가돌봄(Extra Care)

4. Transportation (From School Only)

G&P After School Registration Form