BKSD Class Registration Form

Bilingual Kids San Diego Registration Form

Our program proudly offers a variety of bilingual education classes. Whether you want to enhance your child's Spanish, Mandarin, or ESL skills, our experienced instructors are committed to helping them reach their goals. Our classes provide a fun and engaging environment for learning a new language and building connections with other students who share a passion for multiculturalism. Don't miss this exciting opportunity to broaden their horizons.
CLASS OPTION
Student Information
Student's Name

First NameLast Name
Grade and School
Age
Please describe area where your child needs most support with language learning.
Gender
Level of Experience with Foreign language
Parent/Guardian Information
Parent's Name

First NameLast Name
Mobile Number
Format: (000) 000-0000.
Emergency Information
E-mail
example@example.com
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Format: (000) 000-0000.
Authorized Person to Pick-Up
Name

First NameLast Name
Phone Number
Format: (000) 000-0000.
Language of Choice
Special Instructions? (IEP's, allergies ETC.)
How did you hear about us?
Photo/Video Release?
Informed Consent and Acknowledgement

I hereby release Bilingual Kids from any and all liability arising out of my child’s participation in this program. I assume all risks associated with this activity. In case of illness, I authorize a representative of Bilingual Kids to obtain immediate care deemed necessary by licensed medical personnel. I have read and fully understand these terms and I sign it voluntarily.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature