Kinmon Gakuen Fall 2026 - Spring 2027 Registration Form

Kinmon Gakuen Fall 2026- Spring 2027 Registration Form

Japanese Classes for Children Ages 5 to High School
Application deadline: August 22.

Please note: Class placement and levels may be adjusted depending on enrollment and student proficiency. Current planned class groupings are Beginning, Intermediate, and Advanced. If the minimum number of students is not met, a class may be canceled and a full refund will be issued.

Registration Fee: $50

Tuition: $500 (all inclusive)

Class Schedule: Every Saturday

Fall Semester: August 29 to December 12
Spring Semester: January 23 to May 15

Class Time: 9:00 AM – 12:00 PM
Class Level

Class placement and levels may be adjusted later depending on enrollment and student proficiency levels.
Preferred Class Level
Student Information

We kindly ask that siblings also fill out separate registration forms.
Student Name

First NameLast Name
Japanese Name (If applicable)

First NameLast Name
Current Grade (in regular school)
Japanese Language School Last Attended
Gender
Date of Birth

MonthDayYear
Date
Age as of August 29, 2026
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Email
example@example.com
Alternate Contact Email 2, if needed
example@example.com
If you use a different email address for Google Classroom, please enter it here.Gmail is recommended.
example@example.com
Parent(s)/Guardian(s) Information
Please list the parent(s) or guardian(s) in the order we should contact them. Click the + button to add another contact.
Student's Background
What is the primary language at home?

Other
Whose idea is it to attend a Japanese Language school?

Other
Is this his/her first time attending a Japanese language school?
If No, where has he/she attended before?
Comments and Expectation from guardians.
Emergency Information

In case we are unable to reach the registered parent/guardian, please provide an alternate emergency contact.
Emergency Contact Name

First NameLast Name
Relationship to Student
Emergency Contact Phone Number
Format: (000) 000-0000.
Health Information
Does this child have any allergies? If yes, please specify.
Is this child currently taking any medications that staff should be aware of during the program? If yes, please list below.
Family Doctor
Doctor Name
Clinic
Family Doctor Phone Number
Is there anything else regarding your child's health that we should be aware of?
Waiver and Release of Liability
Photo Release Permission

We respect students’ privacy. When sharing photos on our website or social media, we make reasonable efforts to avoid clearly identifying individual students, including through cropping or editing when appropriate. Photos may also appear in printed materials such as newsletters or community publications, where images are typically smaller or lower resolution.
As a parent or guardian of this student, I hereby consent to the use of photographs and/or video taken during the school year for publicity, promotional, and educational purposes, including publications and posting through newspapers, the internet, social media, or other media sources. I do this with full knowledge and consent and waive all claims for compensation or damages related to such use.
How did you hear about this summer program?
Please tell us the medium that led you to apply
If "Other", please specify where
Signature
Date of Registration

MonthDayYear
Date
Signature
Payment

Please make payments separately for each student. We kindly ask that siblings also fill out separate registration forms. Sibling discount applies to the second and additional siblings only.
Registration Fee

The registration fee is a one-time payment per academic year.

Students who have already paid the registration fee for the Fall semester do not need to pay it again for the Spring semester.

Registration Fee: $50

Tuition

First child: $500
Siblings (second child and onward): $480 each

If you are registering more than one child, the first child will be charged $500 and each additional child will be charged $480.

Payment Notice

This form may be submitted without payment.

If you prefer to pay by credit card or check at the office, please contact us by email in advance.

Payment deadline: August 22.
How many children are you registering from your household?

Other
Payment Option:Registration Fee is required at the time of registration.Tuition may also be paid later by credit card or check during office hours.

Payments

Kinmon Gakuen Early Registration Fee

$50.00

Kinmon Gakuen Fall 2026

August 29, 2026 to December 12, 2026

$500.00

Kinmon Gakuen Spring Semester 2027

January 23, 2027 to May 15, 2027

$500.00

Sibling: Fall Semester 2026

Please submit a separate registration form and payment for each sibling.

$480.00

Sibling: Spring Semester 2027

Please submit a separate registration form and payment for each sibling.

$480.00

Total

Payment Methods

Credit Card

Apple Pay

Google Pay

Should be Empty:

Kinmon Gakuen Fall 2026- Spring 2027 Registration Form

Class Level

Student Information

Parent(s)/Guardian(s) Information

Student's Background

Emergency Information

Health Information

Waiver and Release of Liability

Photo Release Permission

How did you hear about this summer program?

Signature

Payment

Payments

Payment Methods