Registration Form

Child's Name

First NameLast Name

E-mail

School / Grade

SchoolGrade Fall 2020

Parent's Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Primary Phone

Area CodePhone Number

Emergency Contact

Area CodePhone Number

Returning GC Student?

Attends Before/After School Program?

Summer Course Selection

Register For:

Paying for

Total Amount

PARENT/GUARDIAN PERMISSION: I hereby give permission for my child to participate in courses sponsored by Global Child Inc. and his/her School. I waive and release all rights for claims that I may have against Global Child Inc. and damages or injuries to my child that may occur while participating in the Global Child program. I am responsible for picking up my child promptly. In case my child has difficulty cooperating in class, and after having myself and the teacher talk with him/her to clarify classroom expectations, if problem continues and jeopardizes other children's learning, I understand that I may be asked to withdraw my child from the program with no refund. No refunds after the first class of the semester. Global Child reserves the right to cancel the class if less than 8 children register; your money will be refunded. I give permission to GC to modify course placement to accommodate my child's learning level.

Required

We accept Mastercard, Visa & Discover.