Application

after submitting this form, a confirmation message will be sent to your email with the next steps to follow, and you will be redirected to the link to pay the tuition fee. please make the payment to complete enrollment.

If you’re enrolling more than one child please fill out the information of all the kids attending the school then proceed to payment, you. may add to the cart as many classes as you need depending on the amount of kids been enrolled. (ex: if 3 kids are being enrolled then 3 classes need to be payed)

Parent Full Name

Phone

parent Full Name

Phone

Child Physical Address

Pick up authorized person (please select multiple if more than one)

Mother Father Other

Pick up authorized person (if selected other)(may be more than 1)

Emergency contact other than parents

Emergency contact phone number

Child Full Name

Child Date of Birth

Child’s age

allergies

2nd Child Full Name (if Enrolling another child please fill the info bellow)

2nd Child Date of Birth

2nd Child’s age

2nd child allergies

3rd Child Full Name (if enrolling another child please fill the info bellow)

3rd Child Date of Birth

3rd Child’s age

3rd child allergies

Primary doctor

Phone

Additional questions, notes or medical conditions

Please select the date of the Saturday your child will be starting with us

select the program you would like to apply for

3 hour drop off (9:00am - 12:00pm) Reading & Writing 4 Week Program (9:00am - 11:00am) Spanish Immersion 4 Week Program (9:00am - 11:00am) Mommy & Me Spanish Immersion (11:00am - 12:00pm)

permission to photograph the child and use pictures for social media/marketing

yes no

IMPORTANT

Render consent to apply First Aid / Call 911 when required. (a life-threatening situation exists)

IMPORTANT: PLEASE READ CAREFULLY ALL THE INFORMATION OFFERED ABOUT THE PROGRAM. THIS INCLUDES: THE TUITION, THE ENROLLMENT AND PAYMENT PROCESS .

PLEASE READ CAREFULLY AND ACCEPT THE TERMS: I state that I have read, understood and accept the terms and condition of Fasttrack-Languages. This includes but it is not limited to the program information, the enrollment, the tuition, and the payment process, and the parent handbook. * Tuition may update from time to time. Please check rates at the time of enrollment. please proceed to payment after finishing filling the form to secure the spot in our classrooms.* The Fasttrack-Languages center is well childproofed and the children are consistently well supervised. However, accidents do happen. The undersigned(s) assume(s) all risk of injury to the child associated with participation in any program that our school offers.