Fun with Foreign Language Registration

Fun with Foreign Language
443-616-7343
info@funwithforeignlanguage.com

Registration Form

Student 1 Name

Gender

Birth date

Age

Please provide possible options
for day of week and time for
tutoring.

Language

Any medical conditions of the
student that we should be aware of?
If none, please write "None".

Photo Permission

Do you authorize the use of images of your child to
be used on the FwFL website or in printed
materials? Additional permission to include
student's name will be obtained when applicable.

Yes

Please use this space to tell us if the student has had any
exposure to the foreign language. If so, please indicate how
many years. If student is enrolled in a language class in school,
please indicate which level.

Please use this space to tell us what outcome you are expecting
at the completion of the tutoring sessions.

If enrolling more than one child, please submit an additional registration form.

Parent(s)/Guardian(s) Name

Street Address/Apt.

City, State Zip code

Home Phone

Day Phone

Cell Phone

How did you hear about us? If you were
referred, please list referer's name.

Email address--please provide an address
that is checked often.

Liability Agreement: I agree that I will not hold a faculty member or an employee of Fun with Foreign
Language(FwFL), liable for injuries sustained or for illnesses contracted by me/my child/my children while a
student/participant at FwFL. I agree to indemnify FwFL and its faculty for all liabilities, costs, and judgments
arising for acts of omissions of the undersigned, which result in injury or damage to any person or party. I
further agree that I will not hold FwFL or any faculty member responsible for the loss or damage of personal
property during participation.

Services Agreement: Individuals responsible for payment of tutoring services must sign a services agreement,
which you will receive from Director, prior to the start of the services.

I have read and understand the information regarding the services agreement and waive all claims of liability. I
understand that I can visit the Policies section of the Fun with Foreign Language website for all other policies.

Signature:

Date:

How would you like to pay? (please select one of the following)
First payment must be made prior to the start of services.
Subsequent payments must be made monthly prior to the 1st
week of each month.

All payments must be in the form of check or money order.
Checks should be written out to Fun with Foreign Language

Mail—Please mail payment along with completed registration form to:
Fun with Foreign Language
PO Box 1874
Bel Air, MD 21014

In-person: Call or email us to schedule your in-person registration. Provide
payment along with completed registration form.