Child/Teen Reg Form (Group Class) - Capital Region Language Center

Child/Teen Registration Form (Group Class)

URL

This field is for validation purposes and should be left unchanged.

Register for a group language class with the Capital Region Language Center (CRLC). Please provide the requested information to help us tailor your learning experience. The information obtained is kept for internal purposes only.

Thank you for registering with CRLC! Once your form is submitted, we will send you an invoice for your selected course. The invoice will include a one-time $75 registration fee for new students to CRLC in addition to the course tuition.

I understand that I am registering my child/teen for a group class.(Required)

Yes, I understand.

No, I must click here and fill out a different form

Contact Information for Parent/Guardian

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Cell Phone

Work Phone

Home Phone

Email(Required)

Preferred contact method:

Text Cell Phone

Call Cell Phone

Call Work Phone

Call Home Phone

I understand that my child's instructor will have my contact information and that I may receive language-specific and general CRLC emails and/or calls:

Child/Teen Information

Name(Required)

First Last

Preferred pronouns:

Preferred name / nickname:(Required)

Date of Birth:(Required)

Grade Level:(Required)

Does your child have any special physical needs that we should know about? If yes, please describe below.(Required)

Yes

Please describe any special physical needs that we should know about:(Required)

Does your child have any food allergies? If yes, please describe below.(Required)

Yes

Please describe any food allergies that we should know about:(Required)

Language Course Information

Language you are registering your child for:(Required)

Course Information (If you do not know the class schedule, please provide your child's availability.)

Day Time

Registering for:(Required)

Virtual classes

In-person classes

For how long do you plan to have your child study this language?

One Session

One Year

1+ years

Not Sure Yet

Why is your child studying this language?

In addition to teaching, how can we help your child achieve their language-learning goals?

Please list other adults who have permission to pick up your child from CRLC if your child is attending in-person classes.

First Last

Phone

Relationship

How did you hear about Capital Region Language Center (CRLC)? Check all that apply:(Required)

Name of person who recommended you?

First Last

Other way you heard about CRLC?

All of the information provided above is correct and accurate.(Required)

Date(Required)

Capital Region Language Center Policies

CRLC Policies(Required)

I (parent/guardian name), understand that... I am registering my child for a session of classes and that neither a refund nor a credit will be issued if we choose to drop the class. In the event that my child cannot attend a group class, and I have provided at least two business days' notice, my child will be allowed to attend any other group class in the language they are studying. This make-up class should be completed within the current class session with the knowledge of a CRLC staff member. I understand that there may not be a class make-up option. Classes are designed for registered CRLC students, and if my child would like to bring a guest, I will seek permission from the instructor and a CRLC staff member. I understand that my child may have a substitute teacher if the instructor is unable to fulfill their responsibilities. If CRLC cancels a class, it will be made up within the session at an agreed upon time, or my session dates will be extended to allow for the class to be made up. If a weather condition or other emergency prevents CRLC from holding the class at the regularly-scheduled time, I will call or be sure to check my messages in case CRLC has contacted me. Classes may be observed by CRLC staff or non-staff members who have sought previous permission from CRLC's director. Teachers and other staff may be photographed, videotaped, or audiotaped during the class time for marketing or training purposes. I understand that classes might be recorded for training purposes.

Enrollment & Session Structure(Required)

A. I understand that my payment reserves mutually agreed-upon instructional time and that all fees are non-refundable once a session has begun.

B. The instructional time is scheduled to occur on the same day(s) and at the same time weekly.

C. I understand that my session must be completed within the designated session dates provided in my class confirmation email. Unused classes after this period do not transfer to future sessions and will be forfeited.

D. I understand that approved rescheduled classes must take place within the designated session dates and may not extend the session end date.

Attendance, Rescheduling, & Cancellations(Required)

A. I understand that I am allowed to reschedule up to two classes per session provided I give the office and my instructor at least 48 business hours’ written notice. (For a Monday class, notice must be received on the Thursday before.)

B. I understand that cancellations made with less than 48 business hours’ notice will result in a forfeited class.

C. I understand that repeated late cancellations within a session may result in may require payment of future sessions in full or private instruction not being an option for future sessions.

D. I understand that exceptions to the attendance policy may be considered in the event of extenuating circumstances such as a serious medical condition or the death of a family member. Documentation may be required.

Instructional Standards & Professional Conduct(Required)

A. I understand that consistent attendance supports both my progress and the effective use of scheduled instructional time.

B. I understand that CRLC reserves the right to review attendance patterns and make enrollment decisions in the best interest of the instructional community.

C. I understand that CRLC reserves the right to decline renewal for a 1:1 course if attendance patterns disrupt instructional continuity and that a group class option may be suggested when appropriate.

D. I understand that I may have a substitute teacher if the instructor is unable to fulfill their responsibilities.

Observation, Recording & Media(Required)

A. I understand that classes may be observed by CRLC staff or approved visitors with prior authorization from the center director.

B. I understand that teachers and staff may be photographed, videotaped, or audiotaped during class time for marketing or training purposes.

C. I understand that classes may be recorded for training purposes.

Authorization for Use of Photos, Audio and/or Video Recordings of Class

Photo Authorization(Required)

I, (parent/guardian) do permit and authorize Capital Region Language Center, LLC (CRLC) and its employees, agents, and personnel who are acting on behalf of CRLC to photograph, video or audio record my child's class for purposes related to the educational mission of CRLC including publicity, marketing, and promotion of CRLC and its various programs. I understand that a photograph, video or audio file may be copied and distributed by means of various media, including video presentations, television, news bulletins, mail outs, billboards or signs, brochures, placement on CRLC’s website & social media, or newspapers. I understand that, although CRLC will endeavor to use the photograph, video or audio recording in accordance with standards of good judgment, CRLC cannot guarantee that any further dissemination of the photograph, video or audio file will be subject to CRLC supervision or control. Accordingly, I release Capital Region Language Center from any and all liability related to dissemination of my child's photograph, video or audio file. I understand that my child might be identified by name in photographs, video or audio files. I have read this authorization, and I understand its contents.

I, (parent/guardian) DO NOT permit and authorize Capital Region Language Center, LLC (CRLC) and its employees, agents, and personnel who are acting on behalf of CRLC to photograph, video or audio record my child's class for purposes related to the educational mission of CRLC. I have read this authorization, and I understand its contents.

Payment Options

Payment Options(Required)

ACH (Full Payment): I will pay the full session tuition via ACH (bank transfer) through the payment link on my invoice.

Credit Card (Full Payment): I will pay the full session tuition by credit card through the payment link on my invoice. Please note: Credit card processing fees apply.

Credit Card (Recurring Payments): I authorize CRLC to process recurring monthly payments to my credit card on the first of each month until the total tuition balance is paid in full. Please note: Credit card processing fees apply to each transaction.

Pay in Full Procedures(Required)

Following the submission of this form, you will receive an invoice via QuickBooks to the email entered above. Payment can be completed by clicking "review and pay." Please contact the office if you are unable to locate your invoice. Please note: registration is not complete until CRLC has received payment for the full session.

By checking this box, I acknowledge that I have fully read and understood the billing policy.

Invoice Notifications

Check the box if you wish to have your invoice sent by text as well.

I agree to receive invoice notifications from CRLC by text in addition to email.

Payment Information

Payment Information(Required)

Enrollment is for the full session as reflected on your invoice, which will include the applicable course dates and tuition amount. Payment must be received prior to the first class. By selecting “I Agree,” I acknowledge that I have read and understand these terms and accept responsibility for timely payment. A copy of my responses will be sent to me via the email I have provided in this form.

I agree.

CRLC's Privacy Policy(Required)

Click here to read our privacy policy.

By submitting this form, I have read and agreed to CRLC's Privacy Policy.

Date(Required)

Please provide your signature by typing your full name in below(Required)

First Last