Child/Teen Registration Form (Group Class) X/TwitterThis field is for validation purposes and should be left unchanged.RegistrationThank 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.Contact Information for Parent/GuardianName(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Cell PhoneWork PhoneHome PhoneEmail(Required) Preferred contact method: Email Text Cell Phone Call Cell Phone Call Work Phone Call Home Phone Please initial: 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:(Required)Child/Teen InformationName(Required) First Last Preferred pronouns:Preferred name / nickname:(Required)Date of Birth:(Required) Month Day Year Grade Level:(Required)Does your child have any special physical needs that we should know about? If yes, please describe below.(Required) Yes No 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 No Please describe any food allergies that we should know about:(Required)Language Course InformationLanguage 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 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 Registering for:(Required) Virtual classes In-person classes For how long do you plan to have your child study this language? Just One Session About One Year More Than One Year 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?What types of virtual or in-person events would you like us to host?Would you be interested taking a language immersion trip organized by CRLC with your child and/or your family? Yes No Maybe Please list other adults who have permission to pick up your child from CRLC if your child is attending in-person classes. First Last PhoneRelationshipHow did you hear about Capital Region Language Center (CRLC)? Check all that apply:(Required) I am a former student My child is a former student Another student's recommendation (please provide name below) Word of mouth The LEAP! program WAMC underwriting Facebook Instagram LinkedIn Reddit Other (please fill in below) 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) MM slash DD slash YYYY Capital Region Language Center PoliciesCRLC Policies(Required) Please initial below. 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. Signature(Required)Authorization for Use of Photos, Audio and/or Video Recordings of ClassPhoto Authorization(Required) I, ___________________________________ (parent/guardian name) 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 name) 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. Signature(Required)Payment OptionsPayment 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. Recurring Payment Authorization Click here to read about the recurring payment authorization. By signing below and submitting this registration form, I am confirming that I agree to the terms outlined in the recurring payment authorization.Invoice NotificationsCheck 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 InformationPayment 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. Signature(Required)CRLC's Privacy PolicyClick here to read our privacy policy. By submitting this form, I have read and agreed to CRLC's Privacy Policy.
