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MANDARIN REGISTER & PAY

PARENT'S CONTACT INFORMATION

1. Parent's First name*

1. Parent's Last name*

2. Parent's First Name*

2. Parent's Last Name*

Email*

Phone*

STUDENT'S INFORMATION

School Name*

Mandarin Immersion Magnet School

Child's First Name*

Child's Last Name*

Grade*

Teacher Name*

Any Allergy's*

Choose an option*

Extended Learning

Car Pick Up

CHOOSE YOUR CLASS (Student #1)*

Hip-Hop Dance (TUE)$0

Cheer Dance (WED)$0

Ballet (MON)$0

Martial Arts (THUR)$0

Paint Explorers (MON)$0

Bollywood (THUR)$0

STUDENT #2 INFORMATION

Child's First Name

Child's Last Name

Grade

Teacher Name

Any Allergy's

Choose an option

Extended Learning

Car Pick Up

CHOOSE YOUR CLASS (Student #2)

Hip-Hop Dance (TUE)$0

Cheer Dance (WED)$0

Ballet (MON)$0

Martial Arts (THUR)$0

Paint Explorers (MON)$0

Bollywood (THUR)$0

STUDENT #3 INFORMATION

Child's First Name

Child's Last Name

Grade

Teacher Name

Any Allergy's

Choose an option

Extended Learning

Car Pick Up

CHOOSE YOUR CLASS (Student #3)

Hip-Hop Dance (TUE)$0

Cheer Dance (WED)$0

Ballet (MON)$0

Martial Arts (THUR)$0

Paint Explorers (MON)$0

Bollywood (THUR)$0

AUTHORIZED STUDENT PICK UP

Be prepared to present your I.D. and school assigned car tag # for verification at the time of pick up.

For your child’s safety, they will only be released to the individuals listed below.

1. Authorized Parent Pick-up Name*

1. Authorized Parent Pick-up Contact #*

2. Authorized Parent Pick-up Name

2. Authorized Parent Pick-up Contact #

3. Authorized Parent Pick-up Name

3. Authorized Parent Pick-up Contact #

INTERESTED AND WOULD LIKE MORE DETAILS?

INTERESTED AND WOULD LIKE MORE DETAILS?*

Spring Break Classes

Summer Camp

Weekend Enrichment

Monthly Newsletter

Not Interested

ANY QUESTIONS

Any Questions or Comments?

EST. 2009

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