Baltimore Chinese School- Registration Form

学生信息 Student Information
Last Name*: First Name*:
Gender*:Male Female Birthday*:
Medical Insurance(Company + insurance number):
食物过敏 Allergy:
中文课程 Chinese Class(Select One one, A 1:30-3:20pm, B 3:30-5:20pm):
KAKBKC   1A1B1C  2A2B2C   3A3B
4A4B   5A    5B   6A6B    7A8A9A
Chinese as Second Language (CSL 3:30-5:20pm):
CSL Kids BeginnerCSL Kids IntermediateCSL Adult
兴趣班 Electives class for children
Chinese Calligraphy(12:30-1:20pm)Chinese TutoringMath Engagement A(12:30-1:20pm)
Math Engagement B(1:30-2:20pm)Speech(12:30-1:20pm)
Keyboard(12:30-1:20pm)Children Chorus(3:30-4:20pm)
Kids' Pre-Ballet(2:30-3:20pm)Painting(Beginner) A(12:30-1:20pm)
Painting(Beginner) B(2:30-3:20pm)Painting(Intermediate)(3:30-4:20pm)
成人兴趣班 Electives for adults
Painting(1:30-3:20pm)Dongfang Performance(1:30-3:20pm)
Parent Ballet(3:30-5:20pm)Tai-JI(1:30-3:00pm)
家长信息 Parent contact information
Father's Name*: Cell Phone:
Mother's name:Cell Phone:
Home Phone:Work Phone:Email*:
Home Address*:
紧急联络人 Emergency Contact*: 电话 Phone:


By signing below, I agree to pick up my child on time (by 3:30pm for 1:30-3:20pm class and by 5:30pm for 3:30-5:20pm class). Any incidents occur after the pick-up time will be my own responsibility. In an emergency, the school has my permission to take my child to the emergency room of the nearest hospital. if I cannot be reached or contacted, the hospital staff has my authorization to provide treatment which a physician deems necessary for the well-being of my child. I relieve the school of responsibility in case of accidental injury during all activities. I also understand that my child may be disciplined if breaches of rules and regulations occur, and assume responsibility for damage to school property brought about by my child. I hereby authorize Baltimore Chinese School, its affiliates, successors and assignees and any person acting under its permission and authority, to reproduce, publish and circulate photographs of me or my child(ren) on the Baltimore Chinese School Internet Web Page and School Publications. I hereby grant, assign and transfer to Baltimore Chinese School all of my rights regarding the use of such photographs of my child. BCS has photography and videography permission for publication. I acknowledge that I have read and understand this Authorization and Release.