Free French in your school EDEP!

Child's Name______________________________________________________ male / female

School ………………………………...............................In after-school? Yes / No. Grade _____ Age_____

Parents’ Names……………………………….......................................................................................

Address___________________________________City______________________Zip_________

Home phone ____________________Work phone (Mom)_________________(Dad)__________

Cell #------------------------------------------- e-mail -------------------------------------------------------------------------

I give permission for my child to participate in all the activities. In case of sickness or injury, Mrs. Charudattan may seek treatment for my child at the nearest emergency center or from the physician named below, if I cannot be reached. I understand that all necessary precautions will be taken by Mrs. Charudattan for the welfare and safety of my child and I will not hold her responsible in case of injury to my child.

Parent/Guardian Signature____________________________________________________________

Medical / Emergency Information

Any health concerns__________________________________________________

Emergency contact physician ___________________________________ Phone___________

SEPT. 12, 2011 - MAY 30, 2012

[ Winter/Spring/Summer Language Camps: full / half day: Dec. 19-30, 2011. April 2-6, 2012.

Extra. ]

SONGS GAMES BONBONS VOCABULARY CULTURE CUISINE DRAMA CONGRESS PRIZES

FRENCH in your school: MONDAYS, TUESDAYS, FRIDAYS, Elementary, 2:00-5:00pm Gr. K,1,2, 3,4,5.

Middle School, 4 -5pm Gr. 6,7,8.

FREE weekly classes for K.G. Please complete registration with $20 fee for the school year.

FEES Grades 1-5: INCLUDES WEEKLY CLASSES, MONTHLY CUISINE & ALL SUPPLIES

New students please add $20 Registration fee to your 1^st payment.

Please choose and circle one:

1.$40 / Quarter, due by Sept.12, Nov.7, 2011, and Jan.9, Mar.6, 2012.

2. $60 / Semester, due by Sept.12, 2011 and Jan.9, 2012. Save $40 !

3. $100 / School year [Sept.-May] weekly classes, due by Sept.12, 2011. Save $60 !

4. SPECIAL $50 / School year [Sept.-May] Monthly Cuisine classes only, due by Sept.12, 2011

MISSED CLASSES MAY BE MADE UP ANY TIME DURING THE SCHOOL YEAR AT Ecole Française Home School