Student Participant Information

Student Name

Student Grade

Student Age

Student Date of Birth

Student Status

Student Address

Parent #1 Contact Information

Parent #1 Name

Parent #1 Email

Parent #1 Mobile Number

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. Reply STOP to cancel. View our terms of service & privacy policy.

Parent #1 Alternate Number

Parent #1 Address

Relationship To Participant

Parent #2 Contact Information

Parent #2 Name

Parent #2 Email

Parent #2 Mobile Number

Parent #2 Alternate Number

Parent #2 Address

Relationship To Participant

Health and Emergency Information

Does your child have any known allergies?

If yes; please list all allergies.

Does your child take medication we should know about?

If yes, please list all medications

Does your child have any medical conditions we should know about?

If yes, please list all relevant condiitons

Do you have a preferred hospital?

Name of Hospital

Hospital Phone Number

Emergency Contact

Emergency Contact Name - Other Than Parents

Emergency Contact Number

Relationship to participant

Policies

Media Release

I hereby grant permission to World Language Connection the right to use, publish, and reproduce, for promotional and educational purposes my child’s image, likeness and sound of voice as recorded on audio or video tape without payment or any other consideration. I understand that this material may be used in diverse educational settings within an unrestricted geographic area. I understand this permission signifies that photographic or video recordings of my child may be electronically displayed via the Internet, in print or in the public educational setting.

I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against this organization for utilizing this material as described above.

I have read and agree to the media terms above

Class Cancellation Policy

Cancellation Terms

It is our intent to avoid cancellation or rescheduling of any language classes. Unfortunately, circumstances occasionally require us to cancel or reschedule class.

Instructor-led classes are student-enrollment dependent. Classes with enrollment of less than the minimum amount of students are subject to cancellation or rescheduling at the discretion of the management.

Classes will be canceled, if necessary, before the scheduled start date of class. Cancellation notices will be sent to enrolled students by email, to the address provided at the time of registration.

Individual sessions may occasionally have to be rescheduled due to instructor availability.

Full refunds will be issued for classes canceled by World Language Connection.

I have read and agree to the terms above.

Enrollment Cancellation Policy

Enrollment Terms

If for some reason a registered student will be unable to attend, we request students/parents cancel enrollment as soon as possible. All classes have limited seating, in the event you cannot attend please cancel your enrollment immediately to allow room for other students to participate.

If you cancel student enrollment:
- More than 7 days before the first day of class, a full refund will be issued
- 7 days or less before the first day of class, a 50% refund will be issued
- On or after the first day of class, no refund will be issued

There will be no refund or credit for missed classes.

I have read and agree to the terms above.

Personal Conduct & Discipline Policy

Personal Conduct & Discipline Terms

Our classes are designed to be active, we need to make sure that they don’t become too chaotic as this is not conducive to learning. Students need to respect each other and the teachers in class in order to provide a safe environment. Should a child become disruptive in class the following steps will be taken:

1. Parents will be notified and asked to work with the child to correct the problem.
2. If there is no improvement, a conference will be called between the teacher, the parent(s) or guardian(s), the student, and the Area Coordinators.
3. If the problem persists, the child will be asked to leave the class permanently.

Parent/Guardian Permission

I will take responsibility for seeing that my child complies with the appropriate behavior guidelines as stated here.

I have read and understand the above statement and agree to comply with the relevant World Language Connection policies.

My child understands the classroom rules and agrees to follow them. They understand that if they do not comply with the rules, they will be asked to leave the class permanently.

I have read and agree to the terms above.

Pick-Up Authorization

Be assured that your child shall not be released to any person whose name is not listed on your child’s authorization form. In case of emergency, please contact Program Director Yorleny Clapper at (512) 225-4777. Please be sure to pick up your child immediately after class ends. Please come to the class location to pick up your child.

In the case of a morning class, you take responsibility for dropping off, or having an authorized person drop off your child/children promptly by the beginning of class. Please don’t drop of your child more than 5 minutes before the class starts as teachers and the organization cannot be responsible for them before that time.

The following persons are authorized to pick up my child. I fully understand that under no circumstances will the instructor be allowed to release the above child (student) to anyone unless listed below. (Parents and/or Guardians must be listed also):

Pick-Up Person #1

Pick-Up Person #1 Phone Number

Pick-Up Person #2

Pick-Up Person #2 Phone Number

Pick-Up Person #3

Pick-Up Person #3 Phone Number

Late Pick-Up Policy

Late Pick Up

If you know you are going to be late picking up your student(s), please notify the teacher or Parent Coordinator as soon as possible. A late fee will be applied at the rate of $10 for every 10 minutes that an instructor must wait with a student after the class ends.

If a parent or authorized pick-up person does not arrive or call by 10 minutes past the designated pick-up time, the teacher will assume an emergency exists and will begin to call emergency contacts for your child.

If no emergency contact can be reached within 1 hour past the designated pick-up time, the teacher/staff may contact the appropriate law enforcement officials who will pick up the child.

Late fees will be due within two business days. Late fees can be paid via check upon pick up.

Continued disregard for the pick-up time or failure to pay late pick- up fees can be cause for the child’s termination from the classes.

It is very important to have updated contact information in your child’s file at all times.

Any child who is not picked up will be under the supervision of an assigned teacher/staff until the parent, emergency contact, or the authorities arrive. All information about the incident will be discussed directly with the parent or guardian and never with the child.

In the case of a morning class, I take responsibility for dropping off, or having an authorized person drop off my child/children promptly by the beginning of class, but not more than 5 minutes before.

I have read and agree to the terms above.

Registration - 2024/2025 Spanish Classes

Payment Options

25 Classes ($399.00)
*Pay for tuition in full using Credit Card or Check.
Please make checks payable to World Language Connection and mail to: 3800 Bridgeport Way W #A265 University Place WA 98466
OR
*Pay for tuition in two installments. Credit Card only.
Pay a deposit of $199.50 at registration, and pay the remaining balance at mid-term. Note: This is a continuous class consisting of 25 sessions, and WLC offers this option to pay in two installments for your convenience.
By electing to pay half of tuition as a deposit at the time of registration, you authorize WLC to charge the remaining balance of $199.50 to this credit card on January 13, 2025.

Charges on credit cards will appear as "Chi Chack Community Language Center."

Coupons

Coupon Code

We offer a 10% discount for two or more siblings registered in a language class at World Language Connection with the code SIBLING2024. This code will only work if you have multiple children enrolled in a class.

Parent Coordinators may enter the code provided by WLC in the coupon code space above.

Donations

Help World Language Connection provide the benefits of multilingual education to our entire community with a donation to our scholarship fund.

Total

$399.00

Billing Information

Name

Payment Method

Credit Card
Check

Credit Card

Visa
Mastercard
American Express
Discover

Address

Phone Number

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