Registration Form

The registration will start on March 23, 2010 for the 2010/2011 School Year.

Registration is for one full school year (September 20, 2010 to June 9th, 2011). Tuitions are paid by semester before the class period starts.

- French Classes:

Tuition fees: $1,850 for the full year ($925 for the small-ones - 2h a week -), $2,000 for the "Grands" Level
(the cost of Lexington/Sudbury could be higher depending on the cost of the rental fees)
- A discount of $200 fee will be applied in the case of a registration before April 9th 2010 (the deadline for the FLAM grant submission is April 15th 2010).

- The tuitions could be paid in 2 installments at the end of September and end of January.
- A deposit of $200 is required at the submission of the application form to secure your registration. This sum is not refundable (except if the class is not open) and is deducted from the total tuition (in the second semester in January if payment option is in 2 times). - The registration fees to efgb ensure a place for your child for one school year from September to June 10th.
- Discount of 5% for the second child and %10 for the third child.

- Drama Classes: The tuition fees are:

- Monday and Tuesday Classes: $ 675/Child (30 sessions)
Saturday Classes: $ 540/Child (24 sessions)

- The tuitions could be paid in full when you register or in 2 installments at the end of September 2010 and end of January 2011.
- A deposit of $200 is required at the submission of the application form to secure your registration. This sum is not refundable (except if the class is not open) and is deducted from the total tuition (in the second semester in January if payment option is in 2 times). - The registration fees to efgb ensure a place for your child for one year from September to end of May.

STUDENT INFORMATION

First Name : *

Last Name : *

Date of birth : *

Citizenship : *

Gender : *

Sign-up program : *

Current efgb Student : *

Address

Street : *

City : *

State : *

Zip Code : *

Grade : *

Current Grade

School Name & Town : *

Level of French : *

MOTHER INFORMATION

First Name : *

Last Name : *

Citizenship : *

E-Mails

Home email : *

Work :

Phone numbers

Home phone number : *

Work :

Cellphone :

Languages spoken with mother : *

FATHER INFORMATION:

First Name : *

Last Name : *

Citizenship : *

E-Mails

Home email address :

Work email address :

Phone numbers

Accueil :

Work :

Cellphone :

Languag(e)s spoken with father : *

SIBLINGS

Sibling 2

First Name :

Age :

Gender :

Sibling 1

First Name :

Age :

Gender :

Language(s) spoken with siblings :

MEDICAL INFORMATION:

Food allergies :

Allergies to medications :

Asthma :

Requires inhaler :

Contact in case of an emergency: Name and telephone number : *

Name and telephone number of doctor in case of emergency : *

MEDICAL RELEASE

I hereby authorize emergency medical care for my child. If, in the judgment of the staff, treatment is required for an injury or illness, I hereby also authorize the administering of anesthetics and recourse to other procedures deemed necessary by the attending physician. I understand that whenever possible I will be notified prior to medical treatment of my child, or at the earliest possible time should prior notice prove impossible. I am financially responsible for expenses medical care or transportation incurred.

Signature : *

Date : *

Other agreements

I agree to hold abide by the conditions herein and agree to hold harmless, waive and release any and all rights to claims for damages against efgb, its agents and employees who may have been involved in the planning and implementation of this program.

Signature : *

Date : *

efgb reserves the right to exclude on a temporary or permanent basis any child whose behavior in class has a negative impact on other children or the overall performance of the class. Fees will be reimbursed on a pro-rate basis, less the initial $150 deposit.

Signature : *

Date : *

FINANCIAL AGREEMENT

- French Classes: Tuition fees: $1,850 for the full year ($925 for the small-ones - 2h a week -), $2,000 for the "Grands" Level (the cost of Wellesley could be higher depending on the cost of the rental fees) - A discount of $200 fee will be applied in the case of a registration before April 9th 2010 (the deadline for the FLAM grant submission is April 15th 2010). - The tuitions could be paid in 2 installments at the end of August and end of January. - A deposit of $200 is required at the submission of the application form to secure your registration. This sum is not refundable (except if the class is not open) and is deducted from the total tuition (in the second semester in January if payment option is in 2 times). - The registration fees to efgb ensure a place for your child for one school year from September to June 10th. - A late fee of $25 will be applied to payments received 10 days after the due date, $50 after 20 days. - Any check returned by the bank will be subject to a $35.00 processing fee. - Discount of 5% for the second child and %10 for the third child. - Drama Classes: - Monday and Tuesday Classes: $ 675/Child (30 sessions) Saturday Classes: $ 540/Child (24 sessions) - The tuitions could be paid in full when you register or in 2 installments at the end of june 2010 and end of January 2011. - A deposit of $200 is required at the submission of the application form to secure your registration. This sum is not refundable (except if the class is not open) and is deducted from the total tuition (in the second semester in January if payment option is in 2 times). - The registration fees to efgb ensure a place for your child for one year from September to end of May.

Signature : *

Date : *

VOLUNTEERING

If you would like to volunteer and/or join our organization, please complete the information below. Your help is most welcome. EFGB needs volunteers to help in the field of Communication and Fundraising.

Field of Interest :

Number of hours/month :

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