Registration form

Naperville German Language School

Registrant Information
(please print or type)______________________________________Today's Date:_______

Student Name/ Date of birth:
Parent/ Adult Name
Street Address

City, State, ZIP
Telephone
 home:_____________cell:______________other:______________
E-mail address
Class description, time
You heard about us from
 Newspaper:______Friend:______Internet:______
Phone Book:______Other:______

Payment Information:

_______Cash_______Check (payable to German Language School Naperville)_______other

Authorized Signatures:_____________________________________________

(Signatures by parent or authorized guardian, 18 years of age or older)

No refunds are given after September 25, 2010, or 10 days after the date of registration. Students enrolled in classes at the Naperville German Language School are expected to arrive on time, prepared, and behave appropriately during class time. Students may be excused from a class at the teacher's discretion for behavior issues or arriving unprepared.

I acknowledge that I am undertaking any classes or activities at The German Language School at my own risk. I understand that The Naperville German Language School takes every reasonable measure to insure the care and safety of students. I hereby agree to hold The Naperville German Language School, its staff, and affiliates, harmless from any and all claims, losses, suits, or related causes of action for damages. Initial:____

I understand that from time to time photos may be taken of me, my family, or my child as he or she or we participate in a class or activity. I hereby give permission for my/our photos to be used in newspapers, flyers, or on the web for the strict purpose of advertising or informational articles written on or about The Naperville German Language School by a reputable source such as The Naperville Sun, Daily Herald or other such publication including our webmaster for our website. Initial:_____

I understand and agree with the above policies and procedures.

Sign & Date:___________________________________________

Please mail form to: Angela Jostlein, 432 W Jefferson Ave., Naperville, IL 60540