Registration form - Children

Teaching German Language and Culture in a stimulating and fun environment. Please fill out the registration below to become part of the German Language School experience.

Student information

Student first name

City of birth

Student last name

Country of birth

Date of Birth

Are you registering more than one student?

Yes

Parent 1 / Guardian 1 information

Parent 1 / Guardian 1 first name

Parent 1 / Guardian 1 last name

Parent 1 / Guardian 1 cell

Parent 1 / Guardian 1 email

Parent 2 / Guardian 2 information (if applicable)

Serves as emergency contact

Parent 2 / Guardian 2 first name

Parent 2 / Guardian 2 last name

Parent 2 / Guardian 2 cell

Parent 2 / Guardian 2 email

Emergency contact information

Emergency first name

Emergency last name

Emergency cell

Student address information

Street Address

Street Address Line 2

City

State

Postal / Zip code

Chose your language class

Language class

How did you hear about us?

Returning

Teacher

Internet

Newspaper/Flyer

Other

Medical requirements or disability information?
You must inform the German Language School of Naperville of any learning disabilities (ADD, ADHD, dyslexia, IEP, etc.) or medical information (food allergies, diabetes, etc.) that would impact your/your child’s ability to effectively participate in class. Otherwise please fill in NA (not applicable).

By signing, you confirm that you understand and agree with the policies and procedures of GLSN.

I read and agree to the policies and procedures.

Your Signature

Select a date

German Language School of Naperville