Registration Form (2016 Fall)

华根中文学校2016年秋季报名表

家庭信息

Family Information

父亲姓名 Father's Name *

父亲电话 Father's phone number *

父亲电子邮箱 Father's Email Address (尽量使用Gmail) *

母亲姓名 Mother's Name *

母亲电话 Mother's phone number *

母亲电子信箱 Mother's Email Address（尽量使用Gmail） *

加入华根中文学校微信群了吗？ *

Did you join Huagen WeChat (parents need to read in Chinese)?

是(yes)

否(no)

家庭地址 *

Home Address

紧急联系人姓名(非父母） *

Emergency Contact Name (Other Than Parent)

紧急联系人电话(非父母） *

Emergency Contact Phone (Other Than Parent)

学生信息

Student Information

学生姓名-中文

Student Name -Chinese

学生姓名- 英文 *

Student Name -English

性别 *

Gender

男（M)

女（F)

生日 *

Date of Birth

MM

/

DD

/

YYYY

中文课

Chinese Class (1:30 - 3:20pm), Pre-K Chinese (3:30 - 5:20pm), Happy Chinese Class (3:30 - 5:20pm).

班级（老师） *

Class(teacher)

不上中文课，None

学前班（潘胜）， Pre-K

一年级1班（邱惠君），Grade 1-1 (原潘胜班)

一年级2班（未参加过学前班），Grade 1-2

二年级1班（徐尧）， Grade 2-1 (原邱惠君班)

二年级2班（惠玉萍）， Grade 2-2

三年级1班（曹培娟）， Grade 3-1 （原刘婉琦班）

三年级2班（爱新觉罗·闿琛）， Grade 3-2，(原黄哲班)

四年级1班（张冬雨）， Grade 4-1

四年级2班（张静）， Grade 4-2 (原董蓉蓉班)

五年级班（张雪梓）， Grade 5 （原张静班）

六年级1班（匡欢）， Grade 6-1 （原尚胡兰班）

六年级2班（李靖伟）， Grade 6－2

七年级（林玉明）， Grade 7

八年级（王彭华）， Grade 8

Happy Chinese 1 (Beginner) （徐尧）

Happy Chinese 2 (Intermediate) （徐尧）

繁体字文化（陈慈仪）

Required

活动课（三，四节）

* Activity Classes Not Applicable for Pre-K or Happy Chinese Students 课外活动不接受学前班和快乐中文学生报名。
* Please prepare one basketball and one soccer ball for sport class. 球类课的请准备篮球和足球各一个
* Craft class has $30 extra material fee and please pay at the same time when you pay tuition fee. 手工课另外收$30材料费,和报名费一起收
* The violin class ONLY accept registration that parents have already applied in advance and received the Confirmation Email from school小提琴课只接受提前报名并且收到学校确认信的注册
＊Dancing classes accept new students ONLY in spring semester， no new students accepted in fall. 舞蹈课仅在春季接收新学员报名，秋季报名仅适用于当前舞蹈班学员。
* Music class accept new students ONLY in spring semester， no new students accepted in fall. 音乐课仅在春季接收新学员报名，秋季报名仅适用于当前音乐班学员。

课外活动课（第三节）

Activity Class 3rd Period, 3:30-4:20

舞蹈 I, Dancing 1, age 5 and up

舞蹈 II, Dancing 2, age 8 and up

舞蹈 III, Dancing 3, age 11 and up

功夫（Kongfu)

空竹/扯铃，Diabolo

美术（小）, age 8 and below

美术（中）, age 9 and above

国际象棋（小）,Chess I, age 8 and below

国际象棋（中）,Chess II, age 9 and above

小提琴（初级)（beginning level violin）

Ipad 酷学初级 Beginner

课外活动课（第四节）

Activity Class 4rd Period, 4:30-5:20

美术（小）, age 8 and below

美术（大）, age 9 and above

手工（额外30材料费）Craft （extra $30）

小提琴（中级),（intermediate level violin）

音乐, Music

球类 I, Sports I, age 5-8

球类 II, Sports I, age 9-11

球类 III, Sports I, age 11 and up

会话, Conversation

Ipad 酷学中级 Intermediate

古筝，Chinese Zither

Tuition and fees

华根中文学校将于2016年8月20日开学。上课时间为星期六下午1:30至5:20（见校历）。8月20日只有中文课（不包括学前班和Happy Chinese class），8月27日活动课开始。
报名截止日期：9/10/2016
中文学校缴费时间：8/20/2016，8月27日 1:30pm - 3:20pm.
中文学校缴费地点：Oak Hall School ---食堂
学杂费：全部四节课(1:30 - 5:20pm) 每人每学期$245。如果选课少于四节，每节课每人$75(中文两节必须一起选)。每家第二个孩子起学杂费优惠$30, 第四个孩子免学费。9月3日以后注册，须交纳滞纳金$30。所有学生都必须缴纳学杂费。9/17/2016以后一律不予退款。若报名人数过少，学校有权取消课程。如果课程取消，学校会退回相应的学杂费。

Hua-Gen Chinese School will resume on Aug.20， 2016. School Time: Every Saturday from 1:30pm - 5:20pm, except holidays. For Aug.20, Chinese class only, excluding Pre-k and Happy Chinese Class
Registration must be completed by 9/10/2016
Payment Date: 8/20/2016 1:30pm - 3:20pm.
Location: Oak Hall School --- Cafeteria
Tuition and fees for each student are $245 per semester for all four classes (1:30pm-5:20pm), or $75 for each class (two Chinese classes must be taken together). Each additional sibling receives $30 discount after the first child is registered. The fourth sibling and beyond are free. There will be a late fee of $30 if register after 9/3/16. No tuition waiver will be granted, and there will be no tuition refund after 9/17/2016. Hua-Gen Chinese school reserves the right to cancel classes due to low enrollment. Should a class be canceled for the whole semester due to low enrollment, the school will refund tuition and fee for that class

Tuition and fees

华根中文学校将于2016年8月20日开学。上课时间为星期六下午1:30至5:20（见校历）。8月20日只有中文课（不包括学前班和Happy Chinese class），8月27日活动课开始。
报名截止日期：9/10/2016
中文学校缴费时间：8/20/2016，8月27日 1:30pm - 3:20pm.
中文学校缴费地点：Oak Hall School ---食堂
学杂费：全部四节课(1:30 - 5:20pm) 每人每学期$245。如果选课少于四节，每节课每人$75(中文两节必须一起选)。每家第二个孩子起学杂费优惠$30, 第四个孩子免学费。9月3日以后注册，须交纳滞纳金$30。所有学生都必须缴纳学杂费。9/17/2016以后一律不予退款。若报名人数过少，学校有权取消课程。如果课程取消，学校会退回相应的学杂费。

Hua-Gen Chinese School will resume on Aug.20， 2016. School Time: Every Saturday from 1:30pm - 5:20pm, except holidays. For Aug.20, Chinese class only, excluding Pre-k and Happy Chinese Class
Registration must be completed by 9/10/2016
Payment Date: 8/20/2016 1:30pm - 3:20pm.
Location: Oak Hall School --- Cafeteria
Tuition and fees for each student are $245 per semester for all four classes (1:30pm-5:20pm), or $75 for each class (two Chinese classes must be taken together). Each additional sibling receives $30 discount after the first child is registered. The fourth sibling and beyond are free. There will be a late fee of $30 if register after 9/3/16. No tuition waiver will be granted, and there will be no tuition refund after 9/17/2016. Hua-Gen Chinese school reserves the right to cancel classes due to low enrollment. Should a class be canceled for the whole semester due to low enrollment, the school will refund tuition and fee for that class

Payment

现金支付 Bring Cash
或者支票请付 or Check please pay to the Order of：Hua-Gen Chinese School
学校地址 School Address: Oak Hall School, 8009 SW 14th Avenue, Gainesville, FL 32607
学校事务联系 School Contact Email: info@huagen.org

Liability Waiver

By signing below, I/We declare that I/we fully understand the dangers associated with my/our child’s participation in the activities sponsored by Hua-Gen Chinese School, and therefore assume full responsibility for all risks, including body injury, death or property damage. I/We hereby release, waive and discharge Hua-Gen Chinese School, including its directors, officials, administrators, teachers, staff and agents, from any and all liabilities.

Liability Waiver * *

I agree

Photo Release

I understand that students in Hua-Gen Chinese School activities may be included in photographs and/or videos taken during such activities either by members of the public as audiences, parents, teachers, staff members, or by professional photographers retained by the school. By signing below, I understand and do hereby give Hua-Gen Chinese School and its legal representatives the right, without reservation or limitations, to use the pictures, videos, names, and likeness of the students at no cost and without compensation to student(s) or me, for the non-profit purposes of advertising, promoting and public relations engagement of the school. Hua-Gen Chinese School promises the pictures, videos, names, and the likeness of the student(s) will not be used for any for-profit purpose. I represent that I am a parent/legal guardian to the student(s) and I agree that the grant and release contained therein binds me and the minor to all of the terms; and I CONFIRM THAT I HAVE READ THIS PHOTO RELEASE, FULLY UNDERSTAND ITS TERMS, BY SIGNING IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

我了解在华根中文学校的学生参与的各种学校活动将可能被观众，父母，老师，工作人员及摄影师拍照或录影。作为学生的父母或法律监护人，我授权华根中文学校在未来无偿及无责使用学生的照片，录像，名字等作宣传，推广，公关等非营利性用途。华根中文学校承诺所有学生的照片均不会被用作营利用途。我作为学生家长或法定监护人，确认已阅读并明白以上条款并自愿签署此授权。

Photo release *

I agree

Parent Duty Agreement

I understand that the proper functioning of Hua-Gen Chinese School relies on not only the teachers and staff members, but also the parents and the students. Hua-Gen Chinese School rent facilities from Oak Hall School and are expected to maintain the conditions of the facilities as they are. By signing below, I agree to fulfill class room monitoring, housekeeping and cleaning duty when being requested, by Hua-Gen Chinese School or its teachers, staff members, room parents, for EACH class enrolled (normally no more than twice per semester, depending on teacher's preference. Pre-K class may need more.). Hua-Gen Chinese School reserves the right to terminate the student's class(es) when the parent of whom repeatedly fails to timely sign up or fulfill class room duty.

我了解华根中文学校的正常运行不仅有赖于老师和工作人员，也有赖于学生及其家长的协助。华根中文学校从Oak Hall School租赁教学场地并被要求维护场地的清洁和完整。签署此条款表示我同意在校方或学校老师，工作人员或班级家长代表要求下值日，值日内容包括维持课堂纪律及负责教室清洁和教具完整。值日次数每学期每节课一般不超过2次，具体由任课老师决定，学前班值日次数可能略多。对于没有及时报名参加值日或者多次值日缺席的家长，华根中文学校保留终止学生课程的权利。

Duty agreement *

I agree

填表的家长签名 *

Type your name here, prefer Chinese （中文）

More Students

Parents/Guardians need to fill out one registration for each student. To register additional children, please click the "BACK" button on your browser after clicking the "SUBMIT" button below. Some computers may remember most of the information you filled to save your time.