2026-27 One Stop Learning Center Registration & Admission Agreement

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We accept students from Kindergarten (age 4 years and 10 months or older) through Grade 5.
Each student must complete a registration form. If you have more than one child, please submit a separate form for each.
We will review your submitted form and follow up with an invoice.
Enrollment is not finalized until payment is received.

Email *

Student's Name *

Student's Date Of Birth *

YYYY

School *

Blue Hills

Eaton

Dilworth

Faria

John Muir

Lincoln

McAuliffe

Nimitz

Portal

Stevens Creek

Other:

Student Grade in 2026-27 school year *

Please select the language course/materials that you prefer your child to take part in

Traditional Chinese

Simplified Chinese

CSL (Chinese as Second Language)/Spanish

Clear selection

Will you need pick up service? *

Yes

Parent 1's Name *

Parent 1's Phone Number *

Parent 2's Name

Parent 2's Phone Number

Address *

Emergency Contacts (other than Parents)

Please list any Food Allergies or Medical Conditions.

Type “N/A” if none.

If you were referred by someone from One Stop Learning Center, please provide the referrer’s name. Otherwise, enter N/A. *

AUTHORIZED Pick-Up (other than Parents)

List ALL individuals authorized to pick up your child. Identification may be requested from listed individuals. To authorize any EXCEPTION pick-up by an individual who is not listed here, parents are required to send information about the individual via email. Identification will be requested from the individual who comes to pick-up the child.

Liability Release

I, the undersigned, in consideration of participation in programs offer by ONE STOP LEARNING CENTER After School (the “School”) agree to indemnify and release the School, its officers, staff and employees, from any and all liabilities from any injuries which may be suffered by the above named child, arising out of, or in any way connected with participation in the classes or activities offered by the School. I acknowledge that I have read the above agreements and release, and fully understand that I have assumed all the risks of injury that may occur in the activities offered by the School. In case of an accident, illness or a medical emergency during a session of any classes or activities offered by the school, I hereby further authorize the School as the agent for the above named child to call 911, and consent to any medical diagnosis or treatment and hospital care rendered by and under the general supervision and advice of a licensed physician or surgeon.

By checking this box, you are agreeing to Liability Release

Required

2026-2027 Admissions Agreement