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2019 Winter Program Final Registration Form (Jan 7th-11th)
Winter Program enrollment is now open.

Please complete an additional form if you have more than one child participating in the Winter Program.
Bus service will be provided for an additional fee.

The cost of the program is 450 000won without busing, and 530 000won with busing; his includes snacks, lunches, a sweatshirt and 5 days of fun.

In order to secure your placement, we ask you to deposit 200 000won as soon as possible. The payment must be made in full before December 1st of 2018.

All payments of tuition and fees are non-refundable.

Please remember we are only accepting the first 10 students from PK/JK, 20 students from K-1, 20 students from grades 2-3 and 20 students from grades 4-6.

The Winter Program will run from January 7th to January 11th from 9:30-3:30pm at KIS Pangyo.

If you have any questions or concerns, please e-mail Mr. Hill at pete.hill@kis.or.kr

Email address *
Student name (full name as shown on passport) *
Your answer
Student number (or write "Faculty Child" if faculty) *
Your answer
Date of birth (MM/DD/YYYY) *
Your answer
Campus Enrolled *
2018-2019 Grade Level and class *
Student Gender *
T-Shirt size *
Parent/Guardian name
Your answer
Primary Phone Number (000-0000-0000, Please do type dash between the numbers) *
Your answer
Alternate Phone Number (000-0000-0000, Please do type dash between the numbers) *
Your answer
Parent E-mail Address *
Your answer
Physical Address *
Your answer
Alternative Emergency Contact Person *
Your answer
Will you use our bus service? *
What subway station is closest to you home? *
Your answer
What bus station will you use?
Please rate your child's swimming ability *
Does your child have any medical condition/s or limitation/s (physical or emotional) that may necessitate care, affect their well-being or the well-being of others, or affect their ability to participate in summer program activities? *
If "YES" please explain
Your answer
I understand that the above information is correct by indicating yes below *
Type your full name below for your electronic signature. *
Your answer
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