After School Program Registration
SPRING 2019 01/07/2019 - 06/04/2018
Student's Name 学生姓名 *
Your answer
Gender 性别 *
Student's Birthday 学生生日
Your answer
Current School’s name & address 现读学校名/地址 *
Your answer
Grade 年级 *
Your answer
Room# 教室房号 *
Your answer
Teacher’s Name 老师姓名 *
Your answer
Native Language 主要语言 *
Your answer
Second Language 第二语言
Your answer
Special Needs or Special care Required 学生有无特殊问题和要求(请详细注明)
Your answer
Pick up ($8/day) *
Pick up time at school *
Your answer
If Yes, days of the week:
Daily Schedule 日常时间表
2:00pm - 3:00pm Start to pick up students from their schools.去学校接学生
3:30pm - 4:20pm Mandarin class/Homework help 中文课程/作业辅导 ✽(optional, students can choose either attend Mandarin class or practice Kung Fu all the time)
4:20pm - 4:30pm Water break (snacks provided) 休息时间 (提供小点心)
4:30pm - 6:00pm Kung Fu class (including basic movement, flexibility, tumbling, and forms) 功夫课程
Choose your prefered classes 选择喜爱的课程 *
Holidays (no school)
1/21/2019 Martin Luther King Jr. Day
2/5/2019 Lunar New Year
2/18/2019 Presidents Day
3/25/2019 - 3/29/2019 Spring Break
3/29/2019 César Chávez Day (observed)
5/27/2019 Memorial Day
01/07/2018 - 06/04/2018 Days & Price 上课天数 & 价钱 *
Parent/Guardian Information 家长/监护人信息
Name 姓名 *
Your answer
Relationship with student 与学生的关系 *
Your answer
Name 姓名
Your answer
Relationship with student 与学生的关系
Your answer
Contact Phone # 联系电话 *
Your answer
Email 邮件 *
Your answer
Address 地址
Your answer
Name of Emergency Contact 紧急联系人姓名 *
Your answer
Phone # 电话 *
Your answer
Fee and Policy 收费和规则
- All fees must be submitted by the time of enrollment to reserve your child’s space. 学费一次付清
- Make your check payable to 支票开头请写 :
Panda Kung Fu Center
2545 Judah St. San Francisco, CA 94122

Refund Policy:
- 14+ days before the start of the session: Full refund ($50 registration fee is nonrefundable)
开学前二周校,学费全退 ($50报名费不退还)
- 50% refund 2 days before the start of the session.($50 registration fee is nonrefundable)
- No refund two days or less before the session starts.

Absences and Late Charges:
- No refund or credit for missed classes unless classes are canceled by the school.
学生缺课不退费, 除非学校删掉课程
- Please pick up your child on time.

The school reserves the right to dismiss or suspend a child for unsatisfactory behavior or for physical needs which the staff does not have the expertise to attend to. 如孩子有身体不适或不良行为, 学校有权让孩子退学

Parents’ Release Form 家长或监护人同意书
- I hereby allow my child to participate in the PKFC programs.I authorize the school and its staff members to take full
charge of any emergency that may occur. I will not hold PKFC, classroom providers, or any staff members liable in case
of accidents or injuries.
- I hereby give Panda Kung Fu Center permission to use the photos that include my child.
- I agree with the PKFC’s financial policy.
Parent’s/Guardian’s Signature 家长或监护人签名 *
Your answer
Date 日期 *
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