Formulário completo de matrícula para 2018: setembro a dezembro/ Registration Form: September to December (apenas para alunos NOVOS)
ATENÇÃO: release of liability e release de photo e video agora são parte deste formulário. Ao preenchê-lo, os responsáveis pelas crianças assumem o compromisso pelo pagamento do semestre e reconhecem a validade de sua assinatura nos releases.
Semestralidade: US$ 390 - turmas de crianças de 3 a 5 anos; US$ 365 - turmas de crianças de 6 anos e maiores.
Dados da criança/Personal Details
Nome/First Name: *
Your answer
Sobrenome/Last Name *
Your answer
Já foi aluno da ABRACE algum dia? / Has this child been an student to ABRACE before (other than last semester)? *
Your answer
Dia e mês de nascimento/day and month of birth *
(ano de nascimento no próximo campo)
Your answer
Ano de nascimento/Year of birth *
Your answer
Sexo/Gender *
Your answer
Ano escolar atual / Current grade (Sept 2017 - June 2018): *
Your answer
Tem irmã(o) sendo matriculada(o) na ABRACE ao mesmo tempo? Se sim, quantos? / Are there siblings being registered as well? If yes, how many? *
Your answer
Dados dos Responsáveis / Other Primary Caregiver Information
Nome da mãe (mother's name) ou principal responsável *
We consider the mother's contact info the one to be used regularly at ABRACE. If would like to change that or add someone else, please inform below.
Your answer
Email: *
Your answer
Nacionalidade da mãe/Mother's nationality *
Your answer
Telefone (celular)/cell phone number: (in case we need while child is at ABRACE): *
Your answer
Ocupação /Occupation *
Your answer
Empregador/Employer *
Your answer
Endereço de residência da criança/Child's primary residence address: *
Número e rua
Your answer
Cidade/City *
Your answer
CEP/Zip code *
Your answer
Nome do pai ou parceiro(a) (father's or partner's name) *
Your answer
Email do pai ou parceiro(a): *
Your answer
Nacionalidade do pai ou parceiro(a)/Father or partner's nationality *
Your answer
Telefone/phone number: (home or cell): *
Your answer
Ocupação/Occupation *
Your answer
Empregador/Employer *
Your answer
Nível de português da criança / Language Proficiency *
Muito boa/Very good
Boa/ Good
Media/ Limited
Não Tem/ none
Comunicação oral/Speaking
Compreensão/Listening
Leitura/Reading
Escrita/Writing
Uso do português pela criança/Child's use of Portuguese language *
Contato com a Língua Portuguesa/Contact with Portuguese Language *
Marcar todos que são válidos/ mark all that apply
Required
Com que frequência a criança visita o Brasil?/ How often does the child visit Brazil? *
Your answer
Informações Médicas / Medical Information
Alergia/ any allergies *
Your answer
Como proceder em caso de reação alérgica? / In case of an allergic reaction, how should we proceed? *
Your answer
Problema de saúde crônico ou diagnóstico que seja relevante informar / any relevant diagnosis or cronic disease: *
Your answer
Além de pai e/ou mãe, informar outro contato em caso de emergência (nome e telefone) / Emergency contact - besides the parents (name and phone number) *
Your answer
Informações adicionais sobre a criança / other additional information (important to share the child's relation to the language and/or to Brazil)
For more than 5 lines, please send the info via email to abracebrasil@gmail.com.
Your answer
Tem interesse em pagamento parcelado para o valor do semestre? (com taxa de 5%)/ Are you interested in paying tuition in installments? (5% fee) *
A opção de parcelar em 3 vezes é válida apenas para matrículas feitas até dia 15 de janeiro.
Gostaria de fazer uma contribuição para a ABRACE, além do pagamento pelo semestre, no valor informado abaixo: / I'd like to make a contribution to ABRACE in addition to the tuition, in the amount indicated below: (if not interested in contributing now, just answer NO in the field below) *
Tuition is US$ 390 for one semester of the program for 3 to 5 year-old kids, and US$ 365 for the program for kids 6 and older. Since tuition does not cover 100% of the costs per student, any contribution is very welcome and can be tax-deductible to the extent of the law.
Your answer
A contabilidade emite o boleto de pagamento apenas às quintas-feiras, por isso pode levar uns dias para a família receber o email com o boleto. *
Release of liability
This section replaces the form that used to be done separately on the registration process.
I do hereby grant permission for this registered child to attend, engage, and actively participate in any and all of the various activities of ABRACE. This consent also includes specific authorization for any of the adult activity leaders (staff or volunteer) to make any medical decisions with respect to said minor child in the event of accident or injury when parental consent shall be unavailable or when circumstances shall require immediate medical decision. *
1. I verify that notice of this child’s medical conditions, medications, or any other special needs which may require the leaders’ attention have been provided on this form. 2. this child is enrolled in a medical insurance program which will cover his or her medical expenses within the U.S., and that any medical expenses not so covered will be solely the responsibility of the parent(s) or legal guardian(s); 3. the parent(s) or legal guardian(s) will bear full legal and financial responsibility for this child, including, but not limited to, the obligation to pay for any debts he or she may incur, damage to property caused by this child, and separate transportation home in the event it becomes necessary. I further verify that I will support the rules and boundaries set by the teachers and leaders who work with our child on behalf of ABRACE, Inc. I recognize that certain activities involve some risk, and hereby indemnify, agree to hold harmless and to release the Fairfax County Public Schools, the McLean Baptist Church and ABRACE Inc, its members, officers, employees, representatives, and agents including any and all volunteer leaders, and each of them, from any liability for any and all past, present or future claims or causes of action for personal or bodily injury or property loss arising out of any ABRACE’s sponsored youth activities that are not due to the negligence of ABRACE’s staff or volunteer leaders.
Release of photo and video
We NEVER publish children's pictures with names, and, in most cases, the pictures would be just to showcase ABRACE's programs once in a while, by email or Facebook.
I do hereby consent, on behalf of myself and my child, to the photographing of myself and my child. I understand that the term "photograph" as used herein encompasses both still photographs and motion picture footage and includes oral and video recordings. I agree that ABRACE Inc. may use such photographs of me or my child without my name or the name of my child, and for the sole purpose of conducting all promoting of ABRACE’s educational and cultural activities (including advertising or promoting its programs on its website or other media). I authorize ABRACE Inc. and all its non profit successors in interest to copyright, use and publish the same in print and/or electronically solely for the purpose authorized in this release. I waive any right to inspect or approve the finished product, including written copy, that may be created in connection therewith. I also agree that this releases ABRACE Inc. and any and all of its representatives from any and all monetary obligations or payments to me or any or all of my authorized representatives for use of video, films, photographs, image and/or voice of myself. *
I am the parent/legal guardian of this child and understand that by filling this form out constitutes legal signature and consent of this registration form and release form.
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