Worldplus Learning Center Registration Form

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Thank you for your interest in Worldplus Learning Center! Please complete this registration form to help us learn more about your child and family. Submission of this form does not guarantee enrollment until confirmation from Worldplus Learning Center.

We look forward to supporting your child’s learning journey!

Student Full Name

Chinese Name (optional)

Birthdate

YYYY

Grade

School

Gender

Male

Female

Prefer not to say

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Parent/Guardian Name

Relationship to Student

Phone Number

Email Address

Home Address

Emergency Contact Name

Phone Number

Relationship

Program Interest

Pre-K Chinese Immersion

Elementary Chinese Level 1

Elementary Chinese Level 2

K - 5 After School Tutoring

K - 5 No-school Day Camp

K - 5 Summer Camp

Middle School Chinese Continuing Class Saturday

Middle School Chinese Continuing Class Sunday

High School Chinese Continuing Class

K - 12 Chinese Private Tutoring

Beijing Summer Study Tour

Math/English Tutoring

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Allergies or Medical Concerns

Anything we should know about your child?

Medical Emergency Consent

I authorize Worldplus Learning Center staff to obtain emergency medical care for my child if I cannot be reached immediately. This may include first aid, emergency transportation, or medical treatment deemed necessary.

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Photo & Video Consent

I give permission for my child to be photographed or recorded during classes, activities, and events. Photos/videos may be used by Worldplus Learning Center for educational, marketing, website, and social media purposes.

I do NOT give permission for my child to be photographed or recorded.

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Liability Waiver

I understand that while Worldplus Learning Center will take reasonable precautions to ensure student safety, participation in classes and activities involves some risk. I agree not to hold Worldplus Learning Center or its staff liable for minor injuries, accidents, or loss of personal belongings.

Sick Policy

I understand that sick children should stay home. Worldplus Learning Center may send a child home if they show symptoms of illness.

Pick-Up Authorization

List of authorized adults allowed to pick up the child

Photo ID may be required at pick-up.

Payment & Refund Policy

I understand that tuition and registration fees are non-refundable unless otherwise stated by Worldplus Learning Center.

Behavior Policy

I understand that respectful behavior is expected. Worldplus Learning Center reserves the right to dismiss a student for unsafe or severely disruptive behavior.

Release for Field Trips / Walks (if applicable)

I give permission for my child to participate in supervised walks or local activities related to the program.

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Technology / Internet Use

If students use computers, I give permission for my child to use educational technology and supervised internet resources.

Make Payment

Check: Please make checks payable to Worldplus Education.

Zelle: Send payment using phone number 503-453-6399 (search for “Worldplus Education”). Please include the student’s name and program name in the payment note.

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Questions or Comments

Submit

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