2019 Formulário completo de matrícula para crianças (apenas para alunos NOVOS) - Setembro a Dezembro / Complete registration form (new students ONLY) - September to December
Sejam bem-vindos a mais um semestre que se inicia!

O programa educativo-cultural da ABRACE destina-se a crianças e jovens que têm vínculo com a língua portuguesa e cultura brasileira. As nossas aulas são ministradas 100% em português, por isso é importante que a criança/o jovem possa ao menos compreender conversas básicas do dia a dia em português. Se tiver alguma dúvida, mesmo antes de matricular, escreva para a Diretora Escolar (abrace.diretoriaescolar@gmail.com), que poderá oferecer as orientações necessárias.

IMPORTANTE: Release of liability e release de photo e vídeo 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$ 320 - Turma Curumins de 2 anos;
US$ 450 - Turmas de crianças de 3 a 5 anos;
US$ 425 - Turmas de crianças de 6 anos e maiores.

Email address *
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 a student to ABRACE before (other than last semester)? *
Dia de nascimento / Day of birth: *
Mês de nascimento / Month of birth: *
Ano de nascimento / Year of birth: *
Sexo/Gender: *
Ano escolar atual / Current grade (Sept 2019 - June 2020): *
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? *
Dados dos Responsáveis / Other Primary Caregiver Information
Nome da mãe ou principal responsável / Mother's name or other responsible adult: *
Nós consideramos as informações de contato da mãe a serem usadas regularmente pela ABRACE. Se você deseja adicionar alguma outra pessoa, por favor informe abaixo. / We consider the mother's contact info the one to be used regularly at ABRACE. If you would like to add someone else, please inform below.
Your answer
Email: *
Your answer
Nacionalidade da mãe / Mother's nationality: *
Your answer
Telefone celular / Cell phone number (precisemos entrar em contato enquanto a criança estiver na ABRACE / in case we need to contact you 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: *
Nome da rua e número / Street Name and number
Your answer
Cidade / City: *
Your answer
CEP / Zip Code: *
Your answer
Estado / State: *
Your answer
Nome do pai ou parceiro(a) / Father's or partner's name: *
Your answer
Email do pai ou parceiro(a) / Father's or partner's email: *
Your answer
Nacionalidade do pai ou parceiro(a) / Father's or partner's nationality: *
Your answer
Telefone / Phone number: (Casa ou Celular / Home or Mobile): *
Your answer
Ocupação / Occupation: *
Your answer
Empregador / Employer: *
Your answer
Nível de português da criança / Language Proficiency: *
Muito bom / Very good
Bom / Good
Médio / 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: *
Required
Com que frequência a criança visita o Brasil? / How often does the child visit Brazil? *
Your answer
Informações adicionais (importante compartilhar a relação da criança com a língua e/ou o Brasil) / Other additional information (important to share the child's relation to the language and/or to 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 relevantes sobre a criança (por exemplo, tratamentos médicos ou psicológicos, comportamento em casa ou na escola, etc) / Relevant additional information (under any medical ou psychological treatment, social behavior at school or at home, and so on): *
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 quem matricular até dia 2 de janeiro.
Gostaria de fazer uma contribuição para a ABRACE, além do pagamento pelo semestre, no valor informado abaixo (se você não estiver interessado em contribuir agora, responda somente NÃO no campo 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): *
A contabilidade emite o boleto de pagamento apenas às quintas-feiras, por isso pode levar uns dias para a família receber o email com os dados para pagamento. *
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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