Petits Bourgeons Registration 2016-2017
ONLINE ENROLLMENT FORM

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Child name *
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ACTIVITY SELECTION AND INFORMATION
Petits Bourgeons 1 (in French)
AGES 6 months - 18 months
Taught by: Chafika Bensadok

Saturdays 9:45am - 10:45am.
(Guided playgroups in French for Francophone and Francophile families). French songs, nursery rhymes, movement and play will help infants create a connection between body movement, rhythm and awareness while laying the foundation for an appreciation of the French language.
Max 10 infants from 6 months to 18 months with their guardians per class.
Enroll for the year for a discount and to ensure a spot! Or enroll per session:

FULL YEAR
Saturdays: October 1st - June 10th (26 weeks)
Price: $500

FALL SESSION
Saturdays: October 1st - February 11th (13 weeks)
No class dates: 11/28 & 12/26
Price: $270

SPRING SESSION
Saturdays: March 4th -June 10th (13 weeks)
Price: $270
Classes held at efgb, 2 Rosary in Watertown
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Petits Bourgeons 2
(in French)
AGES 19 months - 3 years
Taught by: Chafika Bensadok

Saturdays 11:00am - 12:15pm.
(Playgroups in French for Francophone and Francophile families) French songs & rhymes, dancing, vocabulary and story time will help toddlers create a connection between body movement, rhythm, social awareness and facilitate French language learning.
Max 10 toddlers from 19 months to 3 years with their guardians per class.
Enroll for the year for a discount and to ensure a spot! Or enroll per session:

FULL YEAR
Saturdays: October 1st - June 10th (26 weeks)
Price: $600

FALL SESSION
Saturdays: October 1st - February 11th (13 weeks)
No class dates: 11/28 & 12/26
Price: $330

SPRING SESSION
Saturdays: March 4th -June 10th (13 weeks)
Price: $330
Classes held at efgb, 2 Rosary in Watertown

Name *
First Name / Last name
Your answer
I wish to enroll my child for Petits Bourgeons 1
AGES 6 months - 18 months
I wish to enroll my child for Petits Bourgeons 2
AGES 19 months - 3 years
Date *
Month / Day / Year
Your answer
CONTACT INFORMATION
Parent 1 / Guardian 1 Full Name *
First name / Last name
Your answer
Email Address *
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Home phone *
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Work phone *
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Cell Phone *
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Address *
Street, Town, State, Zipcode
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Parent 2 / Guardian 2 Full Name
First name / Last name
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Email Address
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Home Phone
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Work Phone
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Cell Phone
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Address
Street, Town, State, Zipcode
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FINANCIAL AGREEMENT
PETITS BOURGEONS 1 =
FULL YEAR - Price: $500
FALL SESSION - Price: $270
SPRING SESSION - Price: $270

PETITS BOURGEONS 2 =
FULL YEAR - Price: $600
FALL SESSION - Price: $330
SPRING SESSION - Price: $330

Payment schedule and terms
- Please fill out this application online, mail a check for the full tuition and indicate for which activity your child will be part.

- Payment should be made by check only to efgb and mailed to: efgb, 2 Rosary Drive, Watertown, MA 02472.

- Full tuition is due by before the start of class.

Cancellation and refund
- Please note that the classes require a minimum of 6 enrolled children to run. In case this minimum is not reached, we will refund your payment.

- Please note that programs are subject to EEC exemption. In case the EEC does not approve the exemption, we will refund your payment.

- Payments are non-refundable

- If a child is unable to attend a session for any reason, no refunds are provided.

- Should your class be cancelled due to teacher absence, a make-up class will be scheduled.

Wait list
- All applications are processed on a first come, first served basis.
Acknowledgement
By signing this form, I acknowledge that I have read and accepted all of the above financial terms and conditions.
Date *
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MEDICAL INFORMATION
Food allergies *
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Allergies to medication *
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Other medical concerns *
Please make sure to list any medical concern.
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Asthma *
Requires inhaler *
Contact in case of an emergency *
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Pediatrician contact information *
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MEDICAL RELEASE
I hereby authorize emergency medical care for my child. If, in the judgment of the staff, treatment is required for an injury or illness, I hereby also authorize the administering of anesthetics and recourse to other procedures deeemed necessary by the attending physician. I understand that whenever possible, I will be notified prior to medical treatment of my child, or at the earliest possible time should prior notice prove impossible. I am financially responsible for expenses, medical care and transportation incurred.
Date *
Month / Day / Year
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PHOTO CONSENT
efgb activities and events may be photographed or videotaped for publication in efgb informational and promotional materials. Your child may appear in these photographs or videos. If you do not wish for your child's image to be used for this purpose, you must notify the school.
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AGREE TO HOLD HARMLESS AGREEMENT
I agree to hold abide by the conditions herein and agree to hold harmless, waive and release any and all rights to claims for damages against efgb, its agents and employees who may have been involved in the planning and implementation of this program.
Date *
Month / Day / Year
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Signature *
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EXCLUSION
efgb reserves the right to exclude on a temporary or permanent basis any child whose behavior in class has a negative impact on other children or the overall performance of the activity. Fees will not be refunded.
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