ADULT REGISTRATION FORM
Student’s full name (first, middle, last) *
Your answer
Address *
Your answer
Phone Number *
Your answer
Email
Your answer
Date of Birth (mm/dd/yyyy) *
MM
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DD
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YYYY
Language you want to study *
Language proficiency
Payment Options *
Send your payment check to the address listed below or if you prefer to pay online select the pay online option and we will email you an electronic invoice. CZECH AND SLOVAK SCHOOL OF NORTH CAROLINA 6 Barrington Pl. Durham, NC 27705 Visit the PROGRAMS page for the fees structure (http://www.czechslovakschoolnc.org/registration---adults.html) I agree to pay the full tuition listed above using one of the payment options available. I understand that I am committed for the whole semester and that the tuition fees are non-refundable. If exceptional circumstances arise (prolonged illness, unexpected family situation, etc.) a refund for paid tuition may be issued. It is always at the discretion of the Czech and Slovak School of North Carolina to determine the level of the refund. If you select online payment, an invoice with final amount will be emailed to you within 24-48 hours.
Right to use images *
I understand that the Czech and Slovak School of North Carolina may produce or participate in video,motion picture, audio recording, web pages, still photographs, broadcast, social media, and/or other publications which may involve the use of students’ images, video or voice. Such productions will be used for non-commercial education, exhibition, or promotional purposes and will not be sold for any reason.They may be copied, copyrighted, edited, and/or distributed by the Czech and Slovak School of North Carolina in the manner described above. By checking YES and initialing below, I grant the Czech and Slovak School of North Carolina the right to use and re-use the images, video or audio of my child/children in the manner specified above. I waive the right of prior approval and hereby release the Czech and Slovak School of North Carolina, its agents or its designees from any and all claims for damages or remuneration of any kind based on the use of said materials.I have read the information above and fully and completely understand the contents thereof and accept or reject these terms and conditions as indicated below:
Sharing contact information *
To facilitate social interaction among students, the Czech and Slovak School of North Carolina may share contact information within the school community. Distribution is limited to the Czech and Slovak School of North Carolina families and staff for internal school use only. We will not share your information with any third party groups. If you not wish to have contact information shared in this way, please indicate by checking DO NOT below.
WAIVER OF LIABILITY *
The Czech and Slovak School of North Carolina is a non-profit public benefit organization. As condition of enrollment I hereby agree to the following:I understand and agree that, as a condition of being registered for classes at the Czech and Slovak School of North Carolina, I shall not hold liable the Czech and Slovak School of North Carolina, their employees, directors, officers, volunteers or agents for any accidents which may occur in connection with any activity of the Czech and Slovak School of North Carolina before, during, or after school hours, or involving any event, gathering, or occasion that I attend as a result of connection with the Czech and Slovak School of North Carolina.I am aware that by signing below I have agreed to assume full legal liability for all rights involved in a participation in the Czech and Slovak School of North Carolina program and further that I have waived certain legal rights, including my right to sue.I have read and understood this form in full and I agree to register for classes at the Czech and Slovak School of North Carolina. I agree to abide by the rules and regulations of the Czech and Slovak North Carolina. .............................................................................................................................................................................................................Type your name:
Your answer
ADDITIONAL POLICIES
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Data Protection Policy: All information provided in this form is for internal purposes only. It is treated as confidential and will notbe shared with third parties.
Non-Discrimination Policy The Czech and Slovak School of North Carolina is committed to providing a learning environment that is free from discrimination and open to all students. The school does not discriminate on the basis of race class, religion, gender, age, ability, and national or ethnic origin.
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