Summer Class Registration
June 15-Aug 24, NO CLASS AUG 10
Email address *
Student Full Name *
Your answer
Student Age *
Your answer
Sibling 1 Name, age (if applicable for group lesson)
Your answer
Parent Name (if applicable)
Your answer
Cell phone number *
Your answer
Choose Class *
Current Level *
Complete Beginner
Row 1
If the student has previous language experience, please describe below.
Your answer
What is the goal for this session? *
Your answer
Who can we thank for the referral? How did you hear about us? *
Your answer
Is there anything you want the instructor to know ? *
Your answer
Payment Info
Please choose a payment method
*Returned checks will incur a $35 fee
**New students, add a one-time school enrollment fee of $35
payments must be received before JUNE 1 to hold your spot *
Terms and Policies
PHOTOGRAPHY PERMISSION: I hereby allow administration of Academy Road Languages to take photographs and other media of me/my child while in the care of Academy Road Languages on its campuses and/or other sites including, but not limited to outside areas, classrooms, libraries or at Academy Road Languages events. These photographs may be used by Academy Road Languages in any reasonable manner including, but not limited to publications, advertisements and/or posted on websites and social media. Names will not be identified with images at any time.

CANCELLATION of Group lessons: If your school, center or library location is closed on a day of your lesson with Academy Road Languages, due to snow or weather-related issues, there will be no make-up lesson and no refund. We will work with you to reschedule the second missed class within a single session, offering a different time and/or location. Failure to attend a group lesson, does not warrant a make-­up lesson.

CANCELLATION of Private lessons: In the event that you need to cancel or reschedule your lesson, a 24 hour notification is required. Any cancellation within 2 hours of the start time will not be refunded or rescheduled and any payments made towards that lesson will be considered forfeit. Any make-up lessons should be scheduled within the allotted period of time. Ex: If you pay monthly, a make-up lesson should be scheduled before the month is over.

NO SHOWS: Anyone who either forgets or consciously chooses to forgo their appointment for whatever reason will be considered a “no-show.” They will be charged for their “missed” appointment. This amount must be paid prior to your next scheduled appointment. All vouchers and gift certificates become null and void at the time of a missed appointment. Payment in advance may be required to schedule any future appointments.

LATE ARRIVALS: If you arrive late, your session may be shortened in order to accommodate others whose appointments follow yours. Regardless of the length of the lesson actually given, you will be responsible for the “full” time. Out of respect and consideration to your teacher and other students, please plan accordingly and be on time.

LATE ARRIVALS: If for whatever reason your teacher arrives late, you are entitled to the amount of time missed. This may mean that you can stay later after the allotted time or add time to another lesson.

REFUNDS: Full refunds apply when withdrawal of a student is received in writing or email one week prior to the start of any session. Should Academy Road Languages find it necessary to remove any student from a class, a refund will be issued after a deduction is taken for classes already taken. A $20.00 processing fee will be applied to any refund issued. No refunds will be issued for failure to attend a make-up class. To inquire about a refund, you must submit your request in writing to

PAYMENTS: I understand payments must be made in full at least 1 week before the start date. I understand that if I am a new student, I must add a one-time $35 enrollment fee.

A copy of your responses will be emailed to the address you provided.
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