CAoC 2019-2020 Registration Form 註冊單
Please submit ONE form for EACH student. Thank you! 請一位學生填寫一份註冊單。謝謝您的合作！
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Email *
Student Information (Required) 學生基本資料
First Name 英文名字 *
Last Name 英文姓氏 *
Chinese Name 中文姓名
Date of Birth 生日 *
MM
/
DD
/
YYYY
Gender 性別 *
Language Classes: *
2019-2020 Annual Tuition and Fees
Tuition: $380 for Children, $410 for adults
Registration fee: $30
Textbooks and materials fees: $30 for children only

In summary:
$440 for one student
$880 for two students total
$1,290 for three students total ($30 discount for the third student)
$1,700 for four students total ($30 discount for each of the third and fourth student)

 Please note that if your check is bounced by the bank for any reason, whatever amount that your bank charges the school will be added to your total fees.
Cultural Class: Chinese Calligraphy and Painting
1. Age: 8 Years Old and above
2. Classes: 20 weeks total
3. Time: 12:10 to 1 pm
3. fees: $125 including all materials
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How to Pay:
1. Please make the check* payable to "CAoC".
2. Please write all the students' names on the Memo section.
3. Please mail it to:

YuWei Cheng
24108 Edgehill Dr
Beachwood, OH 44122

*Please make sure sufficient funds are in your check-writing account. For a bounced check, any bank fee or penalty that is charged to CAoC will be the check writer's responsibility.
I would like to volunteer to bring food for the concession stand: *
Primary Parent/ Guardian Information (Required) 家長或監護人基本資料
Please Select 請選擇 *
First Name 英文名字 *
Last Name 英文姓氏 *
Chinese Name 中文姓名
Phone 1 聯絡電話 1 *
Phone 2 聯絡電話 2
Email 電子郵件信箱 *
Address 1 住址 1 *
Address 2 住址 2
City 城市 *
State 州名 *
ZIP Code 郵遞區號 *
Occupation 家長或監護人職業
Second Parent/Guardian Information (Optional) 第二家長或監護人基本資料
Please Select 請選擇
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First Name 英文名字
Last Name 英文姓氏
Chinese Name 中文姓名
Phone 1 聯絡電話 1
Phone 2 聯絡電話 2
Email 電子郵件信箱
Address 1 住址 1
Address 2 住址 2
City 城市
State 州名
ZIP Code 郵遞區號
Occupation 家長或監護人職業
In the event we can not get a hold of the parents or guardians, please provide emergency contact person number (Required): 請提供緊急聯絡人資料，以方便我們在聯絡不到家長或監護人時可以聯絡。
Emergency Contact 緊急聯絡人 *
Phone 電話 *
Special Note. If your child has any allergy or other special medical situation, please inform us as soon as possible. 小孩有任何需要注意的健康狀況嗎? 如過敏等...
Health Concerns 需要注意的健康狀況
Chinese Academy of Cleveland Waiver Statements 2017 克里夫蘭中文書院家長同意書
We/I hereby release, discharge and agree to hold harmless Chinese Academy of Cleveland, its board members and staff, as well as Shaker Heights School and its staff and all persons acting under the permission or authority, from a liability whatsoever for any and all claims of any nature which may raise out of our/my attendance at the Chinese Academy of Cleveland, and/or purchase and / or consumption of food and / or snacks offered through the Chinese Academy of Cleveland during snack time, special luncheon, and special events sponsored by the Chinese Academy of Cleveland such as Chinese New Year celebration, outdoor picnic, and end-of-year luncheon. This release covers us/me and any minor members of our/my family. *
We/I hereby also agree on behalf of ourselves / myself and any minor members of our / my family to allow the staffs and board members of the Chinese Academy of Cleveland to release electronic or paper photographs of us / me and any minor members of our/ my family on published materials including newspaper articles, internet websites, and video / radio productions associated with the reporting and promotion of activities associated with the missions, actions, and activities of the Chinese Academy of Cleveland. *
Furthermore, in case of emergency and my designated emergency contact cannot be reached, permission is granted to have my child treated by doctor or hospital appointed by the Chinese Academy of Cleveland or its authorized personnel. *
Withdraw and Refund Policies: 休學及退費須知：
1. Classes are subject to cancellation due to low enrollment. 如果學生人數不足，課堂可能會被取消。
2. Preschool, Pre-K and Kindergarten students’ parents need to be available during class time in order to help your own child when the needs arise.
3. Refund Policies can be found at the end of the Registration information on our website.
Please confirm you agree to abide by our school’s refund policies stated in the Registration Information. *
A copy of your responses will be emailed to the address you provided.
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