Katy GT Academy Summer Class Enrollment Form by MrN305KI

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									                  Katy GT Academy 2010 Summer Class Registration Form


Student Name                                               SSN                              Home Phone
Chinese Name                                               DOB                              Grade         School
Home Address
Mother’s Name                                      Day Time Phone                           Email
Father’s Name                                      Day Time Phone                           Email

5 Days Class              口 Full Day
                          口 Half Day               口 Morning Class
                                                    口 Afternoon Class
3 Days Class              口 Full Day
                          口 Half Day               口 Morning Class
                                                    口 Afternoon Class
2 Days Class              口 Full Day
                          口 Half Day               口 Morning Class
                                                    口 Afternoon Class
Talent Class              Ping         Chess       Dancing         Kung Fu      Gymanastic       Keyboard      Arts
$10/Each                  Pong
Register class for the week of:          口6/7-6/11     口6/14-6/18     口6/21-6/25    口6/28-7/2            口7/5-7/9
口7/12-7/16     口7/19-7/23     口7/26-7/30      口8/2-8/6    口8/9-8/13    口8/16-8/20
Are you interested at any other class that is not in the list above? Please describe ______________


      Lunch: bring own lunch or $15/wk or $4/meal

      * Class schedule and tuition maybe changed without notice.


      Refund Policy: Students requesting refund before semester begins, 100% of tuition will
      be refunded. There is no tuition refund after class started. Registration fee is non-
      refundable.

      Agreements: I, the undersigned, hereby agree that I will not hold Katy GT Academy, its
      officials, teachers and volunteers liable for any bodily injury and property damage I and
      my child/children may sustain by associating with and/or taking part in any of the
      activities sponsored by Katy GT Academy. Furthermore, I agree to be fully responsible
      for any repairs to damages resulting from my child's misuse of the facilities.

      Parents/Guardian Signature _________________                            Date ______________


                                              For Katy GT Academy Use Only
Date              Registration          Tuition    Talent   Field Trip Lunch                        Discount     Total
                  & Material                       Class

								
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