Child Registration

Family Information
Address *
Address
Weekday Phone Number *
Weekday Phone Number
Phone Number to use during Class Time *
Phone Number to use during Class Time
Student Information
Date of Birth *
Date of Birth
Emergency & Medical Information
Please enter Names and Phone Numbers of people allowed to pick up your child
New Student Information
Student’s First and Last Name
Student’s First and Last Name
Right to use images
I give consent for GLPOP to have my child(ren)/self participate in still photography or audio visual programming at Saturday Language Class events *
Agree *
By clicking I AGREE below I agree to comply with all the terms and conditions below