Adult Registration

Student Information

First Name

Last Name

Email

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Weekday Phone Number

(###)

###

####

Emergency and Medical Information

Do you have any medical conditions you would like us to be aware of?

Emergency contact name and phone number

New Adult Student Information

Please describe any exposure you have had to the German language.

Is there any particular need regarding your learning style that we need to know about?

Right to use images

I understand that the GLPOP may produce or have students participate in still photography or audio visual programming. As the Adult Student, I hereby consent to the use of photographs and audio visual programming taken during the course of the Saturday Language Program year for publicity, promotional, and/or education purposes (including publications, presentations or other media sources). I do this with full knowledge and consent and waive all claims for compensation for use or for damages.

Yes, I give consent for GLPOP to self-participate in still photography or audio visual programming at Saturday Language Program events

No, I do not consent GLPOP to self-participate in still photography or audio visual programming at Saturday Language Program events

Liability Waiver

GLPOP is part of The German American Society, a non-profit public benefit organization. As a condition of enrollment I agree to the following: I understand and agree, as a condition of being accepted at GLPOP, that I shall not hold liable the GLPOP or The German American Society, their directors, teachers, employees, officers, volunteers or agents for any injury which may occur in connection with any activity of the GLPOP before, during, after hours or involving any event, gathering, or occasion that I or my children attend as a result of connection with the GLPOP.

I Accept

Enrollment

I have read and fully understand the GLPOP Registration Contract and GLPOP Guidelines, including the Liability Waiver. I am aware that by signing, I have agreed to assume full legal liability for all risks involved in participation in the GLPOP program and have waived certain legal rights. I agree to pay the full tuition required for my participation in the GLPOP program. I understand that the GLPOP reserves the right to refuse admittance to any adult student and to suspend any adult student at any time if the adult student's behavior justifies such action. I agree to abide by the rules, guidelines and regulations of the GLPOP.

By clicking on ACCEPT below, I agree to honor all the terms and conditions in this document.

I Accept