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The School of Italian Language and Culture wants to create a safe and comfortable classroom environment for your child. In support of that goal, we require that all parents of students in youth classes read and sign this form to ensure that we can safeguard and encourage learning in class. I, (parent's name) _____________________ would like to enroll my child, (student's name) _______________________ at the School of Italian Language and Culture. I understand that the School provides services to students at its own discretion and may refuse admittance or continuation of a student's participation at any time. I also understand that if a staff person at the School considers my child's behavior disruptive, I may be asked to remove my child from the classroom. In the event that the School decides to withdraw its services for any reason, I understand that I will be refunded a pro-rated tuition for the remaining classes not attended. I hereby certify, that my child meets the minimum age requirement of six years old and is adequately responsive to instruction to attend class and to attend to directions from staff. Signature: ________________________________________ Date: __________ Office use: Verification of age ___ Birth Certificate ___ Other (describe)
Scuola di Lingua e Cultura Italiana PO Box G, South San Francisco, CA 94083-1507 — (650) 574-3089 © 2010 Scuola di Lingua e Cultura Italiana All rights reserved. |
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