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Registration Form
Student’s Name: First Last: Grade: School: Home Address: Parents’ Names: Home Phone#: Emergency Phone #: Parent email address:
Please check the class your child will be in:
ð Fees due on or before first class date.
ð Refund policy: no refunds after the first class. If a class is missed, materials can be sent or can be picked up the next week; the student may come to a parallel class (if there is one) for a make-up; or the parent may request a partial credit towards a future session’s fees.
ð classes meet at: 5965 Almaden Expwy. #165, San Jose (Jumping Up Learning Center)
ð Teacher reserves the right to cancel or alter the hours of the class in the case of insufficient enrollment.
Signature: ________________________________ Date: _________________ (parent/ guardian ) For more information please contact:
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