Child’s Registration

Please complete the form and press submit at the bottom of the form.We ask you to fill a new registration form for every program you enrol your child in.
Pick the program : *
Pick the day: *

Student's Information

Name: *
Birth Date Y-M-D *
Gender *
Grade *
School Name and Program enrolled in (French Immersion, Regular track...)
Does your child have any allergies(s) /health conditions? Is your child on any medication? (If yes, please specify) *
Doctor's Name
Doctor's Phone

Parent/Guardian Information

Mother's Full Name *
Father's Full Name *
Home Phone
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Cell Phone number where we can easily reach you. *
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E-mail Address. IMPORTANT: All program related updates will be sent to this email. *
Additional Phone Number
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Home Address *
How did you hear about us? *

Emergency Contacts

Emergency Contact's Name 1 *
Phone *
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Relationship to the child *
Emergency Contact's Name 2
Phone
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Relationship to the child

Release of Liability & Medical Emergency

Release of Liability As the legal parent or guardian, I release and hold harmless to the business doing business as My French Club Inc, its owners, operators and franchisor from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of My French Club Professionals, its owners and operators or on route to or from any of said premises.
Medical Emergency The undersigned gives permission to the business doing business as My French Club Inc, its owners, operators and franchisor from any and all liability to seek medical treatment for the participant in the event they are not able to reach a parent or guardian.I understand that every effort will be made to contact me first in the event that such an emergency takes place. The participants are responsible for their own medical coverage. I hereby declare any physical/mental problems, restrictions, or condition and/or declare the participant to be in good physical and mental health.
I have read and understood the terms listed under the title "Release of Liability & Medical Emergency" *

Miscellaneous

My French Club Inc. is not responsible for lost or stolen articles. Parents, please pack nut-free snacks for any programs longer than 2 hours unless advised otherwise.
I give permission to My French Club Inc. to take pictures or videos of my child and use them in their publicity. *

Cancellation and Refund Policy

NO REFUNDS OR CREDITS for cancellations made less than 4 weeks prior to the scheduled start of the program. If the cancellation is made more than 4 weeks prior to the start of the program, a full refund will be provided less a $50.00 administration fee. All cancellations, including those for medical reasons, are subject to a $50.00 administration fee. All cancellation requests must be received by email at admin@myfrenchclub.ca. The cancellation date will be determined based on the date of the receipt of your email. My French Club Inc. reserves the right to withdraw your child from the program for any behavioral or health concerns that may cause harm to himself or others. There will be no refund for the remaining classes. French Tutoring: Changes to the scheduled tutoring program will require a 24 hour notice. If a notice is not provided, you will be charged for the allotted time. If you decide to discontinue the program, there will be no refund for the remaining classes. A $35 fee will be charged on all NSF cheques and registration will be cancelled.

Signature

All information on this application form is strictly confidential and will only be used for administrative purposes by My French Club Inc. By completing this document, you are consenting that the information provided above is true and accurate.
I have read and understand the terms of this contract *
Parent's/Guardian's Electronic Signature *
Date
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Registration to any program is confirmed once payment is received. If you haven't processed your payment yet, it is time to do so ! Go to the program page, pick the right program and you will be able to process your payment via different methods of payments. Thanks

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