Homeschool Collective Registration Form

Spanish class at Tabor Space on Thurs. 1-2pm, Jan 21st-Mar 10th 2016

Student 1: Name *

First & Last Name

Age *

Birth Date *

Month

Day

Year

Student 2: Name

First & Last Name

Age

Birth Date

Month

Day

Year

Are you applying for Fossil funds? *

Parent/ Guardian Name(s) *

Email Address: *

Phone (Best): *

Phone (Alternative):

Street *

City *

State *

Zip *

Other person authorized to pick up student after class:

Relation:

Do you have any comments about your child's learning style or particular interests regarding Spanish language acquisition?

Please list any relevant medical conditions or special needs your child has:

COURSE POLICIES

Refund Policy:
Due to the organizational effort of creating group classes and the need to ensure enough students will participate to hold the class, your payment is refundable minus a $30 administrative fee only with notice of a minimum of 14 calendar days before the start date of the class. We are not able to provide any refunds less than 14 days before the start date or after the class has begun. Group classes require a minimum of 7 students to take place; in the event that there are not enough students registered, a class may be cancelled and parents will be refunded in full.

Severe Weather Policy:
Tierra will cancel classes when PPS and local colleges decide to close due to inclement weather. In this event, we will post a closure notice on our website and will make every effort to contact all students affected. There will be no refunds or pro-rated discounts or credits for cancellations due to weather. We will do our best to schedule a make-up class, however because of schedule constraints, this cannot be guaranteed - we appreciate your understanding.

Pick-up/Drop-off Policy:
Class begins promptly at 1:00pm, please wait outside the room with your child if you arrive before that time. The instructor will escort your child to the Vibe Art Studio at 2:00pm unless you arrive at that time for pick up.

Photo Policy:
Tierra reserves the right to take photos of children's classes and to use these photos on our website and in promotional materials. If you have any questions or concerns about this policy, please let us know.

Absence Policy:
Spanish classes cannot be made up; however, please notify Tierra at (503) 213-3677 or info@tierracenter.com if your child has to miss a class. This notice allows the teacher to better prepare for the class, and assures us that your child is safe.

CONSENT AND LIABILITY RELEASE

I, the undersigned being the lawful parent or guardian of the above declared child, hereby consent to the participation
by the child in the Tierra Educational Center After-school Spanish Class (“program”) at Tabor Space.

The undersigned hereby further releases and holds harmless Tierra Educational Center LLC, and its owners, directors,
officers, advisors, employees, agents, instructors, volunteers and all other persons or entities acting for them from any
and all claims, demands, suits, cost and charges, arising out of or in any way connected with her/his participation in this
program, including but not limited to, personal injury, bodily harm, injury, or property damage occurring while
participating in the program’s activities.

Acceptance *

I have read and agree with the course policies and consent and liability release above.

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