2024-2025 RALC After-school Registration Form
                                          Aug 26, 2024 - June 12, 2025   │ Mon-Fri (2:30-6:00pm)
Sign in to Google to save your progress. Learn more
Email *
Student First Name *
Student Last Name
*
Student Chinese Name
Gender *
Age *
Birthday *
MM
/
DD
/
YYYY
School Name: *
Grade (as of 2024-2025) *
Primary Language *
Secondary Language
Mother's Name *
Mother's Phone Number *
Mother's Email *
Father's Name *
Father's Phone Number *
Father's Email *
Home Address *
Health Care Provider & Phone *
Special Care or Additional Notes (i.e. Allergies)
Emergency Contact Name & Phone *
Persons authorized to pick up your child other than parents:
Days of Attendance (please check boxes to indicate days desired) *
PART TIME--Please select days:
Transportation Options *
2024-2025 After School Daily Schedule
2024-2025 After School Tuition and Fees
Payment Method
To secure your spot,  registration fee (if applicable) and deposit must be paid in full by April 1, 2024 via Zelle, check, PayPal or credit card. The website for payment is http://www.ralcnc.org/payment.html.
One-Year Contract Agreement
I acknowledge that I am signing a one-year contract with RALC. The entire remaining balances for the school year will be charged if a 2-week written notice is not given. Early withdrawal due to any reason will be subject to appropriate fees as explained in TUITION & FEES section.
Permission & Liability Waiver
My child(ren) has my permission to fully participate in RedApple Learning Campus (RALC) after-school activities during 2024-2025 school year. I, as parent/legal guardian, agree to hold harmless RALC and its staff from liability resulting from any accidents and injuries occurring during after-school hours. I hereby grant permission for the RALC staff to take whatever steps may be necessary to obtain emergency treatment for my child. These steps may include: 1) call the parents; 2) contact the Emergency contacts listed on the registration form; 3) call paramedics or the child’s health care provider. Staff will call 911 if parents, emergency contacts, and the child’s physician cannot be reached.
I understand that RALC and staff will not be responsible for anything that may happen as a result of false information provided by parents. I have carefully read and understand all of the above terms and conditions. Prior to signing this agreement, I have had an opportunity to ask any questions. I am aware that by signing this form, I assume all risks and waive and release all substantial rights that I may have and possess.
Photography and Publicity Release
I authorize RALC to use a photography or other image of my child for public relations purposes connected to RALC programs only. I understand that my child’s name will not be published with an image.

Review & Confirm *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy