Registration Form for After School Spanish at Discovery Charter for Grades 1st-8th

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Please register your child for After-School Spanish Enrichment using this form. Cost for the 11-week class is $440 per child. Early Bird Registration Discount is $385. This fee includes all materials. You can pay online or mail a check to:

Habla Language Services
966 Whitethorne Drive
San Jose, CA 95128

Use the link https://squareup.com/store/habla-language-services to pay with credit card. Please be sure to select the correct class when paying as the spots are inventoried.

There are limited spots. You must pay in order to be registered. The first 20 who pay will be registered. After that, we will take a waiting list from your form here.

Once you are registered, please complete this waiver. Feel free to email Gina Covello at gina@HablaLS.com if you have any questions.

Email *

Primary Contact Name *

Primary Contact Phone Number *

Relationship to student

Secondary Contact Legal Name and Phone Number

Can Secondary Contact pick up student

Yes

Student's Legal Name *

Student Grade Level *

Does your child have any learning challenges? If so, please explain. *

Does your child have any allergies? Any alerts we should know about? Also, do you have any objections to our giving them an occasional treat such as candy, popcorn, granola bar. *

Please indicate how your child will be picked up after the class: *

Parent or other adult will come to pick up

Child will go to Afterschool Care

Other:

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