Enrollment Form

Gabby's Classroom

ENROLLMENT FORM

All information entered on this form will be held confidentially and will only be used for administration and emergency purposes.

PERSONAL INFORMATION

Child's Legal First and Last Name （学员法定姓名）

Child's Date Of Birth（学员生日）

Child's Preferred Name（学员平时姓名）

Medications, Allergies, or Medical Impairments（有无药物，过敏注意事项）

Address（家庭具体住址）

Current Day Care/School（目前就读学校）

FAMILY INFORMATION

Parent 1 - First and Last Name（家长姓名）

Parent 1 - Phone Number（电话号码）

Parent 1 - Email Address（电子邮件）

Parent 2 - First and Last Name（家长姓名）

Parent 2 - Phone Number（电话号码）

Parent 2 - Email Address（电子邮件）

EMERGENCY DETAILS

Emergency Contact 1 - First and Last Name（紧急联系人）

Emergency Contact 1 - Phone Number（电话号码）

Emergency Contact 1 - Relationship to Child（与学员的监护关系）

Emergency Contact 2 - First and Last Name（紧急联系人）

Emergency Contact 2 - Phone Number（电话号码）

Emergency Contact 2 - Relationship to Child （与学员的监护关系）

MEDIA CONSENT: I grant consent for the documentation of my child's activities through the capture of photos and videos during class sessions as part of their enrollment in Gabby’s Classroom programs. This may include the recording of my child's complete facial features, either individually or alongside peers, as well as specific body segments such as hands, arms, back, or legs. I understand that the captured content may be utilized in social media, advertisements or local posts for Gabby's Classroom. I acknowledge my responsibility to make a specific request if I do not agree with this consent.

PROGRAM CONSENT: I acknowledge that there are certain risks, known or unknown, during class sessions. By enrolling my child in Gabby's Classroom program(s), I have knowingly and voluntarily decided to assume the risks of these inherent dangers in consideration of Gabby's Classroom's permission to allow my child to participate in all programs. I, individually and on behalf of my child, hereby release and discharge Gabby's Classroom from any and all negligence, including building defects, common area liabilities, or Gabby's Classroom's own negligence, in connection with my child's attendance at or participation in the program(s), including travel to and from Gabby's Classroom, except for any gross negligence or willful and wanton misconduct on the part of Gabby's Classroom. I understand that students are expected and required to follow the directions of all teachers and to be respectful towards others. Parents are expected to act on feedback given and be receptive to feedback regarding their child's behavior and participation in the program.

OUTDOOR CONSENT: I grant permission for my child to participate in local outings and outdoor learning organized by Gabby's Classroom, including visits to the park. I understand that adequate supervision and safety measures will be maintained. I acknowledge and understand the potential risks, releasing Gabby's Classroom, its staff, and representatives from liability, except for instances of gross negligence or willful misconduct. I also affirm my responsibility for ensuring my child is prepared for outings and understands safety guidelines.

Parent/ Guardian's Full Name (家长姓名)

Parent/ Guardian's Signature (家长签字)

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