Babies & Toddlers - Registration Form

Parent 1 Name *
Parent 1 Name
Phone 1 *
Phone 1
Cell phone for text messages *
Cell phone for text messages
Please inform a cell phone # at which you can be reached in case we need to reschedule a session
Parent 2 Name
Parent 2 Name
Phone 2
Phone 2
Address *
Child's 1 Name *
Child's 1 Name
Child's 1 Date of Birth *
Child's 1 Date of Birth
Child's 2 Name
Child's 2 Name
Child's 2 Date of Birth
Child's 2 Date of Birth
I do hereby release (for myself, my executors and administrators) and wave any and all rights to claims for damages arising from illness, accident or occurrence caused by or as a result of my child’s participation or connection with Brazil Ahead (Brazil Ahead Language School, Inc.), its instructors, agents, representatives and/or facilities. Brazil Ahead Language School, Inc. shall not be held responsible by me for any loss or theft of my or my child’s personal items.
I authorize Brazil Ahead to photograph, videotape or interview my child(ren) and to use such photos, videos or interviews, in some of its promotional materials, including web sites, Facebook pages and newsletters, flyers, posters and newspapers (when in group photos) and other materials in print, audio, electronic or visual media. In addition, I voluntarily waive any right, cause of action or demand of any kind whatsoever resulting from Brazil Ahead’s photograph or interview of my child(ren) from which any liability may or could accrue to Brazil Ahead. I also understand that Brazil Ahead will not give me or my child(ren) any compensation for using my child(ren)’s photograph or interview in its promotional materials. Thus, by signing this document, I waive any rights to any compensation now or in the future.
I have read the school policy below and agree to the terms and conditions contained in the policy. I am aware that the schedule I have chosen is subject to change and classes are not confirmed until at least four (4) students are enrolled.