Sleepy Tigers CILC Summer School

Sleepy Tigers Chinese Immersion Learning Center Summer School

(Enrollment opens on Feb 8th for K-5 students. Students need to be at least 5 years old, currently in Kindergarten, entering 1st grade in the up coming fall.)
Name of Child 1

First NameLast Name
Child 1 Gender
Child 1 Birth Date

MonthDayYear
Entering Grade
School Attending
Name of Child 2

First NameLast Name
Child 2 Gender
Child 2 Birth Date

MonthDayYear
Entering Grade
School Attending
Name of Child 3

First NameLast Name
Child 3 Gender
Child 3 Birth Date

MonthDayYear
Entering Grade
School Attending
Home Language
We celebrate (holidays):
Please share more about your child and your family:
Sibling 1

First NameLast Name
Birthdate

MonthDayYear
Sibling 2

First NameLast Name
Birthdate

MonthDayYear
Sibling 3

First NameLast Name
Birthdate

MonthDayYear
Summer School Schedule Request

(minimum 3 days a week, and 4 consecutive weeks. 3 days a week needs to include a Monday or Friday)
Week 1: 6/8-6/12
Week 2: 6/15-6/19
Week 3: 6/22-6/26
Week 4: 6/29-7/3
Week 5: 7/6-7/10
Week 6: 7/13-7/17
Week 7: 7/20-7/24
Week 8: 7/27-7/31
Week 9: 8/3-8/7
Week 10: 8/10-8/14
Week 11: 8/17-8/21
Comment:
Starting Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
General Information
Lunch Option
Payment Schedule
Tuition:
Referral by a family form Sleepy Tigers. The Child's Name:
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Guardian 1’s Name

First NameLast Name
Cell Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
E-mail
example@example.com
Employer
Guardian 2’s Name

First NameLast Name
Cell Phone

Area CodePhone Number
Work Phone

Area CodePhone Number
E-mail
example@example.com
Employer
Persons Authorized to pick up your child (other than parents, you must provide two)
Authorized Pick Up 1: Name

First NameLast Name
Relationship
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
example@example.com
Authorized Pick Up 2: Name

First NameLast Name
Relationship
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
example@example.com
Emergency Contact Person (other than parents, you must provide two)
Emergency Contact: Same as Above
Name

First NameLast Name
Relationship
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Name

First NameLast Name
Relationship
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Emergency: In case of an emergency or serious illness, when parents cannot be reached immediately, I hereby authorize Sleepy Tigers Chinese Immersion Learning Center to obtain emergency medical care and/or provide emergency medical transportation for my child.
Emergency:
Transport: I hereby give the provider permission to transport my child in the vehicle provided by Sleepy Tigers on field trips, with written permission in advance.
Transport:
Photo Release: Frequently we use photos of Sleepy Tigers Chinese Immersion Learning Center students in our school publications, flyers, advertisement, social media and on our website. Unless you notify us at info@sleepytigers.com or 612-568-8819, photos of your child may be included in these publications.
Photo Release:
Sunscreen / Cream / Bug Repellent Permission: I give Sleepy Tigers Chinese Immersion Preschool permission to administer sunscreen to my child. I will provide sunscreen with my child’s name written on the bottle. I will verbally notify the Teacher/Director when my child needs sunscreen / cream / bug repellent and will make every effort to apply sunscreen / cream before my child arrives at school.
Sunscreen / Cream Permission:
*This form must be completed for up to two children enrolled and must be reviewed annually by the parent/guardian, and any changes noted.
Primary Health Care Provider:
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
If unavailable, another licensed Physician may treat my child.
Dentist:
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
If unavailable, another licensed Dentist may treat my child.
Parent/Guardian Insurance Company:
Phone Number

Area CodePhone Number
Group #
List any allergies or health concerns:
AUTHORIZATION: We the undersign hereby agree by the arrangements and authorization to state above. We have discussed the information required in rule part 9502.0405.
Acknowledgement
- It is my/our desire to have my/our child/children enrolled in the preschool / pre-K program at Sleepy Tigers Chinese Immersion Learning Center. I/We have received/viewed the parent handbook. I/We also understand that my/our child is being accepted on a month trial basis. During this time, the staff will make observations and evaluations pertaining to the child’s ability to adapt to the school surroundings. Unless otherwise notified, the child/children will be accepted and permanently enrolled. I/We further understand that if the policies outlined in this handbook were not adhered to, it would be sufficient cause for the removal of the child/children from the program.
  
  I/We also agree to give a minimum of one month written notice of my/our intent to withdraw my/our child/children from the program. If one month notice is not given, I/we agree to make full tuition payment for the final month.
Health Care Summary

Upload a File

Cancelof
Immunization Record

Upload a File

Cancelof
Signature of Parent/Guardian
Date

MonthDayYear

Non-refundable registration fee $80 per child. (please note we are unable to hold the spot until registration fee is received.)

Registration Fee$80.00

Quantity

Total $0.00

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Should be Empty:

Sleepy Tigers Chinese Immersion Learning Center Summer School

Acknowledgement

Non-refundable registration fee $80 per child. (please note we are unable to hold the spot until registration fee is received.)