Sleepy Tigers CILC Summer School

Sleepy Tigers Chinese Immersion Learning Center Summer School

(Enrollment opens on Feb 6th 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*

MaleFemale
Child 1 Birth Date*

MonthDayYear
Entering Grade *
School Attending
Name of Child 2

First NameLast Name
Child 2 Gender

MaleFemale
Child 2 Birth Date

MonthDayYear
Entering Grade
School Attending
Home Language*

MandarinCantoneseEnglishSpanishFrenchGermanArabicRussianOther 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)
Week 1: 6/12-6/16

MondayTuesdayWednesdayThursdayFriday
Week 2: 6/19-6/23

MondayTuesdayWednesdayThursdayFriday
Week 3: 6/26-6/30

MondayTuesdayWednesdayThursdayFriday
Week 4: 7/5-7/7

WednesdayThursdayFriday
Week 5: 7/10-7/14

MondayTuesdayWednesdayThursdayFriday
Week 6: 7/17-7/21

MondayTuesdayWednesdayThursdayFriday
Week 7: 7/24-7/28

MondayTuesdayWednesdayThursdayFriday
Week 8: 7/31-8/4

MondayTuesdayWednesdayThursdayFriday
Week 9: 8/7-8/11

MondayTuesdayWednesdayThursdayFriday
Week 10: 8/14-8/18

MondayTuesdayWednesdayThursdayFriday
Week 11: 8/21-8/25

MondayTuesdayWednesdayThursdayFriday
Comment:
Starting Date*

MonthDayYear
Date
General Information
Lunch Option*

Home LunchSchool Lunch $7.00/meal
Payment Schedule*

Once a month on the 1st of each month
Tuition:*

School Age K-5, $60/day (with minimum age requirement of currently in Kindergarten, entering 1st grade in the upcoming fall)
Referral by a family form Sleepy Tigers. The Child's Name:
Home Phone*

Area CodePhone Number
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: 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 Contact Person (other than parents, you must provide two)
Emergency Contact: Same as Above

YesNo (please enter information below)
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: *

Clear
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:

Clear
Photo Release: Frequently we use photos of Sleepy Tigers Chinese Immersion Learning Center students in our school publications, flyers, advertisement 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:

Clear
Sunscreen / Cream 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 and will make every effort to apply sunscreen / cream before my child arrives at school.
Sunscreen / Cream Permission:

Clear
*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.

YesNo
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.*

YesNo
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.
*

I/we understand that I/we must provide a completed medical form to the school.
Health Care Summary
Immunization Record
*

I/we understand Winter, spring & summer breaks, holidays and absence will be charged at full tuition for Preschool, Pre-K program. Summer school / Schoool Age Care is charged for the days I have registered.
*

I/we understand payment is due on 1st of each month. Late fee or returned / denied payment fee due to insufficient fund is $25.
*

I/we understand the late pickup fee (after 5:30pm) is $1 per minute.
*

I/we understand a $10 fee will be charged for each time switching or changing attendance schedule.
*

I/we understand the vacation policy.
*

I/we understand that I/we can change lunch option on a monthly basis, I/we need to notify school before the 20th of each month for the following month lunch option change.
*

I/we understand the illness policy.
*

I/we understand the behavior policy and I/we have read and shared the preschool rules with my/our child/children.
*

I/we have read and understand the photograph policy.
*

I/we have read and understand the field trip policy.
*

I/We understand there is 15 days advanced notice to withdraw from the program.
Signature of Parent/Guardian*

Clear
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

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

Sleepy Tigers Chinese Immersion Learning Center Summer School

Acknowledgement