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AFTER SCHOOL PROGRAM
REGISTRATION FORM

* Please contact us to check availability before making any payments. Thank you! *

Parent's Information

Child's Information

If more than one child, add additional information to each section separated with a comma (ex: Maya, Liam)

Spanish speaking level

After Spanish class, my child will:

I hereby give my permission to Creative Spanish to use my child’s image. I agree that Creative Spanish (CS) may use my child’s image only on CS materials or written promotions, including but not limited to the CS web site. I can retract my permission in writing at any time. 

Other Emergency Contact

Monthly Payment (After School Program):
Payment due by the 5th of each month.

 

Class hours: 3:30pm - 5:30pm


* Two hour class/ once a week:     $150

* Two hour class/ twice a week:     $300  

* Two hour class/3 times a week:  $400 

* Two hour class/4 times a week:  $450 

* Two hour class/4 times a week:  $550

Extended Care available for $15/hr (starting at 2pm, ending at 6 pm)

Make payments to:
Zelle: 925 234 0989 (Juliana Romero)

or paypal.me/creativespanish

Thanks for submitting!

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