Parent's First Name Parent's Last Name Student's First Name Student's Last Name Address City State AL AK AR AZ CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code Phone (Home) Phone (Alternate) Email (One per Family) Select Program Legegruppen (0-3yrs) FREE Leg & Lær (3-4yrs) $440 full year ($220 per semester) Lær & Leg (5-8yrs) $596 full year ($298 per semester) Lær så Mer (9+) $596 full year ($298 per semester) I apply for scholarship Please give a reason... Select Payment Option Full year Per semester (two payments) None (I only apply for scholarship) None (free fourth family member and up) Discounts (If eligible and select only one) $25 Family Discount per Additional Family Member $25 Sponsor Discount 50% Assistant Teacher Discount (Learn more ) 100% Primary Teacher Discount (Learn more ) I understand that a $25 supply fee per child per semester applies (waived when paying for full year) Yes No Sibling/Family Member Name Name of Sponsor Student's Date of Birth mm-dd-yyyy Student is a Boy Girl Student's Language Spoken at Home Has the student ever lived in Denmark? If yes, how long? Please evaluate child's proficiency in speaking Danish beginner intermediate advanced Please evaluate child's proficiency in writing Danish beginner intermediate advanced Please evaluate child's proficiency in reading Danish beginner intermediate advanced Emergency Contact Name Phone (home) Phone (cell) Authorized Pick-up Release Student's photo for school web site and other marketing materials Yes No Special needs (including food allergies etc.) Comments
PAYMENT AGREEMENT AND LIABILITY WAIVER. I, THE UNDERSIGNED, AGREE TO PAY VIKINGESKOLEN FOR THE ABOVE DESCRIBED SERVICES. THE UNDERSIGNED AGREES THAT ALL CLASSES ARE NON-TRANSFERABLE TO OTHER PERSONS OR TO FUTURE SEMESTERS OF VIKINGESKOLEN. THE UNDERSIGNED AGREES THAT ALL USE OF VIKINGESKOLEN’S FACILITIES BY THE UNDERSIGNED AND THE UNDERSIGNED’S CHILDREN SHALL BE UNDERTAKEN AT HIS/HER SOLE RISK AND VIKINGESKOLEN SHALL NOT BE LIABLE FOR ANY INJURIES OR DAMAGES TO HIM/HER, HIS/HER CHILDREN OR HIS/HER PROPERTY OR BE SUBJECT TO ANY CLAIMS, DEMANDS, INJURIES OR DAMAGES WHENEVER OCCURRING,INCLUDING BUT NOT LIMITED TO, THOSE DAMAGES OR INJURIES RESULTING FROM THE ACTIVE OR PASSIVE NEGLIGENCE ON THE PART OF VIKINGESKOLEN, ITS OFFICERS, AGENTS, ADMINISTRATORS AND ASSIGNS. THE UNDERSIGNED, FOR HIMSELF/HERSELF AND ON BEHALF OF HIS/HER CHILDREN PARTICIPATING IN VIKINGESKOLEN, DOES HEREBY EXPRESSLY FOREVER RELEASE AND DISCHARGE VIKINGESKOLEN, ITS SUCCESSORS AND ASSIGNS, AS WELL AS ITS OFFICERS, ADMINISTRATORS AND AGENTS, FOR ANY AND ALL SUCH CLAIMS, DEMANDS, INJURIES, DAMAGES AND CAUSES OF ACTION THAT MAY ARISE FROM THE UNDERSIGNED’S AND THE UNDERSIGNED’S CHILDREN’S PARTICIPATION IN VIKINGESKOLEN.
I have read and agree to the terms & conditions above yes no