小博士教育中心
Education Center
First Name (名):
________________________________
Last Name (姓):
________________________________
Date of Birth (生日):
________________________________
Grade (年级):
________________________________
Email (电邮):
________________________________
School (学校):
_____________________________
Start Date (开始日期):
________________________________
________________________________
Parent Information
First Name (名):
________________________________
Phone (电话):
________________________________
Address (地址):
________________________________
Emergency Contact
First Name (名):
________________________________
Phone (电话):
________________________________
Address (地址):
________________________________
Name of child’s Physician (家庭医生姓名):
Student Information
[Insert Student Photo Here]
________________________________
Care Card Number (医疗卡):
________________________________
Allergies (过敏症):
________________________________
________________________________
Last Name (姓):
________________________________
Email (电邮):
________________________________
City (城市):
________________________________
Last Name (姓):
________________________________
Email (电邮):
________________________________
City (城市):
________________________________
Physician’s number (家庭医生电话):
________________________________ ________________________________
The Agreements

I Agree to the following:

1) That all rules will be obeyed and that I will take full responsibility for the any breaking of rules.
凡在此读书的学生及学生家长都将遵守本校校规,如有违规者后果自负。
2) That tuition will be paid on a monthly, semester or yearly basis prior to the start of class and that
either you or we may terminate this Agreement with a written notice one month prior to the
termination date. Should there be a breach of contract; the party responsible will pay the
amount equalling one month’s tuition to the center as penalty.
每月最后一个星期，请预缴下个月的学费。退学通知请提前 1 個月以书面通知,否则视为
无效。 所产生的学费, 请照常支付。
3) Make up classes are only available when 24-hours notice has been given for any missed lessons.
Any fees or tuition generated from the missed class must be paid regardless. 24 小时前通知，
学校将择日补课, 否则视为无效, 所产生的学费, 请照常支付。
4) Only 2 make up lessons are offered for each 3 month term. 3 个月内可以有两次补堂。
5) The student will bring their own notebooks, sketchbook and/or other writing utensils to class. 文
具自备。
6) That I allow my child to receive medical attention and be taken to the hospital in case of
emergency if I/We cannot be reached. I understand that any expenses incurred for such
treatment, including ambulance fees, is my responsibility.
学生如有突然出现的健康问题,无法联系到家长的情况下,本中心有权让学生得到及时的医

治(如送急症室等)而所产生的费用家长自负。
7) That any accidents or injuries within the center leading to monetary compensation will be
handled and paid for solely by a third party, The Insurance Company.
在校期间如发生任何的意外或损伤,则由保险公司负责所有赔偿,本公司将不承担任何额外
赔偿。
8) That I allow my child to be photographed while participating in the programs offered by the
Center for the purpose of display or usage within the classrooms, or published in the local
newspaper, on the Center website or other advertisement.
接受拍照,用于本中心宣传用途。
9) That I agree to allow Wisdom Honor Education to send notifications, advertisements, and / or
others of similar nature to me via email or other forms of contact.
接受使用電郵或其它联络方式收取本中心各类资讯。
10) That the center reserves the right to amend The Agreements from time to time.
 我们学校将保留对条款更改的权利。
*所有条款内容，均以英文为准并具法律效力。

Name: ____________________ ________________

Date: (yy/mm/dd)
Signature: ____________________