Apply for Early Summer Care AMERICAN KIDS Summer School Agreement You will find our AMERICAN KIDS Summer School Terms & Conditions below. Please read and AGREE to the Terms & Conditions before confirming your information. • According to the judgment of AMERICAN KIDS, inappropriate behavior or disturbances to other members or staff caused by a participant or the guardian of a participant, failure to comply with our school policies and noticeable damages may result in suspension from our activities or dismissal from AMERICAN KIDS. AMERICAN KIDS reserves the right to make judgment in such cases. Program fees will not be refunded. • AMERICAN KIDS will not be held responsible for medical information and illness (including allergy symptoms) not written in the participant's application. The same condition applies to food poisoning from foods participants bring from home. • Upon enrolling in AMERICAN KIDS program, participants have agreed to be accompanied by the staff in bus or car (or other modes of transportation) when participating in Outside Activity. (if the participant is a minor, the guardian has agreed to this.) • AMERICAN KIDS will not be liable for injuries or theft that occurs during participation in our programs. • The participant is personally liable for any injuries, trouble with other members, unpredictable accidents and damage due to natural disasters that occur during program activities. • We ask for complete cooperation during lessons and events in the classroom and may use pictures, videos, and comments for promotional purposes and materials to recruit new students even after you stop attendance at American Kids. AK Member/Visitor [required] select one AK Member Visitor Name of Child [required] ENGLISH Spelling Ex. John Smith Name of Child [required] Phonetics (in Katakana) Ex ジョン スミス Age [required] Ex. 3 years 5 months Date of Birth [required] [MM/DD/YYYY] Ex. 04/20/2001 Gender [required] select one Male Female Nationality [required] Ex. French, American, Chinese Current School [required] Ex. ______ International School, _______ Middle School Current Grade [required] International School Students must select the grade they completed in June. select one Preschool Pre Kindergarten Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade English Level [required] ・Conversation skill select one No experience Beginner Intermediate Advanced Fluent Native ・Academic select one No experience Beginner Intermediate Advanced Native Application for Weeks June 10(Mon)〜14(Fri) June 17(Mon)〜21(Fri) June 24(Mon)〜28(Fri) July 1(Mon)〜5(Fri) July 8(Mon)〜12(Fri) Application for 1 Day For 1 day applicants, please state which day(s) you would like to apply for. (July 20, 21, 22) Student’s Medical Information [required] Allergies, dietary restrictions, rashes, required medication, etc. (All medication required to be taken at school must be disclosed with the school in this section.) Name of Parent [required] Zip [required] Permanent Address [required] Phone [required] E-mail (computer) [required] Inquiry / Additional Information I agree with the Terms & Conditions [required] Agree