Completing this form does not guarantee your spot in our after-school program, but it will guarantee you to get on the waiting list. A registration confirmation will be sent to you within 3 business days if we have space for your child. Thank you!

See Details of Quentz After-School Program

Sign Up for After School(see Tuition&Fees here). Don't forget to check out our Promotions first.

Child's First Name (required)

Child's Last Name (required)

Child's Nick Name (optional)

Child's Birthday (required)

FemaleMale

Current School

Current Grade

Mom's Name (required)

Mom's Phone (required)

Mom's Email (required)

Dad's Name (required)

Dad's Phone (required)

Dad's Email (required)

Address

Signing Up for
Full-time (M-F)4-day/week3-day/week2-day/week1-day/weekSame-day Arrangement

Does your child need to be picked up from school by Quentz?
YesNo

Please list any allergies or medical conditions that Quentz Bilingual Academy should be aware of:

Please do not send your child to our school with a fever or bad cough. Germs spread quickly through the classroom and we want to try and reduce as much illness as possible. If your child must miss our school due to illness, we will save any important work for your child for when he/she returns. No Child with a fever of 101F or above is allowed to stay in our school. Physician to be called, if needed, in emergency (we will call 911 when necessary)

Doctor's Name (required)

Doctor's Phone (required)

When would you like your child to start

Are you flexible on the start date (Your child will have a better chance to get in if you are flexible on the start date)
YesNo

What would you like your child to accomplish through the After School Program

How did you hear about Quentz bilingual? (Required)
Registered with Quentz Bilingual beforeFrom someone (please enter the name in the following question)From a web searchFrom a local magazineFrom other (please specify below)

Enter the name of the person who referred you or if you choose "From other", please specify

If you have a promotional code, enter here

Name/s of Authorized Person/s to Pick Up Child (required)

Quentz Bilingual Academy teachers occasionally take photographs or videos of students in the classroom.
Yes, I give my permission for my child to be photographed or videotaped during activities at Academy or on field trips.No, I do not want my child photographs to be taken.

Cancellation and Refund Policy: No refunds after used classes. No Refunds for individual missed classes.
I understand and accept the cancellation policy.

I/We, on behalf of myself and my minor child, agree to release, hold harmless and indemnify Quentz Bilingual Academy, their employees, officers and agents, from any loss, cost, damage, accident, illness, or death occurring and/or expense of any nature, including all attorneys’ fees and costs which I or my child may have resulting, either directly or indirectly, from my child’s participation in Quentz Bilingual Academy's curricular programs or activities.
I/we acknowledge that we have read and understand this document and accept the risk and responsibility.

When you click on the button below, you will receive an email confirmation. Please follow the instructions in the email to complete the registration.