{"id":388,"date":"2015-12-30T03:20:51","date_gmt":"2015-12-30T03:20:51","guid":{"rendered":"http:\/\/quentz.org\/school\/?page_id=388"},"modified":"2018-01-22T04:26:27","modified_gmt":"2018-01-22T04:26:27","slug":"afterschool-registration","status":"publish","type":"page","link":"https:\/\/quentz.org\/school\/afterschool-registration\/","title":{"rendered":"Afterschool Registration"},"content":{"rendered":"<body><p><strong><em>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\u00a0within 3 business days if we have space for your child. Thank you!<\/em><\/strong><\/p>\n<p>See Details of <a href=\"http:\/\/quentz.org\/school\/after-school-camp\/\">Quentz After-School Program<\/a><\/p>\n<p>See Tuition&amp;Fees <a href=\"http:\/\/quentz.org\/school\/fees\/\" target=\"_blank\" rel=\"noopener noreferrer\">here<\/a>. Don\u2019t forget to check out our <a href=\"http:\/\/quentz.org\/school\/promotions\">Promotions<\/a> first.<\/p>\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f796-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"796\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/school\/wp-json\/wp\/v2\/pages\/388#wpcf7-f796-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"796\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f796-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<p>Child's First Name (required)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"first-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"first-name\" \/><\/span>\n<\/p>\n<p>Child's Last Name (required)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"last-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"last-name\" \/><\/span>\n<\/p>\n<p>Child's Nick Name (optional)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"nick-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"nick-name\" \/><\/span>\n<\/p>\n<p>Child's Birthday (required)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"date-birth\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"xxxx-xx-xx (year-month-day)\" value=\"\" type=\"date\" name=\"date-birth\" \/><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"radio-sex\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"radio-sex\" value=\"Female\" \/><span class=\"wpcf7-list-item-label\">Female<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"radio-sex\" value=\"Male\" \/><span class=\"wpcf7-list-item-label\">Male<\/span><\/span><\/span><\/span>\n<\/p>\n<p>Current School\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"school\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"school\" \/><\/span>\n<\/p>\n<p>Current Grade\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"grade\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"grade\" \/><\/span>\n<\/p>\n<p>Mom's Name (required)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"mom-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"mom-name\" \/><\/span>\n<\/p>\n<p>Mom's Phone (required)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"tel-mom\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"xxx-xxx-xxxx or xxxxxxxxxx\" value=\"\" type=\"tel\" name=\"tel-mom\" \/><\/span>\n<\/p>\n<p>Mom's Email (required)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"mom-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"mom-email\" \/><\/span>\n<\/p>\n<p>Dad's Name (required)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"dad-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"dad-name\" \/><\/span>\n<\/p>\n<p>Dad's Phone (required)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"tel-dad\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"xxx-xxx-xxxx or xxxxxxxxxx\" value=\"\" type=\"tel\" name=\"tel-dad\" \/><\/span>\n<\/p>\n<p>Dad's Email (required)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"dad-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"dad-email\" \/><\/span>\n<\/p>\n<p>Address\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"mom-address\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"mom-address\" \/><\/span>\n<\/p>\n<p>Signing Up for<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"radio-590\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"radio-590\" value=\"Full-time (M-F)\" \/><span class=\"wpcf7-list-item-label\">Full-time (M-F)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"radio-590\" value=\"4-day\/week\" \/><span class=\"wpcf7-list-item-label\">4-day\/week<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"radio-590\" value=\"3-day\/week\" \/><span class=\"wpcf7-list-item-label\">3-day\/week<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"radio-590\" value=\"2-day\/week\" \/><span class=\"wpcf7-list-item-label\">2-day\/week<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"radio\" name=\"radio-590\" value=\"1-day\/week\" \/><span class=\"wpcf7-list-item-label\">1-day\/week<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"radio-590\" value=\"Same-day Arrangement\" \/><span class=\"wpcf7-list-item-label\">Same-day Arrangement<\/span><\/span><\/span><\/span>\n<\/p>\n<p>Does your child need to be picked up from school by Quentz?<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-52\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"checkbox-52\" value=\"Yes\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"checkbox-52\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p>Please list any allergies or medical conditions that Quentz Bilingual Academy should be aware of:\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"med-condition\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"med-condition\"><\/textarea><\/span>\n<\/p>\n<p>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)\n<\/p>\n<p>Doctor's Name (required)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"doc-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"doc-name\" \/><\/span>\n<\/p>\n<p>Doctor's Phone (required)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"tel-doc\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-tel wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"xxx-xxx-xxxx or xxxxxxxxxx\" value=\"\" type=\"tel\" name=\"tel-doc\" \/><\/span>\n<\/p>\n<p>When would you like your child to start<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"date-start\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" aria-required=\"true\" aria-invalid=\"false\" placeholder=\"xxxx-xx-xx (year-month-day)\" value=\"\" type=\"date\" name=\"date-start\" \/><\/span>\n<\/p>\n<p>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)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"radio-startFlexible\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"radio-startFlexible\" value=\"Yes\" checked=\"checked\" \/><span class=\"wpcf7-list-item-label\">Yes<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"radio-startFlexible\" value=\"No\" \/><span class=\"wpcf7-list-item-label\">No<\/span><\/span><\/span><\/span>\n<\/p>\n<p>What would you like your child to accomplish through the After School Program<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"school-accomp\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\" name=\"school-accomp\"><\/textarea><\/span>\n<\/p>\n<p>How did you hear about Quentz bilingual? (Required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-hearfrom\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"checkbox-hearfrom\" value=\"Registered with Quentz Bilingual before\" \/><span class=\"wpcf7-list-item-label\">Registered with Quentz Bilingual before<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-hearfrom\" value=\"From someone (please enter the name in the following question)\" \/><span class=\"wpcf7-list-item-label\">From someone (please enter the name in the following question)<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-hearfrom\" value=\"From a web search\" \/><span class=\"wpcf7-list-item-label\">From a web search<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"checkbox-hearfrom\" value=\"From a local magazine\" \/><span class=\"wpcf7-list-item-label\">From a local magazine<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"checkbox-hearfrom\" value=\"From other (please specify below)\" \/><span class=\"wpcf7-list-item-label\">From other (please specify below)<\/span><\/span><\/span><\/span>\n<\/p>\n<p>Enter the name of the person who referred you or if you choose \"From other\", please specify<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-refname\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-refname\" \/><\/span>\n<\/p>\n<p>If you have a promotional code, enter here<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"text-promocode\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"text-promocode\" \/><\/span>\n<\/p>\n<p>Name\/s of Authorized Person\/s to Pick Up Child (required)\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"person-pickup\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"person-pickup\" \/><\/span>\n<\/p>\n<p>Quentz Bilingual Academy teachers occasionally take photographs or videos of students in the classroom.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"radio-301\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><input type=\"radio\" name=\"radio-301\" value=\"Yes, I give my permission for my child to be photographed or videotaped during activities at Academy or on field trips.\" \/><span class=\"wpcf7-list-item-label\">Yes, I give my permission for my child to be photographed or videotaped during activities at Academy or on field trips.<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"radio\" name=\"radio-301\" value=\"No, I do not want my child photographs to be taken.\" \/><span class=\"wpcf7-list-item-label\">No, I do not want my child photographs to be taken.<\/span><\/span><\/span><\/span>\n<\/p>\n<p>Cancellation and Refund Policy: No refunds after used classes. No Refunds for individual missed classes.<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-902\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"checkbox-902[]\" value=\"I understand and accept the cancellation policy.\" \/><span class=\"wpcf7-list-item-label\">I understand and accept the cancellation policy.<\/span><\/span><\/span><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"checkbox-liability\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required\"><span class=\"wpcf7-list-item first last\"><input type=\"checkbox\" name=\"checkbox-liability[]\" value=\"I\/we acknowledge that we have read and understand this document and accept the risk and responsibility.\" \/><span class=\"wpcf7-list-item-label\">I\/we acknowledge that we have read and understand this document and accept the risk and responsibility.<\/span><\/span><\/span><\/span>\n<\/p>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"quiz-471\"><label><span class=\"wpcf7-quiz-label\">1+2=?<\/span> <input size=\"40\" class=\"wpcf7-form-control wpcf7-quiz\" autocomplete=\"off\" aria-required=\"true\" aria-invalid=\"false\" type=\"text\" name=\"quiz-471\" \/><\/label><input type=\"hidden\" name=\"_wpcf7_quiz_answer_quiz-471\" value=\"053f984f1972ce6c2d559f8652610df4\" \/><\/span>\n<\/p>\n<p>When you click on the button below, you will receive an email confirmation. Please follow the instructions in the email to complete the registration.\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"I accept Quentz After School program agreement and would like to sign up\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n<\/body>","protected":false},"excerpt":{"rendered":"<p>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\u00a0within 3 business days if we have space for your &hellip; <a href=\"https:\/\/quentz.org\/school\/afterschool-registration\/\">Continued<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"class_list":["post-388","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/quentz.org\/school\/wp-json\/wp\/v2\/pages\/388","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/quentz.org\/school\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/quentz.org\/school\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/quentz.org\/school\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/quentz.org\/school\/wp-json\/wp\/v2\/comments?post=388"}],"version-history":[{"count":1,"href":"https:\/\/quentz.org\/school\/wp-json\/wp\/v2\/pages\/388\/revisions"}],"predecessor-version":[{"id":1515,"href":"https:\/\/quentz.org\/school\/wp-json\/wp\/v2\/pages\/388\/revisions\/1515"}],"wp:attachment":[{"href":"https:\/\/quentz.org\/school\/wp-json\/wp\/v2\/media?parent=388"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}