Registration Form


Non refundable deposit: $75


Please Choose class/camp option(s):






Language(s) spoken at home:


Father (or Legal Guardian):

Father's Address

(for field trip or volunteer purposes)

Mother (or Legal Guardian):

Mother's Address

(for field trip or volunteer purposes)

Are parents living together?

If no, who has custody of child during program hours?

EMERGENCY CONTACT INFORMATION (Other than Parents and Guardians)


Medication or Action Taken:
(i.e. Benadryl, Epipen, etc.)

Additional Notes:

  • Children must be toilet trained (no diapers or pull-ups).
  • Class switches are subject to availability
  • Attendance Policy: Absent students are allowed make up sessions in another class up to 3 classes per term, subject to availability. If the missed class is not available in another day, material and hand outs will be given to the student for self study. Parents are encouraged to revise the missed topics with the students at home.

Please include the following with your registration form:

  • Completed Installment Payment Plan Agreement or full payment
  • $75 non-refundable deposit (in addition to class fees)


30 days' written notice prior to the first day of the program is required to withdraw from Fairouz Academy programs and have the appropriate fees cancelled. Registration fee and installment payment plan administration fee are non-refundable.

We will NOT provide refunds after the start of the program or if registration is cancelled less than 30 days prior to the start of the program, and no prorating of fees will be provided. Those who opt to pay the full program's tuition in advance will not receive a refund on their payment. Parents and Guardians are expected to continue to pay for their monthly payments for the rest of the program regardless of the child no longer attending.

RELEASE OF LIABILITY: I hereby consent to the above terms, and hereby recognizes and acknowledges that Fairouz Arabic Language Academy LTD and staff will not be responsible for personal injury or loss. I give permission for the staff at Fairouz Arabic Language Academy LTD. to administer first aid to my child if there is a minor injury. In the event that the injury of my child requires further medical attention and I cannot be located, I hereby consent to Fairouz Arabic Language Academy LTD contacting the above doctor and calling an ambulance if deemed necessary. It is my responsibility for any costs incurred.

PHOTO RELEASE: I hereby authorize my child's photo to appear in the media or to be used to promote or publicize our programs without compensation. My child’s name and identity will not be revealed. Should I prefer that Fairouz Arabic Language Academy LTD do not photograph my child I will notify Fairouz Arabic Language Academy LTD via e-mail at

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