Registration – Spring 2017 Spring 2017 Class Registration Student Information Student's First Name * Student's Last Name * Address * Address Line 2 City * Zip Code * Student's Date of Birth * Parent, Guardian, or Adult Student Information Please enter in this information for the student being registered. If you are an adult student, self-registering, please also enter your information in the first row (Parent/Guardian #1). Parent/Guardian 1's Full Name * Parent/Guardian 1's Email Addr. * Parent/Guardian 1's Phone # * Parent/Guardian 2's Full Name Parent/Guardian 2's Email Addr. Parent/Guardian 2's Phone # Emergency Contact's Full Name * Emergency Contact's Phone # * Language Classes Please select which language classes the student will be attending. Russian Language Ages 3-4 Ages 4-5 (9:00 AM - 10:00 AM) Ages 4-5 (11:10 AM - 12:10 PM) Ages 5-6 Ages 7-8 Russian Language and Literature Ages 10-11 Ages 11-13 Ages 9-10 + History Ages 9-10 Russian as a Foreign Language Ages 8-11 Beginner - Teens & Adults - Relative of MRS Student ($230) Beginner - Teens & Adults - General Public ($310) Beginner - Intermediate 1 - Teens & Adults - Relative of MRS Student ($230) Beginner - Intermediate 1 - Teens & Adults - General Public ($310) Beginner - Intermediate 2 - Teens & Adults - Relative of MRS Student ($230) Beginner - Intermediate 2 - Teens & Adults - General Public ($310) Ukrainian Language Classes Beginner - Teens & Adults - MRS Relative Beginner - Teens & Adults - General Public Beginner - Intermediate - Teens & Adults - General Public Beginner - Intermediate - Teens & Adults - MRS Relative Children Math Classes Math Classes Math - Ages 5-6 Math - Ages 7-8 Math - Ages 9-11 Artistic Enhancement Classes Select which artistic enhancement class(es) the student will attend. Theater Ages 4.5-7 Ages 7+ Music Ages 4-6 Ages 7+ Art Ages 5-9 (11:05 AM - 12:05 PM) Ages 5-9 (12:20 PM - 1:20 PM) Ages 9+ (10:00 AM - 11:00 AM) Ages 9+ (2:45 PM - 3:45 PM) Final Section I confirm that I have read and understand the Parent Handbook and School Calendar and Payment Information page * Yes, I've read and understand the Parent Handbook and Calendar/Payment Info I authorize the use of my child's image (photo or video) to be used on the school's website, other sites, photo albums, or any other media. * Yes No I am a new student (did not attend the Fall Semester) * Yes No Total Cost for Semester Please check the box below We appreciate the help in preventing spam entries! Once you click on the Submit button, you'll be taken to PayPal to complete the payment for the semester. If you cancel the payment process, the registration will still be logged, but you will need to mail in the payment to the following address before March 15th: Madison Russian School, Inc. PO BOX 5132 Madison, WI 53705 If classes are canceled due to conditions outside of the Madison Russian School’s control (extreme weather, issues with the class facilities, etc.), there will be no reimbursements. The school administration and teaching staff will attempt to reschedule classes, if possible.