Guided registration process for new and returning students. Please complete all sections to begin your cultural journey with us.
The Student may be released to a parent or legal guardian identified in this registration or to an authorized pickup adult listed below. You do not need to list the registering parent or legal guardian again. PLC may require photo identification before releasing the Student.
To add or remove an authorized pickup adult after submitting this registration, the parent or legal guardian must notify Persian Learning Center Inc. through an approved written method.
Persian Learning Center Inc. may photograph or record students during classes, cultural programs, performances, celebrations, and other school or community activities. Approved photographs or videos may be used on the Persian Learning Center Inc. website, social media accounts, newsletters, flyers, brochures, event materials, and other educational, community, or nonprofit promotional materials.
Declining photo or video permission will not affect the Student’s ability to participate in Persian Learning Center Inc. classes, programs, or events.
The Student’s full name will not be published with a photograph or video unless separate permission is obtained from the parent or legal guardian.
If the Student becomes ill or injured during a Persian Learning Center Inc. program or activity, I authorize Persian Learning Center Inc. (“PLC”) and its personnel to call 911, request emergency medical assistance, and arrange emergency transportation when reasonably necessary, including when I cannot be reached promptly or when delaying assistance could endanger the Student’s health or safety. I authorize licensed emergency and medical providers to evaluate and provide treatment they reasonably determine is necessary and permitted by law.
I understand that PLC does not provide health, medical, or accident insurance for the Student. I accept financial responsibility for any medical, ambulance, hospital, transportation, or related expenses incurred on the Student’s behalf. This authorization does not permit PLC personnel to administer routine or prescription medication without separate written authorization.
Please provide any information PLC should know to protect and support the Student. Enter “None” if there are no known conditions, allergies, medications, dietary restrictions, or accommodations.
I have read and agree to the Emergency Medical Authorization above, and I certify that the medical information provided for the Student is accurate.*
Minor Student Liability Waiver
IMPORTANT: THIS DOCUMENT AFFECTS LEGAL RIGHTS. PLEASE READ IT COMPLETELY BEFORE ACCEPTING AND SIGNING.
Please open and review the complete waiver before continuing. You may download or print a copy for your records.
View or Download the Full Waiver (PDF)
I certify that I am the Student’s parent or legal guardian and have authority to sign this agreement. I have read and understood the complete Minor Student Release of Liability, Assumption of Risk, and Promise Not to Sue. I voluntarily accept its terms.*
I consent to the use of electronic records and an electronic signature for this registration and waiver.*
By signing below, I certify that the information provided in this registration is complete and accurate to the best of my knowledge; that I am the Student’s parent or legal guardian and have authority to complete this registration; that I have read and accepted the Emergency Medical Authorization and the Minor Student Release of Liability, Assumption of Risk, and Promise Not to Sue; and that I have recorded my separate Photo and Video Consent selection. I intend my electronic signature to authenticate and apply to this complete registration and its required acknowledgments and consents.
