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New Student Registration - Language Class
Crossing Borders at Katy, TX
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This is a legal contract. All pages of the agreement are binding. By completing and submitting this agreement, you consent to be bound by, and become party to this agreement, and, you agree to keep a current payment method with us .
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Google
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Referral
Who helped you?
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Adriana
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Andrea
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Responsible Party
Please complete this section with the information of the person responsible for payments.
Who is the responsible party?
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Please select
Myself
Parent
Employer
Employer/Company name
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Parent's name
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First
Middle
Last
Phone
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Email
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Address
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Street Address
City
State / Province / Region
Postal / Zip Code
Student's Information
Student's legal name
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First
Middle
Last
Date of birth
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DD
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YY
Month/Day/Year
Occupation
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Does this student have any medical/health issues that Crossing Borders needs to be aware of?
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No
Yes
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Please provide details about the medical/health issues
Add another student?
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Please select
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No
(Only if you are paying for this student)
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