Discovery Summer School Signup Form Questions? Give us a call at 0561-63-1222. Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 3Please note that the summer school option for preschool and kindergarten students is limited to the week of 8/18-22. | 未就学児(プリスクール)向けのサマースクールは、8月18日〜22日の週のみの開催となりますので、ご注意ください。 Choose your Summer School Course(s) |コースを選択してください *7/28~8/1 ADVENTURES IN SPACE (Elementary | 小学生)8/4~8 SCIENCE MAGIC (Elementary | 小学生)8/18~22 CAKE FACTORY (Preschool or Elementary | 年少から年長、小学生)8/25~29 AFRICAN SAFARI (Elementary | 小学生)Extended Day Care Weekly Plans |週極め延長保育8:00-9:15 (¥5,500)14:15-16:00 (¥9,500)14:15-18:30 (¥19,000)Contact us for other options. | 他の時間をご希望の方は、お問合せください。School Lunch Order (¥3,750/week) | スクールランチ *YesNoStudent Information | お子さまについてName | 名前 (ローマ字) *FirstMiddleLast保護者氏名(漢字)| Japan Nationals onlyFirstLastNationality(s) | 国籍 *Gender | 性別 *Male | 男Female | 女Date of Birth | 生年月日 *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Grade Level | 学年 *Preschool 3 | 年少Preschool 4 | 年中Preschool 5 | 年長Elementary 1 | 小1Elementary 2 | 小2Elementary 3 | 小3Elementary 4 | 小4Name of Primary School | 学校名 *Spoken English Level | 英語のスピーキングレベル Selected Value: 0 0 (beginner) ~ 5 (fluent) | 0 ( 初級 ) ~ 5 ( 上級 )Special Needs | 身体的特記事項Information regarding medical conditions, illnesses, hospitalizations, allergies, physical limitations, learning challenges, etc. 病歴、アレルギー、身体的障害等、など。NextParent/Guardian Information | 保護者様についてParent/Guardian Name | 保護者氏名 (ローマ字) *FirstLast保護者氏名(漢字)| Japan Nationals onlyFirstLastRelationship to Child | 親子関係 *Natural mother | 実母Natural father | 実父Step mother | 継母Step father | 継父Legal guardian | 法的保護者Cellular Telephone | 携帯電話番号 *Email | メールアドレス *EmailConfirm EmailHome Address | 住所 *Address Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte 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ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryHow did you learn about us? 当校をどのようにお知りになりましたか?Comments / Questions (コメント/質問等)NextUpdating preview…This is a preview of your submission. 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