监护人委托协议

Name of Student学生姓名

I/We being the parent /legal guardian request LANGUAGE REVIEW（U.K.）Ltd. to act as my representative in undertaking the guardianship of this child during their education in the United Kingdom. 身为父母/法定监护人，委托LANGUAGE REVIEW（U.K）Ltd.负责该生在英国读书期间的生活。

1.The student accepts responsibility of LANGUAGE REVIEW（U.K.）Ltd., the school and the Host Family to act in the best interests of his/her education and welfare. The following rules must be adhered to: 该生必须支付学校及监护人费用，并且必须遵守以下规定：

1）Naturally all Students must obey the laws of the United Kingdom especially regarding to alcohol and tobacco. 所有学生必须遵守英国的法律，特别是关于酒精和烟草的。

2）It is obligatory to comply with the rules of the school , and those set by a Host Family where appropriate. 学生必须遵守学校及监护人家庭的规定。

3）The use of drugs not prescribed by a medical practitioner is prohibited. 食用药品必须遵照医院所开处方。

4）It is not permitted for a student to travel independently without prior permission. 未经许可，不得独自出外旅游。

2.The parent or legal guardian bestows upon LANGUAGE REVIEW（U.K.）Ltd. and its staff, the right to act 'in any situation, particularly in emergencies including the signing of permission for surgical treatment.' 父母或法定监护人授予LANGUAGE REVIEW（U.K.）Ltd. 以下权利：即在任何情况下，特别是紧急情况时，有代表其父母或法定监护人签字的权利。

3.I accept that a student may be expelled from Guardianship for serious or continual misconduct, particularly where such behaviour prejudices the safety of progress of other students, or brings the company or school itself into disrepute. 当孩子有严重违纪行为时，特别是对其他学生造成伤害或毁坏本中心和学校声誉的，本中心有权终止合约，并将其返送回国。此外，家长方同意向本中心赔偿由学生的行为对本中心或学校所造成的一切损失。

4.The parent undertakes to give the Company four months or one full school term's notice of termination of this Agreement, such notice to be given only when sufficient funds are available in the account to cover the actual and contractual expenses. The company will refund any amount remaining in credit on the termination of this Agreement. 父母要终止此合约需提前四个月或一个学期以书面报告形式通知本中心。在合约终止之日起，公司会退还所有剩余金额。

5.Should the balance in credit with Language Review (U.K) Ltd. at any time fall below ￡300 the Company shall be at liberty to discontinue further provision of Guardian Services until it has been replenished. 如果押金少于300英镑，中心有权停止监护人服务，直到家长重新补足。

6.The parent must keep us fully informed in writing of any medical condition and any medical treatments required by your child.父母或法定监护人必须向监护人中心提供其孩子的书面医疗档案。

7.The parent must notify us promptly in writing of any change to your address/contact numbers. 如果父母或法定监护人的联系方法（例如：通讯地址、电话号码等）发生更改，应及时向监护人中心说明。

8.The parent must pay any additional authorised (or necessary unauthorised ) expenses in relation to your child. Prior written authorisation will be obtained where possible. 父母或法定监护人必须向监护人中心缴纳由于特别要求而发生附加的费用。

9.Any notices given by you to us or by us to you will be sent to the appropriate address/fax number given at the top of the agreement or any replacement address/fax number give to the other party. 双方之间的任何通知，应以书面形式传真或邮寄给对方。

10.The provision of the agreement shall in all respects be interpreted in accordance with the law of England. 如果对本协议的任何争议需提交法律程序审理，本协议应被视为在英国签署，受英国法律的约束。

STUDENT DETAILS学生情况

Student's name学生姓名：________________________ Sex性别：□Male男□Female女

Date of Birth出生日期：____________ Identity Card No. 身份证号码：_________________

Passport No. 护照号码：_______________________ Expiry Date 生效日期：________________

Have you ever been refused a visa to visit Great Britain

你有否曾被拒到访英国之签证？□Yes有/ □No没有

FAMIL Y DETAILS家庭情况

Father's name父亲姓名：__________________ Mother's name母亲姓名：_______________

Father's occupation父亲职业：_________________________________

Mother's occupation母亲职业：___________________________________

Brothers and Sisters with their ages兄弟姊妹人数及年龄？________________________

What is your religion宗教？_____________________________

Home Address家庭地址：________________________________

Home Tel住宅电话：_____________________________________

Business Tel办公电话：_________________________________

Fax传真号码：__________________________________________

E-mail电邮：____________________________________________

I wish to register my son/daughter我愿意将我的女儿/儿子___________________

with Language Review（U.K.）Ltd. We agree to abide by the rules and conditions laid down in the brochure of Language Review (U.K) Ltd. and appoint the Company to act on our behalf in case of emergency and if we cannot be contacted.交于Language Review（U.K.）Ltd.监护。而且愿意接受Language Review (U.K.) Ltd. 所定下的条件及守则，并委托该中心在紧急情况及在不能联络本人的情况下代表本人作出所需的决定。

Signed签字：________________ Date 日期：______________

Applicant申请者

Signed 签字：_______________ Date日期：_________________

Parent/Legal Guardian父母/法定监护人