New Student Registration Form

Child's Name *

Date of Birth *

Gender *MaleFemale

Parent/Guardian's Name *

Street Address *

City *

State/Province *

ZIP / Postal Code *

Home Phone

Work Phone

Mobile Phone *

Please check the program that most fits your need

Please select the program *ToddlerPreschoolElementary

Please choose the schedule *3 half days (9:00am – 12:00pm)5 half days (9:00am – 12:00pm)3 full days (9:00am – 3:00pm)5 full days (9:00am – 3:00pm)

Extended day care? *YesNo

Termination Policy

Toddler and Preschool Programs

All deposits and enrollment fees are non-refundable. If parent desires to withdraw Student from Toddler or Preschool Program prior to the end of the School’s academic year, Parent is required to provide the School with a thirty (30) day written notice advising of the Student’s last day of school. Unpaid tuition shall continue to be due and payable notwithstanding any early withdrawal regardless of reason until the last day the Student attends School or until thirty (30) days after Parent delivers written notice to the School, whichever is later.

Elementary Programs

All deposits and enrollment fees are non-refundable. There are no cancellations of this agreement for students enrolled in the Elementary Program. By signing this agreement, you are committing to a 10-month (September-June) enrollment period. Should Parent choose to not have child attend the program, all tuition will continue to be due through the end of the agreement and payable to the School.

I have read and agree to the above policy, which is also stated in our Admissions Agreement: *Yes

Parent Signature *

Date *

Parent Signature

Date

Required Fees

New Student Registration Fee

$200 (Non-refundable)

Earthquake Kit

$25