Contact Us

                                                                                                Office Use Only:

                                                                                                   Date received ___________                                                                                                                     Registration Fee _________

                                                                                                      Check Number __________

 

 

Name _________________________      Nick Name _________________________

         

      Date of Birth ___________________________________________________________

 

      Parent 1 _________________________  Parent 2 _____________________________

       

      Parent 1 Cell ________________________         Parent 2 Cell ______________________

 

       Street Address __________________________________________________________

 

       City __________________________________   Zip Code ______________________

 

       1 Email ___________________________   2 Email_______________________________

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Program Request

 

1st Choice __________________                              

 

2nd Choice _________________                    

 

We would like to participate in the wrap program (8-9AM and/or 2:30-4PM)   ______________                 

 

 Please return this form with a NON-REFUNDABLE and NON-TRANSFERABLE

Registration fee of $100

 

Payment option choice:

 

Full year ______            10 payments ________

 

 

** You will be informed as to what program your child has been enrolled in, by January.

**The non-refundable deposit payment (one tenth of the yearly tuition) is due February 1st  for all students or upon registration after February 1st. 

**We offer a discount of 10% off the lesser tuition if more than one child from the same family is enrolled.

 

  *We reserve the right to add, delete, change or combine any class for any reason.

 

We understand that both registration fee and first tuition payment (deposit) are NON-REFUNDABLE and NON-TRANSFERABLE.

 

Parents Signature ___________________________             Date ___________________