Date *

MM

DD

YYYY

Parent or Guardian Name *

First Name

Last Name

Phone *

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Child's Name *

First Name

Last Name

Terms and Conditions *

By checking the boxes below you are acknowledging your understanding of the following statement:

This form does not constitute an enrollment or the start of a contract term. Enrollment is not complete until the application and related fees have been paid.

Application Fee and Curriculum Fees are due at time of invoice. The invoice will be sent to the email you provided on this form.

Monthly fees is due according to contract at time of enrollment. Family and PIF Discounts available. A late fee will be assessed after a 7 day grace period.