Enrollment Form

Kindergarten 2025-2026 Enrollment Form

Director: Karly Cummins 3698 RR 620 South #103 Bee Cave, Tx 78738
Kindergarten students will be attending our BEE CAVE campus on RR 620 located by Target and Chick Fil A in the city of Bee Cave.
Step 1: Student Information:

A registration form must be completed PER CHILD enrolling in the MTKA Kindergarten program.
Anticipated First Day of Attendance- Kindergarten (first day is August 20, 2025):*

MonthDayYear
Date
Child's Name*

First NameLast Name
Name your child goes by: *
Gender*

FemaleMale
Child's Date of Birth- child must be 5 as of September 1, 2025*

MonthDayYear
Date
Child's Age as of September 1, 2025, please enter as __yrs & ___ mo*
Example: 5 years 2 months
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number- **WE WILL CALL THIS NUMBER FIRST***

Area CodePhone Number
Email- must be one that is checked frequently and that you can be reached by daily*
example@example.com
Kindergarten Program Attendance

Kindergarten program hours are 8:15am to 2:30pm, Monday-Friday. After-care available until 5pm pending availability. MTKA follows a modified version of the Lake Travis school district calendar. MTKA starts after and ends before the district. Our school follows the holiday breaks that align with the district calendar. MTKA reserves the right to amend our calendar should the district amend their calendar. 2025-2026 School Calendar will be posted on school website under the "Enrollment" tab . First day of school will be August 20, 2025.
Attendance Time Options (choose one):*

8:15am-2:30pm~ Kindergarten Program8:15am - 5:00pm Kindergarten Program with Aftercare (limited availability)
Family Information

Please include valid contact information for each parent. Emails and phone numbers must be ones that are checked frequently and specific to each parent.
Child lives with:*

Both parents/guardiansMotherFatherGuardian
Custody Documents submitted to MTK Administration*

Yes, I will submit these via email prior to my child's first day.Not applicableOther- I will contact the MTKA Director to discuss.Type option 4
Parent/ Guardian 1*

First NameLast Name
Relationship to Child:*

MotherFatherGuardian
Phone Number- Parent/ Guardian 1*

Area CodePhone Number
Email- Parent/ Guardian 1*
list an email checked frequently by this parent
Address if different from address listed for child

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/ Guardian 2 *

First NameLast Name
Relationship to Child:*

MotherFatherGuardian
Phone Number- Parent/ Guardian 2*

Area CodePhone Number
Email- Parent/ Guardian 2*
list an email checked frequently by this parent
Address if different from address listed for child

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Important information regarding your child:
Does your child have any medically diagnosed allergies?*

Yes- I understand I MUST submit an Allergy Action Plan signed by physician.No
Does this medically diagnosed allergy require and Epi-Pen?

Yes, I understand that I must provide school with an Epi-Pen for my child.No, this allergy does NOT require an Epi- Pen.My child does not have a medically diagnosed allergy.Type option 4
Please include details about the medically diagnosed allergies listed above (write NA if no allergies):*
ex: Food/ Insect/ Environmental... Reaction type: ingestion/ contact/ proximity
Has your child experienced a significant life event that continues to effect their life? If Yes, please explain. If No, please type NA.*
Please list any serious illness/ injury or hospitalizations/ surgeries since birth.*
If no, please type NA
Special Care Needs (accompanied by medical professional recommendations):*

Limitations/ Restrictions on activities.Reasonable accommodations or modificationsAdaptive equipment neededSpecific symptoms or indications of complications due to medical/ physical needThis portion does NOT apply to my child.
Please share any and all services your child receives or has received in the past. Please include approximate dates of these services. This information is confidential and to be shared with the Kindergarten Teacher and Administration only in order to individualize instruction when needed. EX: Behavioral Support, Speech Therapy, Occupational Therapy, Physical Therapy*
if this does not apply, write NA
MTKA students DO NOT participate in swimming. Supervised water activities at MTKA are: water sprinklers, water slide, water table, splash/ wading pool, water hose for gardening*

I AGREE to the MTKA supervised water activities for my child.I DO NOT want my child to participate in the supervised water activities.
Child's Overall Health: Please share any special needs that your child may have such as: food intolerance/ sensitivities, environmental allergies, existing illness, any medications prescribed for long-term continuous use, and/ or any other important information regarding your child’s well-being. Sharing this information allows us to provide the best possible school environment for your child. *
Varicella (Chickenpox) vaccine is not required if your child has had the Chickenpox disease. If your child has had Chickenpox, please retype and complete the following statement in the field below: MY CHILD HAD VARICELLA DISEASE (CHICKENPOX) ON OR ABOUT(DATE) AND DOES NOT NEED VARICELLA VACCINE.*
By typing your name below- you confirm the medical information above:*
Please type full name (first- middle- last)
Emergency Contact/ Authorized To Pick Up

Please list 2-3 different ADULTS that are permitted to pick up your child in the event you can not be reached or unable to pick up your child from school. These contacts must have a local address. Children will only be released to a parent/ guardian or person designated by a parent/guardian upon verification of ID.
1- Emergency Contact... permitted to pick up child*

First NameLast Name
1- Emergency Contact- Phone Number*

Area CodePhone Number
1- Emergency Contact relationship to child:*

RelativeNanny/ BabysitterNeighborFamily Friend
2- Emergency Contact... permitted to pick up child*

First NameLast Name
2- Emergency Contact- Phone Number*

Area CodePhone Number
2- Emergency Contact relationship to child:*

RelativeNanny/ BabysitterNeighborFamily Friend
3- Emergency Contact... permitted to pick up child

First NameLast Name
3- Emergency Contact- Phone Number

Area CodePhone Number
3- Emergency Contact relationship to child:

RelativeNanny/ BabysitterNeighborFamily Friend
Step 2: Submit Fees
Kindergarten Tuition & Fees:

The Kindergarten program is a nine month commitment to ensure class stability and budgeting for a quality education for everyone enrolled. This is a five day a week program with attendance expectations comparable to that of a public/private school.

All Kindergarten tuition and fees are non-refundable.Please note: Tuition reflects a longer day (8:15a-2:30p) to meet Kindergarten benchmarks and standards.

Tuition & Payment Options: (extended care fees not included)
- Full Payment: $18,552 due at time of enrollment
- Two Half Payments: $9276 due March 1, 2025 & January 5, 2026
- Monthly Payment: $2125 per month
Enrollment Commitment: Our Kindergarten program requires a 9-month enrollment contract which will be sent via email.
Payment Options (please indicate your preference):*

$18,552...Single payment due March 1, 2025 or at time of enrollment if after 3/1/25$9276.00... Semi-annual payments due March 1, 2025 & January 5, 2026$2125.00... Month-to-month payments honored through BrightWheel autopay status only. 1st tuition payment due March 1st or at time of enrollment if after 3/1/25.
TO SECURE ENROLLMENT:
Enrollment is secured upon paying the following non-refundable fees:
Tuition + Activity/ Supply Fee ($375) + Grounds fee ($200) + Enrollment Fee ($500)
Upon receipt of your Kindergarten regsitration form, we will set up your account and email an invoice. Payment can be made using the ACH bank debit through our tuition software.
ACH Authorization:

I herby authorize BrightWheel, acting on behalf of My Time Kids Academy, to initiate withdraws in the form of electronic funds transfer from my financial institution, as listed in my BrightWheel profile, for amounts owed to My Time Kids Academy, including, but not limited to: tuition and program fees, activity/ supply fees, and late fees. I understand that this authorization will remain in effect until My Time Kids Academy has recieved written notification of my child withdrawing from the programs provided by My Time Kids Academy or alternative payment arrangements- such as payment in full- have been approved by MTKA administration.
By typing your name below- you agree to adhere to the payment policy above:*

First NameLast Name
Step 3: Submit Additional Paperwork

Additional forms from the Enrollment Packet are required. These will be due on or before your child's first day of participation in our program. All students MUST have current immunization records or affidavit on file at all times. Kindergarten students must have a vision/ hearing screening on file. You may obtain this service from your pediatrician.
MTKA Kindergarten Withdrawal Policy
- The My Time Kids Academy Kindergarten program is a full, nine month, commitment. This is a five day a week program with attendance expectations comparable to that of the public/ private school.
- Our Kindergarten program requires a 9-month enrollment contract which will be sent via email.
- The Enrollment Fee is non-refundable, noted at time of enrollment.
- The Facility/ Grounds Fee is non-refundable, noted at time of enrollment.
- The Supply/ Activity Fee is non-refundable, noted at time of enrollment.
- Unpaid fees by initial due date will result in forfeit of registration.
- Tuition is non-refundable due to closure or quarantine initiated by state officials, CDC & Health officials, or administration due to COVID-19 or other viruses/disease.
By typing your name below- you agree to adhere to the Withdrawal policy above:*

First NameLast Name
Should be Empty:

Kindergarten 2025-2026 Enrollment Form

Step 1: Student Information:

Kindergarten Program Attendance

Family Information

Important information regarding your child:

Emergency Contact/ Authorized To Pick Up

Step 2: Submit Fees

Step 3: Submit Additional Paperwork