ELP 2021 FALL ENROLLMENT REQUEST

2021 FALL Enrollment Request

CLASSES BEGIN AUGUST 31st
Child's Name *

First Name Last Name
Date of Birth *

Month Day Year
Current Age *
Students 3 years of age and older must be fully potty trained by the first day of school.
Gender *

Male Female
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Does your child have any learning disabilities that we should be aware of? *

Yes No
If yes, please describe
Does your child have any speech delays that we should be aware of? *

Yes No
If yes, please describe
Does your child have any allergies or food restrictions that we should be aware of? *

Yes No
If yes, please describe
Does your child have any medical conditions that we should be aware of? *

Yes No
If yes, please describe
Parent Information
Mother's Name *
Cell Phone *

Area Code Phone Number
Email Address *
Father's Name
Cell Phone

Area Code Phone Number
Email Address
If separated or divorced, who is the custodial parent?

Mother Father
If mother or father cannot be reached in case of an emergency, please contact:
Name 1 *

First Name Last Name
Relationship *
Cell Phone *

Area Code Phone Number
Name 2

First Name Last Name
Relationship
Cell Phone

Area Code Phone Number
Are you a member of Guts Church?

Yes No
If no, where do you attend?
Please list anyone besides parents, who are allowed to pick up your child from school?
Please list anyone NOT allowed to pick up your child from school:
Photo Release
We, at Guts ELP, will be taking photos of students during their activities within the premises. In this regard, we seek your consent for the publishing or use of photos in which your child may be included.

The photos will be used within our Tadpoles app, on our Guts ELP social media accounts, and/or for marketing updates.

By agreeing below, you are granting permission to use photos in which your child may be included.
*

I hereby grant and authorize Guts ELP to use photos involving my child I hereby grant and authorize Guts ELP to use photos involving my child, but only for internal communication I do NOT approve the use of any photos taken involving my child
Parent Signature *

Clear
Enrollment Request
TUITION PAYMENTS

Tuition payments are due by the 1st of each month. All payments can be made through the emailed invoice, or paid in person with cash or check.

No adjustments are made for holidays, illness, or absence of any kind.

There will be a late charge of $25 for all tuition payments made after the 1st of the month.
PRICING

Babies Class (3-12 months)

3 days/ week: $300/month

2 days/week: $250/month

1 day/week: $200/month

1s, 2s, 3s, and PreK classes

3 days/week: $275/month

2 days/week: $225/month

1 day/week: $175/month

Kindergarten & 1st Grade

3 days/week: $350/month
I would like to enroll my child: *

1 day 2 days 3 days KINDERGARTEN (3 day part-time program) 1ST GRADE (3 day part-time program)
Which days? *

Tuesday Wednesday Thursday
Enrollment Request & Supply Fee
A $75 non-refundable Enrollment Request & Supply Fee is due at the time of enrollment. This fee covers all school supplies, activities, and holiday parties.

This fee does not guarantee placement in the program, but it secures a place on our waitlist. You will be contacted by a Director in the coming days, who will let you know the status of your student's enrollment.

My Products *

Enrollment Request & Supply Fee $ 75.00

Total $ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

Should be Empty:

2021 FALL Enrollment Request

Parent Information

If mother or father cannot be reached in case of an emergency, please contact:

Photo Release

Enrollment Request

Enrollment Request & Supply Fee