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RND ACADEMY HOLD AUTHORIZATION FORM
30 DAY VACATION HOLD FOR MONTHLY CLASSES
PARENTS NAME
*
First Name
Last Name
STUDENT NAME
*
First Name
Last Name
Students School
*
Please Select
Academy on the Hill
Anaheim Children's Academy
Apple Tree Preschool & Kindergarten
Casa Montessori
Fullerton Children's Academy
Heritage Christian Preschool-PR
Montessori Children's World
Newport Avenue Preschool
St. Pius V.
Village Montessori
Zion Lutheran Early Childhood Education Center
Zion Lutheran School Age Care
E-mail
*
example@example.com
Cellular Number
Format: (000) 000-0000.
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
VACATION Start Date
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
VACATION End Date
LAST 4 OF CC ON FILE
*
Terms & Conditions
1) I understand the HOLD must be submitted 48 hours before the 1st of the month and that I am responsible for all charges within the 48 hour notice, as well as any classes given in advance. 2) I understand that August classes are given in advance during the regular school year and will be due in full on August 1st. 3) I understand HOLDS are not valid for the 4 major holidays that are included with tuition: Thanksgiving, Winter Break, New Years & Spring Break. *Holds not received 48 hours before the month in question are automatically charged/billed for the full month’s tuition on the 1st of the month.
Date of Signature
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature
*
Submit
Should be Empty: