2026-2027 Learning Like a Rockstar: A Hall of Fame for Electrifying Learners | After-School Enrichment & Tutoring Registration Form

2026-2027 REGISTRATION

We're grateful that your family has decided to join us for the 2026-2027 school year. Please complete this registration form in its entirety. Upon completion you will receive an invoice to process registration fee and finalize registration.
Child's Information:

Please complete this section based upon the 2026-2027 School Year
Child's Name

First NameLast Name
Child's Age
Child's Date of Birth

MonthDayYear
Date
Child's SSN: (Identification Purposes)
Child's Gender:
Allergies (if none, please write n/a:
School of Attendance
Returning Family
After-School Enrichment & Tutoring Hours Needed:
PROMO Code:
Grade Level:
Please select all that apply regarding your child's attendance during school closures for the 2026-2027 school year
T-Shirt Order Information

Students will need to wear The Apple Orchard Academy t-shirt during center organized, sponsored and/or community events. The cost of shirts are $20.
Child's T-Shirt Size
Adult T-Shirt Order Form
OPTIONAL: Parent/Guardians are encouraged to order t-shirts to wear during center organized, sponsored and/or community events.
Adult Order Form

Other
Parent/Guardian Information:
Guardian #1:

First NameLast Name
Relationship to Child:
Driver's License Number:
Email
example@example.com
Home Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home/Cell Phone:
Please enter a valid phone number.Format: (000) 000-0000.
Guardian #2:

First NameLast Name
Relationship to Child:
Driver's License Number:
Email
example@example.com
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home/Cell Phone:
Please enter a valid phone number.Format: (000) 000-0000.
2026 Summer Camp S.M.I.L.E.

SCIENCE, MATH, IMAGINATION, LITERACY & EXPRESSION CAMP
Are you interested in enrolling in our Summer Camp S.M.I.L.E.?
Community Outreach for the Revitalization of Educational Partnerships (CO-REP) Parent Organization

Early Childhood Alliance of Mississippi Pinebelt is our founding non-profit organization and parent to our innovative parent organization group known as our Community Outreach for the Revitalization of Educational Partnerships (CO-REP), at The Apple Orchard Academy. The CO-REP is a strong advocate for family engagement, community awareness and educational partnerships with our local schools to strengthen the academic enrichment of our students, community and program development.
Would you like to join our parent organization, CO-REP for the 2026-2027 School Year?
Please select the committee of interest for the 2026-2027 Academic Year
Authorization and Agreements
2026-2027 ENROLLMENT
REGISTRATION FEE
TUITION POLICY
TUITION SCHEDULE
FEE REDUCATION POLICY
PROGRAM DEVELOPMENT CLOSURES

I understand all staff is required to obtain at least 40 hours of professional development training per academic year. The Apple Orchard Academy will strive to arrange trainings outside of standard business hours; however, I further understand closures may be necessary to fulfill the professional development requirement and full tuition will be required. The Apple Orchard Academy will provide at least a two-weeks notice prior to any professional development closures.
SEMESTER SUPPLY FEE

I understand there is a semester (August/January) supply fee of $150. Please note this fee covers essential supplies (paper, pencil, art supplies, ink, computer software, etc.) in addition to enrichment and tutoring manipulatives (Science of Reading Kits, games, puzzles, toys, outdoor play, etc.). I understand this fee is non-refundable, non-negotiable and will be billed through our Childcare Management Software Parent Portal.
ANNUAL PROGRAM/BUILDING DEVELOPMENT FEE

The Apple Orchard Academy has plans to expand beginning the 2027-2028 academic year in a new construction building. We simply cannot expand without the support of our families through the Program/Building Development Fee, while attempting to keep tuition costs as low as possible. To assist, each child will have a $500 fee balance per academic year. The program will strive to provide fundraising opportunities to assist families in reducing out of pocket costs. All proceeds from the fundraiser will be deducted from the families balance. Payment may opt to pay monthly or bi-weekly installments over the course of the fall semester (August-December). By enrolling in our program, I understand this fee is mandatory and non-negotiable and agree to said charges, even if withdrawal from program happens prior to May 2026. This fee does not apply to drop-in or intersession students/families.
PAYMENT AUTHORIZATION
DECLINED PAYMENT/INSUFFICIENT FUNDS CHARGE
LATE FEE POLICY

I authorize The Apple Orchard Academy to automatically charge my credit/debit card or bank account an additional $20/per day (including weekends) for late payments. I further understand that on-time payments are essential to the success of the business and failure to submit payment in a timely manner may result in termination from the program, additional fees, court cost, and/or student replacement fee.
TUITION POLICY
SPECIAL NEEDS PROGRAM DISCLOSURE
BEHAVIORAL POLICY
PHOTOGRAPHY, MEDIA RELEASE AND SOCIAL MEDIA PERMISSION FORM
EMPLOYEE APPRECIATION/VACATION ACKNOWLEDGMENT

The Apple Orchard Academy provides all eligible employees 14 paid vacation/PTO days during the academic year as an incentive to hire the best educators, to show our appreciation for their contribution to the academic enrichment of our students and for the support of mental health. I understand the program will be closed for said days and will be responsible for payment during the closures. I understand the program will be closed for said days and I will be responsible for payment during the closures.
FALL INTERSESSION & FALL BREAK CAMP
FALL INTERSESSION & FALL BREAK CAMP (FULL DAY ADD-ON)
THANKSGIVING HOLIDAY BREAK CAMP
THANKSIVING HOLIDAY BREAK CAMP (FULL DAY ADD-ON)
60% CHRISTMAS HOLIDAY EARLY RELEASE
FULL-DAY PRE-CHRISTMAS HOLIDAY BREAK CAMP
FULL-DAY PRE-CHRISTMAS HOLIDAY BREAK CAMP (FULL DAY ADD-ON)
CHRISTMAS HOLIDAY/WINTER BREAK CAMP
CHRISTMAS HOLIDAY BREAK CAMP (FULL DAY ADD-ON)
CHRISTMAS VACATION/WINTER VACATION (CLOSURE)
SPRING INTERSESSION & SPRING BREAK CAMP
SPRING INTERSESSION & SPRING BREAK CAMP (FULL DAY ADD-ON)
SUMMER CAMP PROFESSIONAL DEVELOPMENT WEEK
2025-2026 TENTATIVE CLOSURES
SCHOOL BREAK CAMP LUNCH POLICY
CAMP NON-ATTENDANCE POLICY
WITHDRAWAL NOTICE
HANDBOOK ACKNOWLEDGMENT, ANTI-BULLY & CONFLICT-FREE POLICIES
CODE OF CONDUCT POLICY

I acknowledge and understand The Apple Orchard Academy requires all employees, students, and family members of enrolled children to behave in a manner consistent with decency, courtesy, and respect. Our goal is to provide the most appropriate environment in which a child can grow, learn, and develop. Achieving this ideal environment is not only the responsibility of the employees but is the responsibility of every student, parent or adult who enters the facility..
GRIEVANCE POLICY

I acknowledge and understand all families have the right to bring a grievance and it is a fundamental principle of this policy that no family shall be subject to any detriment for having raised a grievance in good faith. Where a grievance is raised maliciously, i.e. where grievance was on grounds which they knew to have been false with the intention of harming the program, legal actions may be taken against the individual/family raising the grievance at individual's or family's expense. Slander or defamation of program will not be tolerated.
ADMENDMENT CLAUSE
TERMINATION OF SERVICES
STAFF VACATION
Signature
Date

MonthDayYear
Date
Hour MinutesAM/PM Option
Should be Empty:

2026-2027 REGISTRATION

Child's Information:

T-Shirt Order Information

Parent/Guardian Information:

2026 Summer Camp S.M.I.L.E.

Community Outreach for the Revitalization of Educational Partnerships (CO-REP) Parent Organization

Authorization and Agreements