New Student Registration Form

New Student Registration Form
Student Details:
Full Name*

First NameLast Name
Birthday*

MonthDayYear
Date
MF
4 Year Old Monday/Wednesday/Friday 9AM-11:15AM4 Year Old Monday/Wednesday/Friday 11:45AM-2PM3 Year Old Tuesday/Thursday 9-11AM
Both ParentsOne Parent who has sole custodyOne Parent who has joint custodyGuardian

Parent/Guardian Info

Emergency Contact Info

We agree to be personally responsible for medical costs that our child(ren) may incur due to accidents during school time, whether in the classrom or during a school activity.
Any medical concerns that we need to be aware of? Please list them below:
Tuition and Fee Agreement

We'll agree to meet our financial obligations as follows:
- Tuition is due the 1st of each month and past due after the 10th. Tuition will not vary from month to month regardless of how many days of classes are held. Some months have three weeks, some have four or five.
- 4 year old 3 days per week class tuition is $125 per month and 3 year old class tuition is $100 per month.
- A late fee of $10 will be added to your account if tuition is not paid by the 10th of each month.
- If an account becomes delinquent by 30 days, student's enrollment will be terminated.
- Tuition for attendance of a partial month will NOT be refunded.
- 30 days' notice is required to drop a class or you will be charged for the next month.
- Make checks payable to Kayla Stoker
- We also have a VENMO account - @Kayla-Stoker
Other Fees:
- A $75.00 non-refundable registration fee must accompany this application for enrollment. Students will not be considered for enrollment until this fee has been paid. Send payment to:
Kayla Stoker

4585 W Buffalo Circle

Syracuse, UT 84075

Or send to my Venmo address @Kayla-Stoker
Should be Empty: