WonderTree Academy Registration

Family Registration Form
How many children are you registering?*
How did you hear about us?
Is your child(ren) NEW to our Academy?
Payment Assistance Information
Childcare Payment Assistance ~ Please choose one of the following:*

I DO NOT receive state subsidy assistance, foster care, or Swift Start assistance.I am currently approved and receiving subsidy childcare assistance.I am currently on the wait list for subsidy assistance. NOTE: You will be responsible for ALL fees and tuition until approved.My child is part of the foster care system.I am currently approved through Swift Start.
Which county are you receiving assistance from:
Child Information
1st Child's Name*

First NameLast Name
1st Child's Date of Birth*

MonthDayYear
Date
1st Child's Gender*

BoyGirl
1st Child's Anticipated Start Date*

MonthDayYear
Date
2nd Child's Name*

First NameLast Name
2nd Child's Date of Birth*

MonthDayYear
Date
2nd Child's Gender*

BoyGirl
2nd Child's Anticipated Start Date*

MonthDayYear
Date
3rd Child's Name*

First NameLast Name
3rd Child's Date of Birth*

MonthDayYear
Date
3rd Child's Gender*

BoyGirl
3rd Child's Anticipated Start Date*

MonthDayYear
Date
4th Child's Name*

First NameLast Name
4th Child's Date of Birth*

MonthDayYear
Date
4th Child's Gender*

BoyGirl
4th Child's Anticipated Start Date*

MonthDayYear
Date
Child(ren's) Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent Information

If the primary parent has physical and/or legal custody of the child being registered, please be prepared to provide copies of legal court documents stating this. Please understand that if you do NOT provide this information and you choose NOT to include the secondary parent on this enrollment form, WonderTree Academy is legally bound to allow the secondary parent access to his/her child after we have properly identified them to do so. We can however alert you if the secondary parent is requesting to see the child.
Who does your child live with?*
If divorced please provide custody details and a copy of the official papers below:

Cancelof
Relation to Child:*
1st (Primary) Parent's Name*

First NameLast Name
Valid Email Address:*
example@example.com
Phone Number*
Please enter a valid phone number.
Va state licensing requires that we obtain your current employers address and phone # if you are currently employed.
Employer's Name:*

First NameLast Name
Employer's Phone Number:*
Please enter a valid phone number.
Is the 2nd parent's physical address the same as the 1st parent?*
Employer's Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
2nd Parent's Information
Relation to Child:*
2nd Parent's Name*

First NameLast Name
Valid Email Address:*
example@example.com
Phone Number*
Please enter a valid phone number.
Va state licensing requires that we obtain your current employers address and phone # if you are currently employed.
Employer's Name:*

First NameLast Name
Employer's Phone Number:*
Please enter a valid phone number.
Employer's Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contacts & Authorized Pick-Up

Virginia State Law requires you to provide a minimum of 2 emergency contacts OTHER THAN the parent(s), that live within 1 hour of your child’s center.If you are new to the area, we allow you 2 weeks to establish emergency contacts. It’s extremely important that you’re available by phone at all times while your child is in our care, especially during the 2 week period of establishing emergency contacts. If this information is not provided within 2 weeks of your child’s first day of attendance, your childcare services may be interrupted until this information is provided to the center.
1st Emergency Contact Relationship To Child:
1st Emergency Contact Name:*

First NameLast Name
1st Emergency Contact Phone Number:
Please enter a valid phone number.
1st Emergency Contact Address: (other than parents)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
2nd Emergency Contact Relationship To Child:
2nd Emergency Contact Name:*

First NameLast Name
2nd Emergency Contact Phone Number:
Please enter a valid phone number.
2nd Emergency Contact Address: (other than parents)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Pick Up List- anyone other than parents or emergency contacts allowed to pick up child.
(List full name, relationship to the child, address, and valid phone number so they can be added to your child's profile in Brightwheel)
Anyone NOT allowed to pick up your child
(List full name and relation if any)
Medical Information:
Child's Doctor/Clinic Name: Doctor's Number: blank*
Parental Agreement with WonderTree Academy:
- Before ANY medication is dispensed to the child(ren), parents/ legal guardian will provide a doctor's note as well as written authorization which includes : Name of child, date, name of the medication, prescription number, dosage, date and time of day medication is to be given, and when it was last given at home. Medicine must be in the original container with the child's name marked on it.
- WonderTree Academy agrees to keep parents/legal guardians informed of any incidents, including illness, injuries, or adverse reactions to medicines, etc., which include the child(ren).
- The child(ren) will not be authorized to enter or leave the facility without being escorted by the parents, or legal guardian, person authorized by the parent or daycare personnel.
- Parents/legal guardians acknowledge that it is their responsibility to keep the child's records current to reflect any significant changes that may occur. (ie. telephone numbers, work location, emergency contacts child's physician, child's health status, infant feeding plans and immunization records, etc.)
Emergency Authorization: By typing my name below, I electronically give permission for WonderTree Academy to obtain medical treatment, including emergency transportation, for my child if I cannot be reached immediately. I agree to be responsible for any emergency medial expenses incurred.*
Does your child(ren) have any allergies documented by a physician? Or any foods or medicines that your child has a reaction from?
List the name of the child(ren) along with the allery/reaction
Please print the following documents. The affidavit needs to be notarized, the health statement needs to be signed by the pediatrician and you'll also need your child's immunization record.
Minor Medical Release Slip: By signing this release form, you are giving WonderTree Academy permission to give your child the following as needed. Parents are required to provide any needed items with a label with the child's name that may be used by our Academy. Please select each of the following that your child will be using and if permission is given.*

Diaper Rash OintmentTeething GelSunscreenAnti-itch CreamBug SprayGas DropsNeosporinPeroxideCalamine LotionNone Needed
By typing my name below, I electronically give permission for WonderTree Academy to administer the above items as needed.*
Please print the Authorization Form for Non-Prescription Over-the-Counter Skin Products document below complete and turn in to WonderTree Academy Director.
Media Permission Slip - WonderTree Academy will occasionally use children's pictures or videos on the WonderTree Academy website, Facebook page, Instagram or on promotional materials. Please let us know whether or not you would mind having your child's photos used in this manner. No names of children will ever be used in any way.
Do you authorize your child's picture to be used in the above stated manner?*
Type a question
WonderTree Academy Parent Contract*

I have received and read the WonderTree Academy Parents HandbookI understand and agree to abide by all policies and proceduresI understand that a minimum 2-week written notice of withdrawal must be submitted to the center director, either in person or by email. This allows us to notify families on our waitlist and prepare for your child’s departure. Failure to provide 2 weeks’ notice will result in a charge equal to your child’s weekly tuition for each week short. Example: Notice given on the 1st for a last day on the 14th = 2 weeks’ notice ✅Notice given on the 8th for a last day on the 14th = 1 week’s notice ❌ (1 additional week’s tuition will be charged)I understand agree to abide by the registration policiesPick-up after 6 pm will result in a $10 fee for the first 5 minutes, and $1 a minute thereafter, no matter the reason! No Exceptions! I agree to pay applicable fees if I or one of my listed contact’s fails to pick my child up by the designated time.I understand WonderTree Academy's No Pause Tuition Policy. (Parents will be informed via; Brightwheel and/or Facebook, of scheduled closings for holidays, unexpected repairs, or in the case of dangerous weather conditions. Please note that there will be no pause in tuition, discounts or credits issued for these closings. For inclement weather days, our center will do everything possible to be open for childcare without endangering our families or employees travel to and from the center. Should we close due to dangerous weather conditions, we will notify families asap.)I understand that my child will not be allowed to play on any equipment unless my child meets the height and weight requirements. I acknowledge, release, and hold harmless the facilities, personel, and property of WonderTree Academy from a possible injury that could occur while my child is playing on the playground equipment. I give my permission to allow my child(ren) to play on the equipment and acknowledge the risk associated with play.I understand and agree to abide by the health and illness policies outlined in the Parent's Handbook, including the medication policy.I understand and agree to abide by the billing and payment policy.I understand that non-payment of tuition and fees or an accumulated balance may result in my child's removal from WonderTree Adacemy.I understand that all registration forms including copy of birth certificate, current immunization records, updated physical, medical forms, and emergency contact information must be turned in before my child is considered officially enrolled.
WonderTree Academy reserves the right to make changes to any policy, procedure, tuition rates, fees, or other processes and information in the parent handbook, rate sheet, or our enrollment forms without prior notice. We reserve this right to maintain licensing compliance, stability, and integrity of the programs, and for the safety and security of the children & families enrolled in our programs, and for the staff that our company employs. The following policies are imposed to ensure consistency in all billing and collection processes with all families, and will be maintained without special regard.

Unpaid Tuition & Late Payments ~ We require payment by auto debit ONLY. We DO NOT accept cash or checks. Payments are processed automatically weekly on Thursday’s prior to the week of attendance according to our billing schedule. Should payment be returned the first time unpaid by your creditor due to Non-Sufficient Funds, Brightwheel will try again to pull the payment and a $35 Late Fee will be added to your account. If the account remains unpaid by closing time on Friday, your account will be paused and services frozen until payment can be made in full.

* Registration Fee ~ $100 per child required with first weeks tuition the week before the scheduled start date.

* Supply Fees ~ A Bi-Annual supply fee is charged in March and September: $50 per child. All fees will be debited from your credit account.
We accept: ALL major credit cards. Credit card processing fees will be added on to tuition – Our software does this automatically (processing fee of 2.95% per transaction), or Checking Account Withdrawal (processing fee 0.6% per transaction.) Tuition runs the Thursday PRIOR to your child’s attendance the following week).

ALL PAYMENTS MUST BE SETUP BY PARENTS/GUARDIANS UPON INVITATION TO BRIGHTWHEEL IN ORDER TO COMPLETE REGISTRATION! *No Checks or cash accepted*

DEBIT AUTHORIZATION AGREEMENT:
Charges that may be automatically debited from your credit card or checking account will include the following as applicable:

* Registration fees (these fees are Non-Refundable)
* Weekly and monthly tuition charges
* Bi-Annual Supply Fees in March & September
* Late payment fee of $35
* Late pick-up fees, $10 1st 5 min, $1 a min thereafter
By typing my name below, I electronically acknowledge that I have read the payment policies in this agreement. I understand that I am responsible for all tuition & fees that I incur upon receipt of this registration and while my child is actively enrolled in WonderTree Academy. I understand that failure to comply with said payment policies could result in applicable late fees, suspension, and/or termination from the program.*
Have there been any birth, illnesses, deaths, adoptions, or any other major life events/changes recently in the family structure which have affected your child? If yes, please describe briefly.
What does your child say when they need to use the bathroom? (if language other than English please write out pronunciation)
Child's favorite play activities
What opportunities does your child have to play with other children?
Is your child attached to a "special item" ?(blanket, toy, etc.)
Does your child have any special fears? (animals, storms, vacuum, etc.) if yes, how do you get them to calm down?
What methods of discipline have you found most effective for your child?
How does your child react to change and new situations?
Are there any habits (nail biting, thumb sucking, etc.) or other issues that we need to be aware of?
Is there anything else we should know about your child or that you would like to share with us?
All registration forms—including a birth certificate, school entrance health form or current physical and immunization records, any required medical forms, and complete emergency contact information—must be submitted before your child is officially enrolled. YOU CAN UPLOAD THESE BELOW!
Should be Empty:

Family Registration Form

Payment Assistance Information

Child Information

Parent Information

2nd Parent's Information

Emergency Contacts & Authorized Pick-Up

Medical Information: