WTCA 25-26 Registration Form

All registrations are received and reviewed in a first come, first serve basis. Upon filling all open spots, all additional submissions will be added to our waiting list. ***We are currently NOT accepting state pay/Subsidy pay***

Expected Start Date*

MonthDayYear

Which class are you wanting to register for?*

First Name*

Last Name*

Gender*

FemaleMale

Birth Date*

MonthDayYear

Home Phone*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Health Care #*

Doctors Name*

First NameLast Name

Doctors Phone Number*

Area CodePhone Number

Full Name*

First NameLast Name

Home*

Area CodePhone Number

Cell

Area CodePhone Number

Work

Area CodePhone Number

E-mail*

Address - Same As Child*

YesNo

If your address is different than the childs please fill out the info below. Otherwise move onto the next section.

Parent/Guardian 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Full Name

First NameLast Name

Home

Area CodePhone Number

Cell

Area CodePhone Number

Work

Area CodePhone Number

E-mail

Address - Same As Childs

YesNo

If your address is different than the childs please fill out the info below. Otherwise move onto the next section.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Custody Court Agreements between parents (if so the school will need documents on file)

We are found on instragram and WTCA has an active social media platform do you consent for your child to appear on either Facebook or Instagram?*

YesNo

I grant permission to Whole Truth Prep Christian Academy for the following pictures to be takenof my child: Please initial if you agree). Your child’s name may or may not appear in the below:

Please sign if you wish NOT to have any pictures taken of your child.

I give consent for my child to take part in field trips or excursions away from the facility under propersupervision.

YesNo

Is your child immunized?*

YesNo

Does your child have any allergies?*

YesNo

If yes please list, including any food or drug allergies.

Does your child have any medical conditions?

Does your child require any medication? If yes, please list these medications.

Do you authorize us to administer the medications listed above?

YesNo

Please list the people authorized to pick up your child.

Does your child have any siblings?*

If yes, what is their age(s)?

Comments

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Home*

Area CodePhone Number

Cell

Area CodePhone Number

Work

Area CodePhone Number

REQUIREMENTS UPON ENROLLMENT:

1. $180.00 Non-Refundable Registration Fee per family (For New Families Only).

2. A Completed Registration form.
3. A signed and dated Parent/student enrollment packet.
WEEKLY PAYMENT POLICY:
Parents will have the option to decide on paying weekly or monthly. Whichever way you decide, you will be
paying ahead for care. Ex. If you choose to pay monthly, the entire following month will be paid on the
Thursday prior to the first week of the new month.

YOUR PARENT FEE
Payment Policy States:
• Day Care Statements will be sent out on Daily connect at the beginning of each month.
• Weekly parent fees are billed according to the number of Mondays within that month.
• Payments must be received by the Thursday before the next billing week (you are always paying
ahead).
• Checks should be written to the “Whole Truth Christian Academy”. Please include the child’s full name
and program in the memo line on your check. There is a $50.00 fee for all returned checks.
DELINQUENT PAYMENT POLICY:
When you become delinquent on your account, not paying according to your agreement, the following
procedure will occur:
• If parent fee is not paid by Thursday, a phone call will be made to you on Friday reminding you
that a payment must be made.
• If no payment is received by 12 noon Monday, you will receive a letter stating that you must
have two weeks paid by that Thursday.
• If the two week payment is not received by that Thursday, your child/children will be terminatedfrom
the program(s) effective that Friday, your security deposit will be applied to the outstanding balance
and your account will be reviewed by our accounting office.
• The Whole Truth Christian Academy will review accounts that are delinquent. Unpaid accounts will
be turned over to a collection agency if not settled within 30 days of termination and are subject

I choose to pay

weeklybi weeklymonthly

All registrations are received and reviewed in a first come, first serve basis. Upon filling all open spots, all additional submissions will be added to our waiting list.

SIGN & SUBMIT

Whole Truth Christian Academy Registration Form

Student Information

Parent/Guardian Information 1

Parent/Guardian Information 2

Other Infomation

Emergency Contact - Other than Parent/Guardian