Registration « The Olive Tree Learning Center

Parent/ Guardian's Name*

FirstLast

Relationship to Child*

Employer*

Address*

Street AddressCityStateZip Code

Main Phone*

Work Phone

Other Phone

Email*

Referred by

Do you need to include information for another parent or guardian?*

Yes
No

Other Parent or Guardian

Parent/ Guardian's Name*

FirstLast

Relationship to Child*

Employer

Address (if different)

Street AddressCityStateZip Code

Main Phone (if different)

Work Phone

Other Phone

Email

Child Information

Child's Name*

FirstLast

Date of Birth*

Gender*

Boy
Girl

Ethnicity

List Previous Schools Attended

May we contact the previous school listed, if necessary?

Yes
No

When is your child's first day of school scheduled?

Please choose the date of your child's first day of school.

Which classroom is your child joining?

Pre-Primary
L'Atelier
Primary

Pre-Primary Class Schedule*

Which is your first choice schedule?

L'Atelier and Primary Class Schedule*

Which is your first choice schedule?

Do you need early arrival hours?

Yes, I need early arrival hours.

Tuition is $25/ month from 7:30am - 8:30am

Do you need after school hours?

Yes, I need after-school hours.

Pre-Primary tuition is $185 from 3:00pm-6:00pm, Monday- Friday. Atelier and Primary tuition is $145 from 3:00pm-6:00pm, Monday- Friday. After-school is only available Monday-Friday.

I understand that any changes to the above schedule require a 30-day notice and I will be responsible for any tuition and fees at that time.*

Yes

I understand that all tuition and fees are non-refundable and based on equal payments over 10 months beginning August 1st.*

Yes

I have submitted the enrollment fee. I understand the enrollment fee will secure my child's classroom placement and is non-refundable.*

Yes

Does your child consistently and independently use the potty?*

Yes
No
Working on it

Please share more details about your child's potty training:

This is very helpful to our team so we can prepare the environment for their success.

List any special circumstances that your child may have, such as allergies, existing illness, previous serious illness, injuries and hospitalizations, and behavioral assessments during the past 12 months, any medication prescribed for long-term continuous use, and any other information which caregiver's should be aware of prior to enrollment.*

Please tell us a little more about your child.

Does this child have a sibling enrolled or to enroll? If so, please list the sibling's name here:

Emergency Contact Information

Name

FirstLast

Phone

Address

Street AddressCityStateZip Code

Emergency Contact's Driver's License Number

Emergency Contact's Relationship to Student

Is this person authorized to pick your child up from school?

Yes

Yes, I have read the following policies and procedures and agree with them.*

Parent Handbook and Guidance Policy
Permission to participate in water activities, included and limited to, sprinkler play, water table, and splash pads
Permission for OTLC management to transport and provide emergency care
Permission for OTLC to use photographs and or video for promotion, documentation, and blogs
Permission for OTLC to provide emergency medical care through clinic, hospital, or private provider

Would you like to join our mailing list?

Yes

Please type your full name, represents your electronic signature.

Email

This field is for validation purposes and should be left unchanged.

Enrollment Form

Other Parent or Guardian

Child Information

Emergency Contact Information