* = Required Information

Please provide the following documentation:

  • Up to Date Immunization Record
  • Copy of Birth certificate

Please complete, return and /or sign:

  • Physical Form LIC 701 completed by physician (School Age children do not need this form)
  • Preadmission Health History LIC 702
  • Children’s Rights LIC 613
  • Parent’s Rights LIC 995
  • Identification Emergency Information LIC 700
  • Consent for Emergency Treatment LIC 627
  • Meal benefit Form for Food Program CACFP
  • Tuition Schedule and Registration Enrollment Agreement
  • Emergency Card with authorized pick up
  • Tuition Commitment Letter
  • Consent for Photography
  • Annual Enrollment Update
  • Termination Policy
  • Infant Needs and Service Plan Required for infants and must be updated every 90 days
  • Administering of Inhaled Medication Required for children with asthma. Completed by physician. An inhaler must be left at center in original box with child’s prescription on it as well.
  • Acknowledgement of Licensing Report

Documents are required by the State of California. Failure to provide the necessary documents will result in denial of services for your child.

Tuition Schedule and Registration Enrollment Agreement

I * have agreed to enroll *

During Higher Learning Academy’s school year, I choose for my child to attend the following programs:

Full Day Program (please select days needed)


Half Day Program (please select days and times needed)


School Day Program (please select days and times needed)


Infant Center Program (please select days and times needed)



Full Day Program (over 4 hours) 2-5 year olds

  • 2 Days Per Week: $120.00/week
  • 3 Days Per Week: $180.00/week
  • 4 Days Per Week: $240.00/week
  • 5 Days Per Week: $300.00/week

Half Day Program (4 hours)

  • 2 Days Per Week: $90.00/week
  • 3 Days Per Week: $135.00/week
  • 4 Days Per Week: $180.00/week
  • 5 Days Per Week: $225.00/week

School Age Program (Before & After School)

  • 2 Days per Week: $95.50/week
  • 3 Days per Week: $143.25/week
  • 4 Days per Week: $191.00/week
  • 5 Days per Week: $238.75/week

Infant Program over ( Birth-24 months)

  • 2 Days Per Week: $153.90/week
  • 3 Days Per Week: $230.85/week
  • 4 Days Per Week: $307.80/week
  • 5 Days Per Week: $384.78/week

School Age Program (Full days vacation time)

  • 2 Days Per Week: $120.00/week
  • 3 Days Per Week: $180.00/week
  • 4 Days Per Week: $240.00/week
  • 5 Days Per Week: $300.00/week

Annual Registration: $100.00 due upon registration.

All Tuition and fees are due according to enrollment agreement. Payment must be received in advance for the 1st week child is enrolled. A $25.00 late fee is assessed if payment is received later than agreement. After two weeks of unpaid tuition a child’s enrollment is discontinued. I further understand the first ten (10) days are probationary for Higher Learning Academy, parent and child. This agreement may be terminated at any time during that period. Thereafter a two (2) week notice, or equivalent payment, is required when the child is terminated from care.

  • I understand that the registration fee holds a spot in the above class for my child and is non-refundable.
  • As a courtesy, please notify Higher Learning Academy of your intention to withdraw your child at least two weeks in advance so that families on the waiting list can be notified on a timely basis.
  • If a parent or guardian is late picking up a child after the 6:00 p.m. closing time, a $25.00 late fee will be charged in 15 minute increments.
  • Payment obligation is based on the hours you agree to use childcare, not on actual hours of attendance.
  • If your child becomes ill endangering the health of other children it will be necessary for the parent/caretaker to make other arrangements for alternate child care.

I understand the above policies and procedures for enrollment and payment of tuition and fees agree to comply with the terms of this agreement. *

Persons authorized to pick up child: Must be over the age of 16 and show valid I.D.

Add Another Person

Tuition Commitment Letter

I have agreed to enroll starting on

  • Annual registration fee is $100.00 per child and is due upon registration. This registration fee is non-refundable.
  • Late Fee for Pick Up after 6 pm: $25.00 amount will increase in increments of 15 minutes.
Full Day (Over 4 Hours)
Half Day (Less than 4 hours)
School Day (8:30-11:30 am / 3-6 pm)
Extend Care
Infant Center

Military - 10% Sibling- 10%

I agree to pay dollars the first day of each month.

I agree to pay dollars every week of each month.

I agree to pay dollars biweekly of each month.

I agree to pay dollars the last week of each month.

I agree to pay the co-payment dollars the first day of each month.

I, THE UNDERSIGNED DO UNDERSTAND THAT A $ 25.00 dollar late fee is assessed after nonpayment of tuition. After two weeks of unpaid tuition a child's enrollment is discontinued. *

Consent Form for Photography and Images of Children

Dear Parent,
During your child’s life at Higher Learning Academy we may wish to take photographs of activities that involve your child. The photographs may be used for school displays, or presentations. The result is that we are unable to celebrate children’s work and activities in the way that we would like. As you know, photography can be a powerful tool for children’s learning and forms an interesting and exciting visual record of work and events. We are actively encouraged to take photographs for assessment purposes, and pupils should also be encouraged to take digital images for their ICT work.

When we display photographs in school, we will only photography and no names. Should we wish to use an image of your child on our website or in a school publication, we will contact you to receive your express permission. The photographs we take will be archived periodically, but may be used for presentations or special occasions. We will soon be publishing a leaflet to give guidance to children and parents who wish to photograph school events and activities.

Photography will only take place with the permission of the Director / Lead Teacher, and under appropriate supervision. Images that might cause embarrassment or distress will not be used nor will images associated with material on issues that are sensitive.

Before taking any photographs of your child, we need your permission. Please answer the questions below, sign and date the form and return it to school as soon as possible. You can ask to see images of your child held by the school. You may withdraw your consent at any time by informing the school in writing.

I understand that: *

  • staff, pupil or professional photographers acting on behalf of the school may take images for use in displays and presentations;
  • the school will contact me if they wish to use my child’s image in a school publication or ontheir website;
  • the local media may take images of activities that show the school and children in a positive light e.g. Reception Year pictures of new starters, drama and musical performances, sports and prize giving;
  • embarrassing or distressing images will not be used;
  • the images will not be associated with distressing or sensitive issues; and
  • the school will regularly review and delete unwanted material.
Yes, I give my consent for pictures to be taken and used
No, I do not give my permission for pictures to be taken and used

Termination Policies

We reserve the right to terminate a child for the following reasons (but not limited to):

  • Failure to pay
  • Routinely late picking up your child
  • Failure to complete the required forms
  • Lack of parental cooperation
  • Failure of child to adjust to the center after a reasonable amount of time
  • Physical or verbal abuse of any person or property
  • Our inability to meet the child’s needs
  • Lack of compliance with handbook regulations
  • Serious illness of child
  • Behavior issues that threaten his/her or others safety

We appreciate as much advance notice as possible when terminating, and we will give the same courtesy in return. Parents are required to give two weeks written notice when they decide to terminate child care. The two weeks will be paid in full regardless of whether or not the child is in attendance.

The provider reserves the right to give written notice of immediate termination where there are extreme circumstances that affect the well-being of the provider of other children in attendance.

Anyone who terminates daycare and has a balance that is outstanding will need to have the account settled within 30 days. All accounts not settled within 30 days will be turned over to a collections agency regardless of amount owed. All accounts turned over to collections will have a $25.00 per week late fee plus 45% collections fee added to amount due.

Revisions to Handbook and Contract

We reserve the right to make changes in rates and policies as we deem necessary. You will be notified in writing of any changes that may occur. Every attempt will be made to give at least two weeks notice of changes.

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