First link

Please review the entire student enrollment packet and Family Policy and Enrollment Agreements with each family.
Be sure that all forms are filled out completely with appropriate signatures. Review the childs health record
and Immunizations for State compliance to ensure the physician has stamped/signed it and has filled in all the
necessary dates.



Review with Family
The childs first day Immunization/Health information

Child guidance and classroom management
(discipline policy)
Tuition payment schedule, amounts and due dates

Parent conferences and other communications,
what to expect daily and/or weekly
Process and Procedures of Security Access

Authorized pickup, late pickup policy and
emergency controls
Child Custody Documents (if applicable)
Clothing and other items to bring (labeled)
Any pickup restrictions
Any field trip restrictions
Any photo restrictions
Annual registration fee
Late fees
Vacation policy

Special needs
Absenteeism policy
Sick policy
Meals
Allergies
Security deposit (if applicable)

Medication policy

Relevant curriculum features for childs age group
Infant/Toddler Needs Services Plan (if applicable)

The information above was reviewed with me and all of my questions have been answered to my
satisfaction. I have a clear understanding of Ivy Leagues policies.


Name Parent/Guardian signature relationship Date



Name Owner/Dire ctor signature title Date
Obtain Signed Forms From Family
Standard Enrollment Packet Family Policy Agreement
Permission form for after school pickup,
& emergency care
Authorization for Student Pickup
field trips Enrollment Agreement

Security Deposit and Registration Form
Other State/Fed Forms





ENROLLMENT FORMS

FIRST PARENT/ GUARDIAN INFORMATION


Last Name First Name




Address City State Zip


Home Phone

Cell Phone

Driver License State Social Security Number



Place of Employment Corp. Partner
Work Address City State Zip
Work Phone Work Hours Title Email Address




How did you hear about us?


SECOND PARENT/ GUARDIAN INFORMATION

Last Name First Name
Address City State Zip
Home Phone Cell Phone
Driver License State Social Security Number
Place of Employment Corp. Partner
Work Address

City State Zip
Work Phone Work Hours Title Email Address
How did you hear about us?


PEDIATRIC PHYSICIAN & DENTIST INFORMATION



Dr. Last Name First Name


Office Phone Number


Address City State Zip


Dentist Name Phone Number


Hospital Name Phone Number


Insurance Carrier Policy #


Primary Insured Social Security Number

CHILD'S BASIC INFORMATION


Last Name First Name Date of Birth

Gender Social Security Number
Restrictions:
Parent * Yes No Comment:
*Where restriction is requested, you must provide documentation showing legal rights.






Please give details of other restrictions

Allergies* Yes No Comment:
*Must have documentation of allergies

CHILD'S PROGRAM INFORMATION


Application Date Expected Start Date
(School Age Child) Name of School Time of Dismissal
Expected Schedule:
Mon Tues Wed Thurs Fri

Program Classroom Tuition Mode Amount
Registration F ee Security Depo sit Start Date Drop Date
Field Trip Yes No Comment:
Photo Yes No Comment:
Other Yes No Comment:



A copy of THIS FORM, for each child, shall be placed in a 1" binder separated alphabetically by
last name and taken on the bus/van for each field trip orto the emergency evacuation site.

AUTHORIZATION FOR MEDICAL TREATMENT OF A MINOR

In the event of an emergency requiring a physician's care, doyou wish us tocall your family physician? Yes

No
Name Phone Number
Address City State Zip
I (we), do hereby state that I am (we are) parent(s) or
legal guardian(s) of _, who resides with me (us) at


I (we), authorize for emergency purposes only, adesignated
employee of the center to transport the above minor by ambulance & consent to any necessary
exam, anesthetic, medical advice and/or medical treatment from aphysician or surgeon licensed to
practice medicine in the State of
Allergies to drugs or food
Last Tetanus/ Diphtheria Booster

Please list any special medications or pertinent information




AUTHORIZATION


Parent(s) Legal Guardian (s) Signature(s) Date


Center Director (witness) Date

EMERGENCY CONTACTS AND AUTHORIZED PICK UP (in order of preference)

Name Relationship Daytime Phone
Name Relationship Daytime Phone
Name Relationship Daytime Phone
Name Relationship Daytime Phone
Name Relationship Daytime Phone

PASSWORD FOR UNUSUALPICKUP AUTHORIZATION


This password should be kept confidential. Only the parent and the Center Director will know it.
The password is used as a mean of positively identifying aparent if they call the center to
authorize an unusual pickup. The pickup person does not need to know the password. They just
need a photo ID.





AFTER HOURS
If a child has not been picked up by closing time, it is the responsibility of the Center Director to
attempt to contact the parents and every authorized pick up person listed on this form. If no contact
can be made to arrange a pick-up, legal authorities must be notified. If these authorities are also
unable to make a contact, the child must be cared for as directed by these authorities. The staff is
not permitted to remove the child from the child care center and continue to provide care in their
home or any other location.


Signature (Parent or Legal Guardian) Date

Signature (Parent or Legal Guardian) Date


Witness Date

CONSENT AND RELEASE
For film, photos, internet, intranet, as well as any other form of electronic or digital communication
On various occasions, your child may be photographed while at Ivy League Early Learning Academy.
These photographs may be used by Ivy League Early Learning Academy and/or its affiliated
companies, in program planning and/or public relations. They also may be used in various types of
advertising, or by public television, newspapers, magazines, electronics, social media, or
digital communication. For this reason, we request that each parent sign the following release"

PARENT CONSENT
I hereby, give, or do not give, Ivy League Early Learning Academy and its agents, the absolute
right and permission to copyright and/or publish, or use photographic portraits or pictures of
my child, or reproductions thereof in color or otherwise, made through any media for art,
advertising, trade electronic or digital communication or any other lawful purpose
whatsoever. These pictures may be used in conjunction with his/her own or fictitious name.

No, I do not grant full permission
Yes, I do grant full permission
Yes, I grant permission for internal use only



Child's Name Age Date
Parent/Guardian Signature Date
Center Director's Signature Date
Ivy League School Name City and State





PARENTPERMISSION FOR AFTER SCHOOL PICKUP, FIELD TRIP OR EMERGENCY

We may plan special field trips for the children away from the school. These trips are carefully
arranged and shall be supervised by an adequate number of adults. You will be notified of all
such trips that require transportation and a special permission form will be required. This also
includes children taking walks and infants strolling in their buggy off school property. You will
always receive advanced notice of ALL field trips.

We have your permission to take your child, _on these field trips,
as described above



Parent(s) Legal Guardian (s) Signature(s) Date


Witness Date

We have permission to pick up your child, _, on a daily basis from
school.



Parent(s) Legal Guardian (s) Signature(s) Date

Witness Date

For emergency purposes, our emergency evacuation site is:




Parent(s) Legal Guardian (s) Signature(s) Date


Witness Date


Childs Full Legal Name




Enrollment Agreement

Date of Birth _
Parent / Legal Guardian Name(s)
_

Please initial each section listed below, then sign and date on the last page
TUITION and MODIFICATIONS CONDITIONS
I have enrolled my child in the following program(s)

From_ _ am/pm to _am/pm
Monday Tuesday Wednesday Thursday Friday



AGENCY REIMBURSEMENT

I understand that I am solely responsible or any tuition payment and late fees in excess of any agency or
third-party reimbursement in accordance with the applicable contract. I also understand that I am solely
responsible for promptly communicating any changes in my status that would affect my agency
reimbursement, and that I am solely responsible for payment to Ivy League Early Learning Academy of any
tuition in excess of any agency or third-party reimbursement resulting from my failure to promptly
communicate status changes.

Government (HRA) co-payments are due the Friday prior to service. If not paid on that Friday enrollment
will be immediately suspended until your account is current.




PAYMENT OF TUITION

All fees (materiel, learning, etc.), deposits, and registrations are non-refundable

Monthly Payments: $ due on the 1
st
(pre-paid). A late fee of $50 will be charged if
tuition is not paid by the first (1
st
), an additional $5 will be charge each day thereafter, if not received by
10am. If your account is not paid in full by the fifth (5
th
) of the month, enrollment will be suspended
until your account is current.
Weekly Payments: $ due on Friday before the week service is provided (pre-paid). A
late fee of $30 will be charged if tuition is not received by close of business on Friday, an additional $5 will
be charged each day thereafter, if not received by 10am. If your account is not paid in full by Wednesday,
enrollment will be suspended until your account is current.
If payment in full is not received when due, I agree to pay a late payment fee per week/month or part of
each week/month that tuition is not received. All late fees are subject to change without notice. I
understand that if my account is delinquent according to the weekly/monthly payment of tuition terms I
will be asked to withdraw my child until my account is made current. Payments are still due and accruing





during suspension. The center cannot guarantee a childs spot will be held when a child is withdrawn due
to non-payment of tuition. Any unpaid tuition fees may be sent to a third-party collection agency. Any
accounts going to collection or any outside services for collection, you will be responsible for payment
of those fees. If your account in not current including any late charges, late fees will continue to
accrue.


RETURNED CHECKS

I understand that a processing fee of $50 will be charged to my account for all checks which are returned
for any reason. This fee is in addition to any charges that my bank or financial may charge me. I further
understand that once a check has been processed electronically the check is no longer negotiable and will
not be returned. If more than 2 checks are returned within a calendar year, I will be required to pay by
money order, cash or credit card. Late fees, as described above, will be applied for all returned checks.



REGISTRATION FEE

I understand that an annual, non-refundable, registration fee of $100 per child shall be paid in advance to
enroll my child. I Understand that I may guarantee my childs enrollment for fall by paying this fee no later
than 8/15 each year. In instances of agency of reimbursement, the registrati on fee is to be paid according
to the applicable contract. Upon payment of registration fee a start date will be given. Any changes in
start date will require new registration fee, which is non-refundable.




SUMMER REGISTRATION, ACTIVITY FEES, AND EARLY LEARNERS FEE

School age camp will be open during the summer months according to the local public school calendar.
Camp children will pay a separate registration and camp tuition fee during these months. Preschoolers
will have a separate summer activity fee. Other age groups may also incur a summer activity fee.
Please consult the Center Director for details. In instances of agency reimbursement, the summer
registration and activity fee will be my responsibility.

LEARNING MATERIAL FEE

Fee for children in our Pre-school and Pre-K programs of $50.00 is due each semester (September and
January). Learning material fee for children in our Young Learner program (Infants Juniors) of $25.00 is
due each semester (September and January)







DISCOUNTS

A ten percent (10%) discount is offered to me for each additional child from my immediate family enrolled
in the center. The discount is applied to the lowest tuition rate. These discounts are available only to those
accounts when full tuition is paid in advance. Discounts are not applicable to the registration fee,
curriculum/program fees, agency co-pays, special program promotion or for any other fees or services
and cannot be combined with any other discounts or promotions.




ADMINISTRATORS FEE

Failure to supply current and valid emergency contacts will result in your account being charged with a
twenty-five ($25) dollar administrator fee.



CHARGES AND PROCEDURES FOR LATE PICK-UP

Our school closes at 6:30 p.m. All families must be on time picking up their child. You must make sure
that you leave ample time to be out of the building at 6:30pm. Any family picking up after 6:30pm will be
charged $30 for each 15 minute period of time. This fee is due upon pick up. If this fee is not paid at the
time of pick up, late fees will be charged. This fee also applies if you pick up your child past your
scheduled pick up time.

If the center has closed and we have not heard from you the authorities will be contacted.




ENROLLMENT:

I understand that the completion and execution of any forms and the payment of any tuition, timely or
in advance, is not a guarantee of enrollment, continued enrollment or re-enrollment. My child may be
refused enrollment or may be dis-enrolled at any time, with or without notice, when it is believed, at
Ivy Leagues sole discretion, that discontinuing or refusing enrollment is in the best interest of my
child, the center or the other children in Ivy Leagues care. I further understand that enrollment at
Ivy League is not a guarantee of academic or other success, progression or promotion.


________


INCLEMENT WEATHER OR OTHER DISASTERS

I understand that it is Ivy Leagues intention to be open and provide child care service every
weekday of the year, excluding holidays, but that inclement weather, natural/national disaster or
major building issue may disrupt service from time to time. I will contact the center to ensure that it is
open during inclement weather/natural disaster. I will continue to be responsible for my tuition
payments for up to three days.




I understand that the center is closed on the following holidays: New Years Day, Memorial Day,
Independence Day, last Friday in August, Labor Day, Martin Luther King Jr Day, President's day,
Thanksgiving day, the day after Thanksgiving and Christmas day. The center will be closed at 3pm on
Good Friday, Christmas Eve and New Year's eve. I agree that I will not receive a refund, credit or any
other allowance for holidays. If a holiday falls on a weekend, it will be observed on either the
preceding Friday or the following Monday.




ABSENCES

I agree to inform the center immediately if my child(ren) will be absent on any day. I understand that
no allowances, credits, refunds or make up days shall be made for occasional absences. My regularly
contracted tuition is due for all weeks when my child attends any part of the week. The terms of a
Vacation Credit are as follows: After six (6) continuous months of enrollment, I may elect to use one week
of Vacation Credit when my child is not in attendance for an entire week Monday through Friday. During
the Vacation Credit week, my regular tuition charge will be reduced by 50%. There is a two (2)
week maximum annual Vacation Credit allowance which is non-cumulative and must be taken in full
week increments.
There is no credit given for single days and vacation credits may not be carried over.



WITHDRAWL FROM PROGRAM

I understand that I must provide a two (2) week written notice of withdrawal from the program. If this
notification is not provided, I agree to pay all tuition and fees for two (2) weeks, whether or not my child
attends. I understand that when my child is withdrawn, s/he will only be eligible for re-admission based
upon space availability and all other enrollment criteria. If my child is selected for re-enrollment, I will be
required to pay a new non-refundable Registration Fee. If there is an outstanding balance (including
tuition or fees) when my child was withdrawn, I will be required to bring my account current prior to
completing a re-enrollment application. I understand all fees (Registration or Activity) are non-refundable.



CHILD ACCIDENT INSURANCE

Supplemental child accident medical insurance is provided as a complimentary service to reimburse the
cost of medical treatment resulting from any injury to my child while in Ivy Leagues care. I understand
that this is an excess policy only and that my health insurance is and remains the primary responsible
party for payment for the cost of treatment for my child(ren). I also understand that the policy requires a
$50 deductible for each incident, and that I have one year from the date of injury to make a claim under
this policy. I further understand that I am solely responsible for initiating a claim, for requesting all
appropriate forms from the center and for tracking the status of my claim.









DAILY SIGN IN AND SIGN OUT

I agree to sign my child(ren) in and out every day on the Ivy Leagues computer accounting system. I
understand that my child is not permitted to sign him/herself out. I understand that I am required to enter
the center to drop off and pick up my child(ren) and that I must escort my child(ren) to and from the
designated classroom each day. In states where a manual signature is required due to state child care
licensing regulations, I agree to complete the required computer and manual sign-in and sign-out
procedures.

HOLIDAYS:




RELEASE OF CHILDREN

I understand that my child will only be released to me, a parent or legal guardian (except where prohibited
by state child care law or court order) and to those persons whose names I have listed on the
Authorization for Student Pick-up form. I understand that Ivy League may require, at any time and
without notice, satisfactory proof of identification and a valid drivers license from any person, including
myself, who proposes to pick up and transport my child(ren). I understand that,
for the safety and security of my child(ren), if an emergency were to arise where an unauthorized person
must pick up or drop off my child(ren), I will be required to provide a password or other verification, as
directed by the center. I will be required to follow the centers instructions for Student Release to an
Unauthorized Person policy which requires a photo ID from the person picking up my child and the
completion of a release form which I must sign upon my next arrival at the center. I understand that Ivy
League has the right to refuse to release a child to any person, including myself, who fails or refuses to
follow Ivy Leagues Sign-In, Sign-Out and Child Release policies, or to any person who appears, in the
sole discretion of Ivy League, unable to safely transport my child(ren). I understand that no person under
the age of 18, including family members but excluding emancipated minor parents, may pick up a child
from the center.



MODEL RELEASE
Ivy League Early Learning Academy, its agents, affiliates and licensees, may may not use
photographs, reproductions, images or sound recordings of my child for advertising, publicity or any other
lawful purpose.




CHILD INFORMATION

I understand that it is my sole responsibility to inform Ivy League of any changes in my personal
information or my childs personal information including, but not limited to, address, home phone
number, work phone number, cellular phone number, pager number, days and hours of work, days and
hours of school, transportation arrangements, childs medical conditions and any changes that may affect
my childs enrollment. I understand that Ivy League will not be responsible for errors or claims resulting
from my failure to provide current personal information.





EMERGENCY CONTACTS

I understand that I am required to provide and maintain at all times a minimum of two (2) additional
emergency contacts other than myself, including full names, home and work phone numbers, cellular
phone numbers, addresses, drivers license numbers or state identification numbers, and relationship to
my child(ren). I understand that in the event of any emergency for which I cannot be reached and the
emergency contacts cannot be reached, that the center may contact the police or other local authorities
for assistance.







CENTER SAFETY

I understand that Ivy League has an open door policy for parents and legal guardians and that I have
unlimited access to the center, while my child is in attendance. I understand that access to the center
may be restricted to custodial parents pursuant to state child care regulations, or may be further
restricted by court order. I further understand that, for any reason it deems appropriate for the
preservation of the safety, security, health or general wellbeing of the center, Ivy League may temporarily
or permanently exclude any person from the center, including a parent, whom Ivy League finds at its
sole discretion, poses or is likely to pose a risk to the center or who fails or refuses to conduct him or
herself in a manner befitting a child care environment. Prohibitions include but are not limited to:
profanity, yelling, threatening, aggressive or violent behavior, intoxication or failure to follow Ivy League
policies and procedures.



INTERVIEWING CHILDREN AND
INSPECTING RECORDS:

I understand that the state child care regulatory enforcement and administration agency and the local
department of social services or child protective services has the authority to interview children or staff,
to inspect and audit child or facility records, to interview children privately, to observe the physical
condition of the children in the center, to make provisions for the independent medical examination by a
licensed physician of any child, and to contact and instruct any other appropriate authority to do the same,
without prior notice or consent by myself or by Ivy League.




ILLNESS AND RE-ADMISSION

I understand that I will be notified should my child become ill during the day, and that I will pick up my child
promptly upon such notification. If my child is exposed to or contracts a contagious disease, I agree to
notify the center and I understand that my child will be re-admitted according to the Ivy League Re-
admission Criteria in the Policy Agreement. Additionally, I understand that if I am notified to pick up my
child due to illness, arrangements must be made within one (1) hour. Failure to comply will result in late
fees being charged, at $30 for every 15 minutes.





MEDICATION

I understand that Ivy League does not administer any medication, and that I must administer all
prescription and over-the-counter medication at home. If diaper cream or sunscreen must be administered
during the day, I agree to fill out the Non-Prescription Medical Treatment Instruction, Consent
and Waiver form or the Authorization for Administering PrescriptionMedical Treatment Waiver
and Consent form and give the medications and completed forms to the appropriate management person
in charge. I understand that I must strictly follow all Ivy League policies related to the administration of
medication in the center, and that Ivy League may refuse to administer any medication at any time,
without notice when, at Ivy Leagues sole discretion, such action is in the best interest of my child





PERSONAL ITEMS:

I understand that Ivy League is not responsible for lost or damaged personal items. I will ensure that
my child(ren)s clothing, backpacks and other personal items are clearly labeled with child(ren)s first and
last name.



ALL IVY LEAGUE POLICIES & STATE REGULATION:

I understand that the above policies are not an all-inclusive list of policies, and that my child(ren), my
family members, authorized agents and I are bound by state child care regulations, the Policy
Agreement, and all other Ivy League policies, which may be modified at any time, without notice. I
also understand that the child care regulations of the state in which my child attends may prevail over
these Ivy League policies when the state regulation is stricter. I further understand that my continued
enrollment at Ivy League constitutes my acknowledgement of, and agreement to abide by,
all Ivy League Policies and state regulations.
All children should be in their classrooms no later than 10am. UPK children should be in their classroom at the assigned start time.






CELL PHONE FREE ZONE

Cell phones are not permitted to be use in the school at any time. I agree that I will not use or have
my cell phone out at any time with on school property.


OUTSIDE FOOD AND TOYS

For the safety of all children food may not be brought in from the outside. We have many children
with severe food allergies. We must insure a safe environment and follow mandated policies for
food safety. If you would like to have a birthday celebration for your child, all items must firs
cleared with your child teacher. All of the items must be prepackaged with the ingredients label
visible. We are nut free, egg free and latex free school. You are prohibited for giving you child
food in the hallways or any other area of the school. Food served in a classroom, may not leave
that classroom. You child may not bring in items from the outside; they may contain small parts
that are choking hazards to children. Each toy and learning material supplied by the school is
safety for children in the school; we do not have this safety check for item being brought from
home. Any item (food of toy) that is brought in to the school will be disposed of.

NO MODIFICATIONS:

No terms of this Agreement may be altered, revised, modified or deleted by any person except in
cases of Ivy League policy change or rate change to which both Ivy League and I must initial. Any
alterations, revisions, modifications or deletions of any term of this Agreement are null and void.


These policies have been reviewed with me by center management. I understand and will
comply with the policies included in Ivy Leagues Enrollment Agreement and Policy Agreement.
Policies in this contract will supersede all other documents.


Parent or Legal Guardian:
(Signature) (Date)



(Printed Name)


Center Director Signature: