ABC Childcare Enrollment Ages 0-4yrs

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Midtown: My Child's Daily Schedule will be Monday-Friday between the hours of:*
Eagle's Landing.-My Child's Daily Schedule will be Monday-Friday between the hours of:*
Stone Mountain: My Child's Daily Schedule will be Monday-Friday between the hours of:*
Are you a current participant of the GA CAPS Program?

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Parent/Guardian #1-Primary Account Holder
Parent/Guardian #1*

Parent #1 First NameParent #1 Last Name
IF Parent/Guardian #1's Home Address is same as Child's*

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Parent #1 Home Address*

Street Address

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Parent #1 Drivers License #*
Parent #1 Last 4 Social Security*
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Parent #1 Employer's Address*

Address

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Parent/Guardian/Spouse #2
Parent/Guardian/Spouse #2 Full Name

Parent #2 First NameParent #2 Last Name
IF Parent/Guardian #2's Home Address is same as Child's

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Parent #2 Home Address

Street Address

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Tuition Payment Options
Tuition is processed electronically each week on Thursdays.
Please select ONE of the following weekly tuition payment options and fill in the required information for your selection:*

ACH or Auto Bank Draft from Checking Account (FREE)Auto Payment by Debit/Credit Card (FREE)
Electronic Funds Transfer Authorization (ACH)

I (we) authorize ABC EARLY LEARNING ACADEMY (called “Center” in this authorization) to initiate debit/charge entries to my (our) Checking or Savings Account as indicated above at the depository financial institution indicated above (called “DEPOSITORY” in this Authorization). I (we) authorize CENTER to withdraw sufficient funds to pay my (our) regular childcare tuition and/or other fees that are due and payable. I (we) authorize CENTER to use the third-party sender, Tuition Express to process all payments. I (we) acknowledge that the origination of Automated Clearing House (ACH) transactions to my (our) account must comply with the provisions of United States Law. Credit Union Members: Please contact your Credit Union to verify account and routing numbers for automatic payments.
ACH or Auto Bank Draft Details*

Name on Bank Account

Bank Name

Routing NumberAccount Number

Account Holder's Phone NumberCountry
Credit Card Account Authorization

I (we) hereby authorize ABC Early Learning Academy (called “CENTER” in this Authorization) to initiate recurring credit card charges to the above referenced credit card account for the purpose of collecting childcare related payments. I (we) understand that the charges to the above referenced credit card account will be based on charges that are due and payable at the time of the credit card transaction. I (we) understand that this agreement is between myself (us) and the below referenced “CENTER”. I (we) authorize CENTER to utilize Tuition Express* to capture, create, and transmit all credit card information. I (we) indemnify and hold harmless, Tuition Express from any and all liability resulting from any and all transactions. All disputes will be directed to and addressed by and between CENTER and the below signed cardholder.
Debit/Credit Card Auto Pmt Details*

Cardholder Name

Cardholder Billing Address

CityState

Zip CodeCountry
Debit/Credit Card Details Continued*

Card Number

Expiration Date

3 Digit CodeCardholder Phone #

Cardholder email
Check to acknowledge and Agree to above ACH and/.OR Credit Card Authorization*

I agree to the financial agreement and to abide by the Policies and Procedures Provided. This authorization will remain in full force and effect until I (we) notify the CENTER in writing of its termination in such time and in such manner as to afford Center, Tuition Express and DEPOSITORY a reasonable opportunity to act upon it. I (we) understand that to properly affect the cancellation of this agreement, I (we) are required to give CENTER written notice of revocation. A minimum of 5 business days is required to affect revocation.
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Signature*

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ABC Early Learning Academy Enrollment Application: Parental Agreement

1. I understand that it is MANDATORY that I clock my child in/out each and every day. This is a State requirement and there are no exceptions. I further understand that failure to clock-in/out excessively may result in a $25 penalty fee or involuntary withdrawal from program. If I have difficulty clocking in/out I will notify management for assistance.

2. My child will not be allowed to enter or leave the facility without being escorted by a parent(s), authorized person(s) or an ABC ELA staff member.

3. For the safety, security and privacy of the children entrusted in our care, taking photos and/or recording on our property during business hours is strictly prohibited without the written consent of the Executive Director.

4. My child will participate in the following meals: Breakfast, Lunch and Afternoon Snack. I understand that any deviations from ABC’s USDA Meal Service plan requires a written notice from child’s Physician and outside food cannot be accepted until notice is furnished.

5. I understand that I will be notified should my child become ill during the day, and that I will pick up my child promptly or make arrangements for an authorized pickup person to come. Depending on the symptoms or illness contracted, I understand that my child may be required to wait before being permitted to resume attending according to the criteria in our Parent Handbook. I further agree to notify the school if my child contracts a contagious or communicable disease.

6. Before any medication is dispensed to my child, I will submit a written Medication Authorization Form. Prescription must be in its original container with my child’s name on it. ABC does not administer over the counter medications. Medications will only be dispensed once daily between 12noon and 1pm. Only a member of the management team can accept and dispense medication.

7. I give ABC ELA permission to apply one or more of the following topical ointments/preparations, when applicable, to my child in accordance with the directions on the label of the container: baby wipes; Band-Aids; Neosporin or similar ointment; Bactine or similar first aid spray; sunscreen; insect repellent; non-prescription ointment such as A&D, Desitin or Vaseline.

8. I acknowledge it is my responsibility to keep my child’s records current to reflect any significant changes as they occur, i.e., address, telephone, emergency contacts, physician(s), health status, feeding plans, immunization records, etc.

9. ABC ELA agrees to keep me informed of any incidents that may include my child. This could be but is not limited to Illness, injury, adverse reactions to medication, exposure to communicable disease or another situation that could create difficulty to the child(ren) or staff.

10. To maintain professional boundaries and equal treatment; I understand that ABC staff are NOT allowed to babysit/home care and/or mingle after hours with ABC clients/affiliates. Violation of this policy will result in immediate removal from our program.

11. I give ABC ELA permission to use the likeness or image of my child in print or online materials such as those on the ABC ELA Website.

12. 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 school, 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 the school.

13. ABC ELA agrees to obtain written authorization from me before my child can participate in routine transportation, field trips, special activities away from ABC ELA and water related activities occurring in water that is more than two (2) feet deep.

14. I understand that the school is closed on federal holidays and TWO training days per year. 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.

15. In case of a medical emergency, if medical attention is needed for my child before I can be contacted, I authorize ABC Early Learning Academy to act on my behalf by contacting medical emergency personnel and following their advice for my child. I further agree to be fully responsible for all medical expenses incurred during the treatment of my child.
Please check to acknowledge and accept the above terms*

I have read, understand and agree to abide by the policies and procedures contained within and understand that it is my responsibility to review. I further understand that ABC reserves the right to terminate childcare services if policies/procedures are violated or if providing services is deemed to be out of our normal scope of care.
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Parent / Guardian Signature*

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ABC Early Learning Academy Enrollment Application: Tuition Agreement

REGISTRATION FEE: We require a non-refundable prepayment of the registration fee and first week’s tuition in order to secure a slot at ABC. These fees are collected at the time of application submission. To allow sufficient time to process, application and payment must be received at least 2 business days before your child(ren)’s first day. The registration fee is $150 for one child and $250 for two or more. In addition, a nonrefundable, reoccurring administrative fee of $150 per child or $250 per family is also due annually on the first Thursday of March, and is not applicable to tuition fees.

WEEKLY TUITION PAYMENTS: Tuition is always paid in advance for the upcoming week. It is due every Thursday and processed electronically via automatic debit, (ACH) or automatic charge to debit/credit card. Credit cards accepted: Visa, MasterCard, and Discover *WE DO NOT ACCEPT CASH, CHECK OR MONEY ORDER PAYMENTS* Tuition is required to be paid whether your child attends the week or not in orde to retain slot in ABC’s Full-Time Program.

TUITION DISCOUNT: A discount will be allowed for families with more than one child actively enrolled for care. A 5% discount will be applied to your account once based on the lowest tuition rate. The discount will be applied once, even if a family has more than two children enrolled at one time. The Tuition Discount is not applicable to any additional fees or agency payments/copays.

LATE PAYMENTS TERMS: Tuition is due and payable each Thursday of the week before services are to be rendered. If tuition is not paid in full by the close of business on Friday, a $25 late fee will be charged. Service will be refused the following Monday morning without receipt of payment in full. There are no waivers of late fees. In addition, after five business days without payment, childcare slot will be forfeited, and family will be involuntarily withdrawn from the program. The school cannot guarantee a child's slot will be available when a child is withdrawn due to non-payment of tuition.

LATE PICK-UP FEES: ABC ELA closes promptly at 6:00PM. A late pick-up fee of $10 for the first minute (6:01pm) and $1 per minute after will be charged until the time of arrival. If your child is enrolled in GA Pre-K but is not registered for extended care; the late pickup policy will be applied for pickups after 2:30PM. This fee applies to each child picked up late and is due upon pick-up. Excessive instances of late pick-up will result in involuntary withdrawal from our program.

ATTENDANCE, VACATION, SICKNESS AND EMERGENCY CLOSURE POLICY: Tuition is due and payable weekly whether your child attends school or not in order to retain their reserved slot in ABC’s fulltime program. This weekly tuition amount is not discounted, prorated or waived if child(ren) does not attend for sickness, personal reasons, vacations/trips, family emergencies, inclement weather proceedings or a force of majeure/emergency closures up to five consecutive business days.

WITHDRAWAL: A written two weeks notice is required in advance when electing to withdraw your child(ren) from the program. Tuition is still due through the child(ren)’s last two weeks of attendance. If the child(ren) leaves mid-week, tuition is still due in full and will not be prorated or discounted. If short notice is given that is not equal to two weeks before the child’s last day, the full tuition is still due and the account of file will be automatically charged for the two weeks of tuition from the date that notice was received in writing.

RENROLLING: If space is available in the program and a parent wishes to reenroll later, the registration fee will be due. If applicable, any unpaid balances that were left on the account must be received before resuming childcare services.

AGENCY REIMBURSEMENT: ABC accepts scholarships from the CAPS program. The scholarship must be issued and accurately reflect current tuition rates prior to entry in the program. Families are responsible for their portion of the registration fee and weekly tuition copayment as outlined in the scholarship. It is the family’s responsibility to monitor scholarship expiration dates and renew case(s) in a timely manner. If scholarship expires and is not renewed; tuition will be due and payable at the full rate. Late fees and annual administrative fees are applicable and not covered by CAPS if incurred.

GA PreK Extended Care and School Age Aftercare: Standard rates are for extended care services only and do not cover a full day. Additional fees are required for Teacher Workdays, Full Week School Breaks and Summer Camp. Families must already be enrolled in Extended/Aftercare to be eligible for additional days of service and must sign-up to pay in advance to guarantee coverage for any school breaks.
Please check to acknowledge and accept the above terms*

I have read, understand and agree to abide by the tuition agreement/policies stated above. I also understand that my childcare services may be terminated if I do not follow all policies stated.
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Signature (Parent or Guardian)*

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PARENT/CLIENT CODE OF CONDUCT
We all have the right to be safe and feel safe in our educational childcare community. ABC Early Learning Academy’s Code of Conduct sets clear standards of behavior that apply to all individuals involved in our school community, including parents or guardians, volunteers, staff, students, and visitors. These standards apply whether they are on school property, speaking to staff members over the phone, digital platform meetings, or at school-sponsored events and activities.

All members of the school’s community are to be treated with respect and dignity regardless of race, creed, sexual orientation, disability etc. Parents are expected to respond to staff members as stated above when a staff member approaches them: for example, regarding their child’s incident and/or accident, their child’s behavior, their child’s development, or enrollment/tuition policies.

All adult members in our school community have the responsibility to act as models of good behavior. Foul language (swearing, name-calling and shouting) is never appropriate. Loud shouting, threatening and/or aggressive behavior of any kind cannot take place on school premises, including parking lot, playground, or School sponsored events. This includes - between parents (same family), parent to another parent, towards their child or another person’s child. In addition, other than ABC staff members, adults cannot redirect or discipline another person’s child or approach the parent of another child regarding an incident. If you have concerns, go directly to your schools Site Director.

Inappropriate behavior as listed above, harassment, or threat of violence of any kind towards a child, student, volunteer, caregiver, parent, staff member or other adult will result in police intervention and immediate dismissal from our program.

For the safety, security and privacy of the children entrusted in our care, taking photos and/or recording on our property is strictly prohibited without the written consent of the Executive Director. The school’s cubbies are to be used solely for the purpose of child’s storage and for communication between the parents and ABC ELA. No soliciting material, invitations, medications, or anything that says “keep out of reach of children” may be placed in a child’s cubby and/or classrooms.

No weapons are allowed on the premises or at school-sponsored events. It is the parent’s responsibility to make sure that their child does not carry prohibited items to school such as karate knives, nun chucks, Swiss army knives, etc. Personal electronic equipment is also excluded.

Alcohol and illicit drugs are not allowed on the school premises/property including playground and parking lot, or at school- sponsored events. The consequences for failure to comply will include but is not limited to the family’s expulsion from the school.

Parents, partners, caregivers, emergency contacts who appear to be unwell or intoxicated will be asked if they would like someone on the application form to assist them in picking up the child. Children will be released to parents on the application form unless a certified copy of a Child Custodial Agreement is in the child’s file. The privacy and confidentiality of our parents, guardians, caregivers, staff, students, volunteers are important to us. All concerns and comments should be addressed with the Site Director.
Please check to acknowledge and accept the above terms.*

I have read, understand, and agree to abide by the Parent/Client Code of Conduct policies listed. I further understand that ABC values safety as a top priority, therefore my childcare services will be terminated for Code of Conduct violations as stated above.
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Parent/Guardian Signature:*

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Document Uploads
Please upload a copy of the following documents:

1. Copy of Primary Parents Driver's License/ID

2. Copy of Medical Insurance Card

3. Copy of child(dren)'s Immunization Certificate (Form 3231)
Upload Copy of Primary Parent/Guardian #1 Driver's License/ID

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Upload Copy of Medical Insurance Card

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Upload Copy of Child(rens) Immunization Certificate(s)

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Page 1 - Let's Get Started

Page 2 - Child's Information

2nd Child Information, Authorization and Medical Information

3rd Child Information, Authorization and Medical Information

Parent/Guardian #1-Primary Account Holder

Parent/Guardian/Spouse #2

Emergency Medical Authorization, Contacts and Authorized Pickup Persons

EMERGENCY MEDICAL AUTHORIZATION

Tuition Payment Options

PARENT/CLIENT CODE OF CONDUCT

IEF Form (For School Meals-Breakfast, Lunch and PM Snack) CACFP Meal Benefit Income Eligibility Statement

PART V: Participant’s Ethnic and Racial Identities (optional)

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Document Uploads

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