2020-21 Toddler Enrollment Contract – customized 2021-22 Toddler Enrollment Contract - customized This contract is for enrollment in the 2021-2022 year. Child's Name* First Last Date of Birth* Gender*MaleFemaleParent/Guardian #1 Name* First Last Parent/Guardian #1 Email* Parent/Guardian #2 Name First Last Parent/Guardian #2 Email I am enrolling my child for the program identified below:Half Day (8:45 am to 11:45 am) Toddler Program at the Park CampusSchool Day (8:45 am to 3:00 pm) Toddler Program @ the Park CampusAll Day Montessori (7:45 am to 6:00 pm) Toddler Program @ the Park CampusPark Campus Toddler Program Tuition Options*Half Day 8:45 am - 11:45 am. Tuition to be paid each month in the amount of $1460.00 regardless of the number of days in the month.School Day 8 :45 am - 3:00 pm. Ten monthly payments of $1870.00 regardless of the number of days in the month.All Day 7:45 am - 6:00 pm. Monthly payments of $2160.00 regardless of the number of days in the month. Summer tuition is additional. Half Day program hours are Monday through Friday from 8:45 am to 11:45 am). School Day program hours are Monday through Friday from 8:45 am to 3:00 pm All Day Montessori hours are Monday through Friday from 7:45 am to 6:00 pm.Desired start date in the Toddler Program - child must be 18 months old to start*Summer 2021September 2021Mid-Year Start - April 2021Total $0.00 Billing InformationPlease note: to submit the enrollment contract you pay the Non-refundable deposit payment with a credit card. This payment is for June 2022.Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Cardholder Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Cardholder EmailCardholder PhoneI UNDERSTAND AND AGREE TO THE FOLLOWING TERMS: Please click in box directly below to read terms.1. Registration at Bellevue Montessori School requires agreement with the philosophy and policies described in the Parent Handbook. By signing this contract, I acknowledge that I have read the parent handbook for the program in which my child is enrolled and agree to and accept the provisions and policies that are contained in it, as well as any revisions that may be adopted after this date. I acknowledge that it is my responsibility to request an explanation or clarification for any provision which I do not fully understand. I understand that the school may revise the handbook at any time, and that written notice of revisions will appear in a school newsletter. I agree that I am responsible for reading the newsletter to be aware of any revisions. 2. I specifically acknowledge that I have read, understand, and agree to each of the following (found online at https://bellmontessori.com/toddler/: -Emergency Response Plan -Pesticide Policy (in the Handbook) -Health Policy (in the Handbook) -Pet Policy (in the Handbook) 3. I agree that I will promptly notify Bellevue Montessori School in writing of any changes in the information contained in the application for enrollment and of any other information required by school policies. 4. Bellevue Montessori School charges an annual tuition for the school year as described at the beginning of this contract. The tuition payment obligation remains the same each month regardless of the number of days of school in the month, attendance, vacations, family emergencies, school closure, holidays, student illness, and any other reason that my child does not attend school. School closure days due to natural disasters, such as a pandemic, weather or power outages are not made up. 5. When 2 children from the same parents attend school at the same time, the second child’s tuition will be reduced by 3%. The tuition of a third child in the same school year from the same parents will be reduced by 3%. This reduction is taken on the final payment of the school year. 6. Families who chose to pay the full tuition in one payment before school starts may reduce the annual payment by 3%. 7. The total of all combinations of discounts cannot exceed 6%. 8. Unless the total tuition is paid prior to the start of school, the annual tuition is due in equal installments plus the deposit unless program schedule changes. Payment of tuition may be made by preauthorized draft from your bank account or preauthorized payments by a credit card. * Payment #1 is due with the completed enrollment form and contract within 14 days of receiving the enrollment offer and is made by credit card for no additional fee. The non-refundable deposit payment is your payment for June 2022. * Payment #1. This is a non-refundable deposit. ** Credit card payments made online through Tuition Express are subject to a 3.2% convenience fee on all payments. * For New Students Only - Payment #2 is due May 1st or 30 days after you submit the enrollment form, contract and deposit payment #1. This non-refundable deposit payment is your payment for May 2022. If you sign up for the ACH (automatic drafts), this payment would be taken out in May 2022 per the usual tuition payments. Credit card payments made online through Tuition Express are subject to a 3.2% convenience fee on all payments. * For later enrollments, both deposit payments are due prior to the start of the school year in September. * The remaining payments are due the first school day of the month from your child's start date through May, either by automatic drafts (ACH) through Bellevue Montessori School or directly with a check for no additional fee. Credit card payments made online through Tuition Express are subject to a 3.2% convenience fee on all payments. 9. I agree to pay monthly tuition payments on or before the first school day of the month. I will pay a $25.00 late fee if my tuition payment is received after the fifth of the month, a $30.00 handling fee for any declined payment and interest on past due balances at the rate of 1.5% per month. 10. If your child is withdrawn, you forfeit your June 2021 deposit payment. 11. An authorized adult will pick up the student from school each day in accordance with School policy. I agree to pay charges for Activity Club or the applicable Late Pickup Charge fee (for late pickup from Activity Club) if my student is not picked up on time. 12. Bellevue Montessori School reserves the right, in its sole and absolute discretion, to revoke enrollment at any time (before or after the beginning of classes) when it deems it necessary. In the event admission is revoked, Bellevue Montessori School reserves the right to determine whether any portion of the tuition deposits will be refunded. 13. In the event an attorney is employed to collect any amount due hereunder, I agree to pay all attorneys’ fees and costs incurred by Bellevue Montessori School for the collection of the amount due.*I have read the above contract I understand and agree to all provisions.Parent #1/guardian Signature*Date Parent #2 /guardian SignatureDate This iframe contains the logic required to handle Ajax powered Gravity Forms.