Enrollment Forms

Phone numbers where parents/guardian may be reached while child is in care:

In case of an emergency, call:

I authorize Brighter Minds Learning Center to release my child to leave the operation ONLY with the following persons. Children will only be released to a parent or guardian or to a person designated by the parent or guardian after verification of ID.

I acknowledge receipt of the facility's operational policies, including those for:

The following meals will be served to my child while in care:

I acknowledge I have received a written copy of my rights as a parent or guardian of a child enrolled at this facility.

Check all that apply:

Child day care operations are public accommodations under the ADA, Title III. To learn more, visit ada.gov/resources/child-care-centers.

My child has permission to:

In the event I cannot be reached to arrange for emergency medical care, I authorize the person in charge to take my child to:

I give consent for the facility to secure any and all necessary emergency medical care for my child.

Vision Exam Results

Hearing Exam Results

Admission Requirement

If your child does not attend pre-kindergarten or school away from the operation, select only one:

Provide the date your child received each dose:

Educational Programs

I agree to the following:

1. The school will open at 7:00 a.m. and will close 3:30 p.m. daily, Monday–Friday. Late pick up begins after 3:30 p.m. A fee will be charged for any child not picked up by the school's regular closing time. This charge shall be $20.00 per child for the first 15 minutes and an additional $5.00 per child per 5-minute period thereafter.
2. I am responsible for communicating all contact information updates as well as maintaining an open line of communication during all hours that my child/children are in care.
3. The school's non-refundable registration fee of $125.00 shall be paid upon enrollment.
4. Monthly tuition is due on the first of each month, it will be considered late after the 7th, and a late fee of $50 will be added to the due tuition.
5. Monthly tuition fees are non-refundable, and no credit is issued regardless of scheduled school closings and holidays, children's illness, vacation, inclement weather days, and/or "Acts of God". The School will make reasonable efforts to open in inclement weather; however, the School may choose to close at the discretion of the school's owners/leadership.
6. A fee of $50 will be charged for checks returned by the school's bank.
7. I am responsible for receiving, reading, and abiding by all information in the Brighter Minds Learning Center Community Norms and Expectations.

The undersigned parent(s) understand the terms of this agreement and agree to be bound by them.

I give my consent for Brighter Minds Learning Center to photograph or video my child and/or me or use photograph(s) or videos of my child or me that were taken in the childcare setting. I understand that the photographs, digital images, or video segments may be used in print or electronic media and that the photographs may be displayed on websites owned or sponsored by Brighter Minds Learning Center. I give Brighter Minds Learning Center permission to publish, exhibit and distribute these materials.

Agreement Not to Post Photos of Other Children: I agree that I will not post nor use any photographs or videos that I take at Brighter Minds Learning Center (or at an event sponsored by Brighter Minds Learning Center) that include children other than my own child(ren).

A parent or guardian of a child at this facility has the right to enter and examine the facility during operating hours; review the facility's publicly accessible records, policies, procedures, and inspection reports; review staff training records and curriculum; review written records concerning their child; inspect video recordings of an alleged incident of abuse or neglect involving their child (subject to conditions); have the facility comply with court orders; receive Child Care Regulation contact information; file complaints; and be free from any retaliatory action by the facility for exercising these rights.

I acknowledge I have received a written copy of my rights as a parent or guardian of a child enrolled at this facility.