Please Note: All returning and new students must complete a new enrollment form every academic school year and every summer session.
Select Your School District* Home Address*
Parent or Custodian 1 Name*
First
Last
Employer Address
Parent or Custodian 2 Name
First
Last
Employer Address
CHILD 1 Child’s Name*
First
Last
Which Hillside School Will This Child Attend?* Which Irvington School Will This Child Attend?* Add On PFP & 4CS PARTICIPANT Drop In/Early Dismissal Dates*
Field Trip Add On Field Trips* Child’s youth shirt size:* Doctor Prescribed Food Restrictions, Allergies, Medical Conditions or Special Needs*
CHILD 2 Child’s Name*
First
Last
Which Hillside School Will This Child Attend?* Which Irvington School Will This Child Attend?* Add On PFP & 4CS PARTICIPANT Drop In/Early Dismissal Dates*
Field Trip Add On Field Trips* Child’s youth shirt size:* Doctor Prescribed Food Restrictions, Allergies, Medical Conditions or Special Needs**
CHILD 3 Child’s Name*
First
Last
Which Hillside School Will This Child Attend?* Which Irvington School Will This Child Attend?* Add On PFP & 4CS PARTICIPANT Drop In/Early Dismissal Dates*
Field Trip Add On Field Trips* Child’s youth shirt size:* Doctor Prescribed Food Restrictions, Allergies, Medical Conditions or Special Needs*
CHILD 4 Child’s Name
First
Last
Which Hillside School Will This Child Attend?* Which Irvington School Will This Child Attend?* Add On PFP & 4CS PARTICIPANT Drop In/Early Dismissal Dates*
Field Trip Add On Field Trips* Child’s youth shirt size:* Doctor Prescribed Food Restrictions, Allergies, Medical Conditions or Special Needs*
CHILD 5 Child’s Name*
First
Last
Which Hillside School Will This Child Attend?* Which Irvington School Will This Child Attend?* Add On PFP & 4CS PARTICIPANT Drop In/Early Dismissal Dates*
Field Trip Add On Field Trips* Child’s youth shirt size:* Doctor Prescribed Food Restrictions, Allergies, Medical Conditions or Special Needs*
CHILD 6 Child’s Name*
First
Last
Which Hillside School Will This Child Attend?* Which Irvington School Will This Child Attend?* Add On PFP & 4CS PARTICIPANT Drop In/Early Dismissal Dates*
Field Trip Add On Field Trips* Child’s youth shirt size:* Doctor Prescribed Food Restrictions, Allergies, Medical Conditions or Special Needs*
Contact 1 Name*
First
Last
Address*
Contact 2 Name
First
Last
Address
Contact 3 Name
First
Last
Address
MY CHILD/CHILDREN SHOULD NEVER BE RELEASED TO THE FOLLOWING PERSON(S) WITHOUT MY EXPRESSED PERMISSION AND/OR COURT NOTICE.
SECTION 1: TUITION AND FEES
BASIC SERVICES* REGISTRATION FEE* TUITION AND MODIFICATIONS CONDITIONS* PAYMENT OF TUITION* LATE OR UNPAID TUITION* E-CHILD CARE SWIPES* CHARGES AND PROCEDURE FOR LATE PICK-UP* ADDITIONAL FEES* DISCOUNTS* SECTION 2: DAILY PROCEDURES
DAILY SIGN-IN AND SIGN-OUT* ILLNESS/ MEDICATION ADMINISTERD* AUTHORIZATION FOR MEDICAL TREATMENT* MODEL RELEASE:* During the school year, we take photographs of student events to share the amazing activities our teachers and scholars engage in, by which incidentally, some photographs may capture your child's participation, directly or indirectly. These photos may be published through our website, social media pages, news bulletins, billboards, and ads.
With this, we seek for your consent in allowing us to publish photos which may involve your child to the said platforms.
PHOTOGRAPHS, VIDEOS, AND AUDIO TAPES* INTERVIEWING CHILDREN AND INSPECTING RECORDS* FIELD TRIPS* WITHDRAWAL FROM PROGRAM* SECTION 3: HOLIDAYS, ABSENCES, AND CLOSINGS
HOLIDAYS* ABSENCES/ VACATIONS* EMERGENCY CLOSING AND INCLEMENT WEATHER INFORMATION* SECTION 4: STATE LICENSING AND OUR POLICIES
ALL POLICIES AND STATE REGULATIONS* Emergency Evacuation* INDIVIDUALIZED CARE PLANS* BEHAVIOR MANAGEMENT* PARENT HANDBOOK* NO MODIFICATIONS*
Good Health Statement*
Upon submitting this form, I indicate my child(ren) is/are in good health and condition to attend the program.
I further give Stepping Stones Child Development Centers and/or its staff, permission to have my child(ren) medically treated in case of any medical emergency while in attendance and/or on a trip.
I agree to the following:* By typing your name below, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application. You also acknowledge that you are are aware of the registration submission timeline. See below the processing time based on when payments are made. Payments made after 12pm will be processed the following business day listed: Registration completed by 12pm Thursday/Attends Monday. Registration completed Friday-Sunday Attends Tuesday. Registration completed by 12pm Monday/Attends Wednesday. Registration completed by 12pm Tuesday/Attends Thursday. Registration completed by 12pm Wednesday/Attends Friday. Upon completion of this enrollment form, payments are due in person or online through the pay tuition form by 12PM every Thursday. Late fees will be applied after 12PM Thursday. To receive important alerts of our School Closures, Emergency Alerts and Important Reminders, please Like and Follow us on Facebook at Stepping Stones Child Development Centers and Subscribe to receive text alerts by texting: STEPPINGSTONES TO: (833) 766-5592 We do not discriminate based on disability in the admission/ enrollment or access to our programs or services. Information concerning the provisions of the Americans with Disabilities Act (ADA), including the rights provided thereunder, is available from the director. Stepping Stones deems appropriate to maintain the safety, security, health or general well-being of the children, families, and staff at our facility, and after appropriate consultation with parents and/or appropriate attempts at re-direction to alter the disruptive behaviors, Stepping Stones in its sole discretion, reserves the right to refuse the enrollment of any child, or at anytime during the enrollment to ask parents to make temporary or permanent alternate arrangements for the care of a child enrolled in the Stepping Stones program. The acceptance of an application for enrollment and fees does not guarantee enrollment. These policies have been reviewed by me and I understand and will comply with the policies included in the Enrollment Agreement and Parent Handbook. The policies in this contract will supersede all other previous documents.
Consent* I agree to the following:
THURSDAY- Payments should be paid no later than 12pm on Thursday prior to the service week that services are rendered. Payments received afterwards will receive a late fee of $20.00 added to the parent/guardian account. Due to processing time, See the attendance schedule based on when payments are made. Payments made after 12pm will attend the following business day listed:
Payments made by 12pm Thursday through 12pm Monday /Attends Monday.
Payments made after 12pm Monday/Attends Tuesday.
Payments made after 12pm Tuesday/Attends Wednesday.
Payments made after 12pm Wednesday/Attends Thursday.
Payments made after 12pm Thursday/Attends Friday.
Thank you in advance for your continued cooperation.
To receive important alerts of our School Closures, Emergency Alerts and Important Reminders, please Like and Follow us on Facebook at Stepping Stones Child Development Centers and Subscribe to receive text alerts by texting:
STEPPINGSTONES TO: (833) 766-5592