Enrollment & Tuition

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Please Note: All returning and new students must complete a new enrollment form every academic school year.

Please Select Form Type*

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Today's Date

Dates of Service*

Child Start Date*

How Many Children Will You Be Enrolling?*

Total Registration Fee ($25 per child)

Price: $0.00

Base Product $0*

Select Your School District*

Hillside

Irvington

Roselle

Home Address*

Street Address Address Line 2 City State ZIP Code

Parent or Custodian 1 Name*

First Last

Phone*

Employer Name

Employer Phone

Business Hours

Employer Address

Street Address Address Line 2 City State ZIP Code

Parent or Custodian 2 Name

First Last

Phone

Employer Name

Employer Phone

Business Hours

Employer Address

Street Address Address Line 2 City State ZIP Code

CHILD 1

Child’s Name*

First Last

DOB*

Which Hillside School Will This Child Attend?*

143 Coe Ave. (A.P. Morris Early Childhood Center)

614 Tillman St. (Deanna Taylor Academy)

1261 Liberty Ave. (Hurden Looker Elementary)

1530 Leslie St. (Ola Edwards Community School)

Which Irvington School Will This Child Attend?*

97 Augusta St. (Augusta Preschool Academy)

602 Grove St. (Grove Street School)

Which Roselle School Will This Child Attend?*

150 E 3rd Ave (Kindergarten Success Academy)

1100 Warren St ( Dr. Charles C. Polk Elementary School)

310 Harrison Ave (Harrison Elementary School)

501 Washington Ave (Washington Elementary School)

Grade:*

Services Needed*

Part Time Services Needed - Hillside*

Drop In Services Needed - Hillside*

Full Time Services Needed - Hillside*

Part Time Services Needed - Irvington*

Drop In Services Needed - Irvington*

Full Time Services Needed - Irvington*

Part Time Services Needed - Roselle*

Drop In Services Needed - Roselle*

Full Time Services Needed - Roselle*

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Full Time Discount

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Early Dismissal

Early Dismissal Services Needed - Hillside*

Early Dismissal Services Needed - Irvington*

Early Dismissal Services Needed - Roselle*

Drop In/Early Dismissal Dates*

Child’s youth shirt size:*

Doctor Prescribed Food Restrictions, Allergies, Medical Conditions or Special Needs*

CHILD 2

Child’s Name*

First Last

DOB*

Which Hillside School Will This Child Attend?*

143 Coe Ave. (A.P. Morris Early Childhood Center)

614 Tillman St. (Deanna Taylor Academy)

1261 Liberty Ave. (Hurden Looker Elementary)

1530 Leslie St. (Ola Edwards Community School)

Which Irvington School Will This Child Attend?*

97 Augusta St. (Augusta Preschool Academy)

602 Grove St. (Grove Street School)

Which Roselle School Will This Child Attend?*

150 E 3rd Ave (Kindergarten Success Academy)

1100 Warren St ( Dr. Charles C. Polk Elementary School)

310 Harrison Ave (Harrison Elementary School)

501 Washington Ave (Washington Elementary School)

Grade:*

Services Needed*

Part Time Services Needed - Hillside*

Drop In Services Needed - Hillside*

Full Time Services Needed - Hillside*

Part Time Services Needed - Irvington*

Drop In Services Needed - Irvington*

Full Time Services Needed - Irvington*

Part Time Services Needed - Roselle*

Drop In Services Needed - Roselle*

Full Time Services Needed - Roselle*

Hidden

Full Time Discount

Add On

Early Dismissal

Early Dismissal Services Needed - Hillside*

Early Dismissal Services Needed - Irvington*

Early Dismissal Services Needed - Roselle*

Drop In/Early Dismissal Dates*

Child’s youth shirt size:*

Doctor Prescribed Food Restrictions, Allergies, Medical Conditions or Special Needs**

CHILD 3

Child’s Name*

First Last

DOB*

Which Hillside School Will This Child Attend?*

143 Coe Ave. (A.P. Morris Early Childhood Center)

614 Tillman St. (Deanna Taylor Academy)

1261 Liberty Ave. (Hurden Looker Elementary)

1530 Leslie St. (Ola Edwards Community School)

Which Irvington School Will This Child Attend?*

97 Augusta St. (Augusta Preschool Academy)

602 Grove St. (Grove Street School)

Which Roselle School Will This Child Attend?*

150 E 3rd Ave (Kindergarten Success Academy)

1100 Warren St ( Dr. Charles C. Polk Elementary School)

310 Harrison Ave (Harrison Elementary School)

501 Washington Ave (Washington Elementary School)

Grade:*

Services Needed*

Part Time Services Needed - Hillside*

Drop In Services Needed - Hillside*

Full Time Services Needed - Hillside*

Part Time Services Needed - Irvington*

Drop In Services Needed - Irvington*

Full Time Services Needed - Irvington*

Part Time Services Needed - Roselle*

Drop In Services Needed - Roselle*

Full Time Services Needed - Roselle*

Hidden

Full Time Discount

Add On

Early Dismissal

Early Dismissal Services Needed - Hillside*

Early Dismissal Services Needed - Irvington*

Early Dismissal Services Needed - Roselle*

Drop In/Early Dismissal Dates*

Child’s youth shirt size:*

Doctor Prescribed Food Restrictions, Allergies, Medical Conditions or Special Needs*

CHILD 4

Child’s Name

First Last

DOB*

Which Hillside School Will This Child Attend?*

143 Coe Ave. (A.P. Morris Early Childhood Center)

614 Tillman St. (Deanna Taylor Academy)

1261 Liberty Ave. (Hurden Looker Elementary)

1530 Leslie St. (Ola Edwards Community School)

Which Irvington School Will This Child Attend?*

97 Augusta St. (Augusta Preschool Academy)

602 Grove St. (Grove Street School)

Which Roselle School Will This Child Attend?*

150 E 3rd Ave (Kindergarten Success Academy)

1100 Warren St ( Dr. Charles C. Polk Elementary School)

310 Harrison Ave (Harrison Elementary School)

501 Washington Ave (Washington Elementary School)

Grade:*

Services Needed*

Part Time Services Needed - Hillside*

Drop In Services Needed - Hillside*

Full Time Services Needed - Hillside*

Part Time Services Needed - Irvington*

Drop In Services Needed - Irvington*

Full Time Services Needed - Irvington*

Part Time Services Needed - Roselle*

Drop In Services Needed - Roselle*

Full Time Services Needed - Roselle*

Hidden

Full Time Discount

Add On

Early Dismissal

Early Dismissal Services Needed - Hillside*

Early Dismissal Services Needed - Irvington*

Early Dismissal Services Needed - Roselle*

Drop In/Early Dismissal Dates*

Child’s youth shirt size:*

Doctor Prescribed Food Restrictions, Allergies, Medical Conditions or Special Needs*

CHILD 5

Child’s Name*

First Last

DOB*

Which Hillside School Will This Child Attend?*

143 Coe Ave. (A.P. Morris Early Childhood Center)

614 Tillman St. (Deanna Taylor Academy)

1261 Liberty Ave. (Hurden Looker Elementary)

1530 Leslie St. (Ola Edwards Community School)

Which Irvington School Will This Child Attend?*

97 Augusta St. (Augusta Preschool Academy)

602 Grove St. (Grove Street School)

Which Roselle School Will This Child Attend?*

150 E 3rd Ave (Kindergarten Success Academy)

1100 Warren St ( Dr. Charles C. Polk Elementary School)

310 Harrison Ave (Harrison Elementary School)

501 Washington Ave (Washington Elementary School)

Grade:*

Services Needed*

Part Time Services Needed - Hillside*

Drop In Services Needed - Hillside*

Full Time Services Needed - Hillside*

Part Time Services Needed - Irvington*

Drop In Services Needed - Irvington*

Full Time Services Needed - Irvington*

Part Time Services Needed - Roselle*

Drop In Services Needed - Roselle*

Full Time Services Needed - Roselle*

Hidden

Full Time Discount

Add On

Early Dismissal

Early Dismissal Services Needed - Hillside*

Early Dismissal Services Needed - Irvington*

Early Dismissal Services Needed - Roselle*

Drop In/Early Dismissal Dates*

Child’s youth shirt size:*

Doctor Prescribed Food Restrictions, Allergies, Medical Conditions or Special Needs*

CHILD 6

Child’s Name*

First Last

DOB*

Which Hillside School Will This Child Attend?*

143 Coe Ave. (A.P. Morris Early Childhood Center)

614 Tillman St. (Deanna Taylor Academy)

1261 Liberty Ave. (Hurden Looker Elementary)

1530 Leslie St. (Ola Edwards Community School)

Which Irvington School Will This Child Attend?*

97 Augusta St. (Augusta Preschool Academy)

602 Grove St. (Grove Street School)

Which Roselle School Will This Child Attend?*

150 E 3rd Ave (Kindergarten Success Academy)

1100 Warren St ( Dr. Charles C. Polk Elementary School)

310 Harrison Ave (Harrison Elementary School)

501 Washington Ave (Washington Elementary School)

Grade:*

Services Needed*

Part Time Services Needed - Hillside*

Drop In Services Needed - Hillside*

Full Time Services Needed - Hillside*

Part Time Services Needed - Irvington*

Drop In Services Needed - Irvington*

Full Time Services Needed - Irvington*

Part Time Services Needed - Roselle*

Drop In Services Needed - Roselle*

Full Time Services Needed - Roselle*

Hidden

Full Time Discount

Add On

Early Dismissal

Early Dismissal Services Needed - Hillside*

Early Dismissal Services Needed - Irvington*

Early Dismissal Services Needed - Roselle*

Drop In/Early Dismissal Dates*

Child’s youth shirt size:*

Doctor Prescribed Food Restrictions, Allergies, Medical Conditions or Special Needs*

Emergency Contacts & Release Persons

Please list the persons you would like contacted (in order of priority) if you cannot be reached in case of emergency

Contact 1 Name*

First Last

Relation*

Address*

Street Address

Phone*

Other Phone

Contact 2 Name

First Last

Relation

Address

Street Address

Phone

Other Phone

Contact 3 Name

First Last

Address

Street Address

Relation

Phone

Other Phone

MY CHILD/CHILDREN SHOULD NEVER BE RELEASED TO THE FOLLOWING PERSON(S) WITHOUT MY EXPRESSED PERMISSION AND/OR COURT NOTICE.

Name

Relation to child

Name

Relation to child

You may reach me at the following number in case of emergency:

Enrollment Agreement

Please read and check each section listed below.

SECTION 1: TUITION AND FEES

BASIC SERVICES*

BASIC SERVICES: I understand that Stepping Stones Child Development Centers provides child care and development services for families with children 3 to 12 years of age. Enrollment ages may vary by availability and location.

REGISTRATION FEE*

REGISTRATION FEE: I understand that the payment of a non-refundable registration fee is required for the academic and summer session on an annual base.

TUITION AND MODIFICATIONS CONDITIONS*

TUITION AND MODIFICATIONS CONDITIONS: I acknowledge the current tuition rate for the services I have chosen are on a weekly basis. I understand that rates are subject to change with reasonable notice as conditions require. The school follows state–specific required time frames on tuition and modifications notices.

PAYMENT OF TUITION*

PAYMENT OF TUITION: I understand that tuition is due in person or online no later than Friday to the prior service week to prevent late fees from occurring. Online payments are to be made Tuesday through Friday to the prior service week. Online payments made Saturday through Tuesday will access a late fee.

LATE OR UNPAID TUITION*

LATE OR UNPAID TUITION: If payment in full is not received when due, I agree to pay a late payment fee of $10 per week that tuition is not received. All late fees are subject to change with reasonable notice. The school follows state–specific required time frames on tuition and modifications notices. I understand that if my account is delinquent for the servicing week, I will be asked to withdraw my child until my account is made current. The school cannot guarantee a child’s 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.

E-CHILD CARE SWIPES*

E-CHILD CARE SWIPES: If enrolled in any of the subsidy programs I agree to sign my child in and out every day using the E-Child swipe machine as required by Programs for Parents or Community Child Care of Union County (4cs). If I fail to properly enter or swipe attendance for any day my child is in attendance, I understand that I am solely responsible for the payment of tuition.

CHARGES AND PROCEDURE FOR LATE PICK-UP*

CHARGES AND PROCEDURE FOR LATE PICK-UP: I understand that if I fail to pick up my child by the scheduled closing time, I will be charged a late fee of $40, per child, until the child is picked up. I am knowledgeable of the operating hours of the elected school I registered my child for. I acknowledge that I am in receipt of the parent handbook which is accessible at https://stonesstepping.com/forms/

ADDITIONAL FEES*

ADDITIONAL FEES: School–age camp will be open during the summer months and scheduled school breaks according to the local public-school calendar. Summer Camp children and children attending during scheduled school breaks may pay a separate Activity Fee for attendance. All other age groups may be subject to Activity Fees as well. In instances of agency reimbursement, Activity Fees may be my responsibility. Please consult the director for details.

DISCOUNTS*

DISCOUNTS: I understand that if I have more than one child enrolled and attending from my immediate family, a discount of $5.00 from the usual tuition fee is offered per child to me. (Excludes Before School) These discounts are only available to those accounts when full tuition is paid on time or in advance. Discounts are not applicable on any fees or services, agency co-pays, or special program promotions and cannot be combined with any other discount or promotion.

SECTION 2: DAILY PROCEDURES

DAILY SIGN-IN AND SIGN-OUT*

DAILY SIGN-IN AND SIGN-OUT: I agree to sign my child in and out every day using the school’s attendance procedure. I understand that my child is not permitted to sign him/ herself out. I understand that I am required to enter the school to drop off and pick up my child. Due to state childcare licensing regulations a manual signature is required and I agree to manually sign-in and sign-out my child(ren). I acknowledge that if I have 5 missed sign-in or sign-outs per calendar year I will be terminated from the program.

ILLNESS/ MEDICATION ADMINISTERD*

ILLNESS/ MEDICATION ADMINISTERD: I understand that I will be notified should my child(ren) become ill during the day, and that I will pick up my child(ren) promptly, or make arrangements for an authorized emergency contact person to pick up upon such notification. If my child(ren) is exposed to or contracts a contagious disease, I agree to notify the school immediately to prevent transmission. If your child requires medication that needs to be administered at the school, please visit our forms page to complete our medication administration form that is required to be sent in before administering.

AUTHORIZATION FOR MEDICAL TREATMENT*

AUTHORIZATION FOR MEDICAL TREATMENT: In case of an emergency I acknowledged that all contacts will be attempted to be reached and I authorize Stepping Stones designated employees to transport the above minor by ambulance and consent to any necessary examination, treatments, and/or hospital care to be rendered to my child(ren).

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.

I allow the reproduction and publication of my child's photograph(s).

I do not allow the reproduction and publication of my child's photograph(s).

PHOTOGRAPHS, VIDEOS, AND AUDIO TAPES*

PHOTOGRAPHS, VIDEOS, AND AUDIO TAPES: I understand and agree that, in consideration for being allowed to photograph, videotape, or audio record my child(ren) on company property or field trips, I shall only use such recording for lawful and private home use, and will not publish, publicly display, or sell such recordings. I also understand that I must have written permission before capturing any image of the other child(ren) in the school or staff.

INTERVIEWING CHILDREN AND INSPECTING RECORDS*

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 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.

FIELD TRIPS*

FIELD TRIPS: During the summer sessions students will attend field trips away from the school that require bus transportation. I give the school permission to take my child(ren) on these field trips. I acknowledge that I will be notified in advance of all trips and that if my children will not attend that alternative child care will have to be arranged for those trip days due to all staff attending trips. (Please make sure you review Stepping Stones trip schedule before enrolling.)

WITHDRAWAL FROM PROGRAM*

WITHDRAWAL FROM PROGRAM: I understand that I must provide a one (1) week written notice of withdrawal from the program. If this notification is not provided, I agree to pay all tuition and fees for one (1) week, whether or not my child(ren) attends. I understand that when my child(ren) is withdrawn, he or she will only be eligible for re-admission based upon space availability and all other enrollment criteria. If my child(ren) is selected for re-enrollment, I will be required to complete a new enrollment agreement at the current rate and pay a new non-refundable registration fee at the current rate. If there is an outstanding balance (including tuition or fees) when my child(ren) was withdrawn, I will be required to bring my account current prior to completing a re-enrollment application. I understand all fees (Tuition, Registration,) are non- refundable.

SECTION 3: HOLIDAYS, ABSENCES, AND CLOSINGS

HOLIDAYS*

HOLIDAYS: I understand and agree that I will not receive a refund, credit, or other allowance for district closed holidays and in-service trainings for Hillside, Irvington and Roselle servicing schools that Stepping Stones are not operating on. If a holiday falls on a weekend, it will be observed on either the preceding Friday or the following Monday.

ABSENCES/ VACATIONS*

ABSENCES/ VACATIONS: I agree to inform the school 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 absences. My regularly contracted tuition is due for my child(ren) who attends any part of the week. There is no credits given for any non attending days paid for. I understand and agree that my child(ren) will be dropped from the program if they have 2 weeks of consecutive absences.

EMERGENCY CLOSING AND INCLEMENT WEATHER INFORMATION*

EMERGENCY CLOSING AND INCLEMENT WEATHER INFORMATION: I understand that it is the company’s 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 issues may disrupt service from time to time. I agree that in the event that the school is closed for an extended period of time, I will continue to be responsible for my tuition payments for up to three (3) business days. (i.e. If school is closed for 2 of the 5 days, A credit will not be issued for the 2 days. A credit will only be issued if school is closed for 3 or more days. I understand that it is imperative that I subscribe to receive important text alerts and notification by texting: STEPPINGSTONES TO: (833) 766-5592.

SECTION 4: STATE LICENSING AND OUR POLICIES

ALL POLICIES AND STATE REGULATIONS*

ALL POLICIES AND STATE REGULATIONS: I understand that the above policies are not an all-inclusive list of policies, and that my child(ren), my family members, and 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 Parent Handbook, and all other company policies, which may be modified at any time, without notice. I also understand that the child care regulations of New Jersey may prevail over these policies when the state regulation is stricter. I further understand that my continued enrollment constitutes my acknowledgment of, and agreement to abide by, all policies and state regulations.

Emergency Evacuation*

I also acknowledge the school will evacuate in case of emergency. I understand that the evacuation site is posted in the school.

INDIVIDUALIZED CARE PLANS*

INDIVIDUALIZED CARE PLANS: I understand that should my child(ren) have an IEP, it must be shared with the director at enrollment so it can determine if Stepping Stones can reasonably support my child(ren)’s needs.

BEHAVIOR MANAGEMENT*

BEHAVIOR MANAGEMENT: I understand that positive redirection and offering choices to children are techniques used to guide children’s behavior at the school. I also understand that I may refer to the Parent Handbook for additional information on behavior management at the school.

PARENT HANDBOOK*

PARENT HANDBOOK: I acknowledge a copy of the Parent Handbook is retrievable on-line at www.stonesstepping.com. under the forms tab. I have read and understand its contents and policies and agree to be bound by same.I also understand that these policies are subject to change.

NO MODIFICATIONS*

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

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Discount Subtotals

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Discount Subtotal

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DISCOUNTS

Sibling Full-Time Discount

Price: $0.00

Summer Early Registration Discount

Price: $0.00

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 if you are submitting this application today before 12:00 p.m. your child(ren) will receive services the following business day. If payment is made today after 12:00 p.m. services will be received in two business days for processing time. 

Upon completion of this enrollment form, payments are due in person or online through the pay tuition form every Friday. Late fees will be applied after Friday. 

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:

FRIDAY- Payments are due prior to service week. Late fees will be applied after Friday.
MONDAY- Payments are past due & Child(ren) will not be accepted into program until payments is made. Payments are due online before 12 p.m. for student to attend the current day of payment.
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

Parent/Guardian Signature:*

Date*

Late Fee

Price:

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