Child's Name
*
First Name
Last Name
Child's Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Your Name
*
First Name
Last Name
Your Email
*
example@example.com
Your Digits
*
Please enter a valid phone number.
Format: (000) 000-0000.
Your Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is there a second parent in the picture?
*
Yes
No
Second Parent Name
First Name
Last Name
Second Parent Email
example@example.com
Second Parent Digits
Please enter a valid phone number.
Format: (000) 000-0000.
Program Enrollment
Program: By checking below, I am enrolling my child in the following program at Piper Preschool for the 2025-2026 school year.
*
Poppy
Johnny
Ruby
Bluebell
Enrollment Schedule: By checking below, I am enrolling my child in the following schedule for the 2025-2026 school year.
*
M-F: 9am-12pm ($2000/month)
M-F: 9am-2pm ($2600/month)
MWF: 9am-12pm ($1550/month)
MWF: 9am-2pm ($2000/month)
TTH: 9am-12pm ($1100/month)
TTH: 9am-2pm ($1400/month)
Enrollment Schedule: By checking below, I am enrolling my child in the following schedule for the 2025-2026 school year.
*
M-F: 9am-2pm ($2475/month)
Policies & Agreements
Tuition Agreement
*
By checking this box, I understand that the Tuition Payment Schedule represents a commitment to the entire 2025-2026 school year. I understand that the timing of payments is not associated with my child’s time of attendance, and that there is no reduction in tuition for absences, vacations, holidays, or school closures.
Enrollment Deposit
*
I understand that the Enrollment Deposit of $2500 secures my child's placement and will be directly applied to my annual balance. I understand that the Enrollment Deposit is non-refundable and non-transferable, regardless of absence or withdrawal.
Tuition Payment Schedule: By checking this box, I understand that my child's tuition for the 2025-2026 school year will be billed in accordance to my selection below:
*
One-Pay: $24,725 due June 1, 2025.
Two-Pay: Equal payments of $12,362.50 due June 1, 2025 and December 1, 2025.
Ten-Pay: Equal payments of $2507.50 beginning June 1, 2025 and concluding on March 1, 2026. A $35 finance fee is included in each payment.
Tuition Payment Schedule (Poppy M-F): By checking this box, I understand that my child's tuition for the 2025-2026 school year will be billed in accordance to my selection below:
*
One-Pay: $26,100 due June 1, 2025.
Two-Pay: Equal payments of $13,050 due June 1, 2025 and December 1, 2025.
Ten-Pay: Equal payments of $2645 beginning June 1, 2025 and concluding on March 1, 2026. A $35 finance fee is included in each payment.
Tuition Payment Schedule (PTPoppy M-F): By checking this box, I understand that my child's tuition for the 2025-2026 school year will be billed in accordance to my selection below:
*
One-Pay: $19,500 due June 1, 2025.
Two-Pay: Equal payments of $9,750 due June 1, 2025 and December 1, 2025.
Ten-Pay: Equal payments of $1985 beginning June 1, 2025 and concluding on March 1, 2026. A $35 finance fee is included in each payment.
Tuition Payment Schedule (Poppy MWF): By checking this box, I understand that my child's tuition for the 2025-2026 school year will be billed in accordance to my selection below:
*
One-Pay: $19,500 due June 1, 2025.
Two-Pay: Equal payments of $9,750 due June 1, 2025 and December 1, 2025.
Ten-Pay: Equal payments of $1985 beginning June 1, 2025 and concluding on March 1, 2026. A $35 finance fee is included in each payment.
Tuition Payment Schedule (PTPoppy MWF): By checking this box, I understand that my child's tuition for the 2025-2026 school year will be billed in accordance to my selection below:
*
One-Pay: $14,550 due June 1, 2025.
Two-Pay: Equal payments of $7,275 due June 1, 2025 and December 1, 2025.
Ten-Pay: Equal payments of $1490 beginning June 1, 2025 and concluding on March 1, 2026. A $35 finance fee is included in each payment.
Tuition Payment Schedule (Poppy TTH): By checking this box, I understand that my child's tuition for the 2025-2026 school year will be billed in accordance to my selection below:
*
One-Pay: $12,900 due June 1, 2025.
Two-Pay: Equal payments of $6,450 due June 1, 2025 and December 1, 2025.
Ten-Pay: Equal payments of $1325 beginning June 1, 2025 and concluding on March 1, 2026. A $35 finance fee is included in each payment.
Tuition Payment Schedule (PTPoppy TTH): By checking this box, I understand that my child's tuition for the 2025-2026 school year will be billed in accordance to my selection below:
*
One-Pay: $9,600 due June 1, 2025.
Two-Pay: Equal payments of $4,800 due June 1, 2025 and December 1, 2025.
Ten-Pay: Equal payments of $995 beginning June 1, 2025 and concluding on March 1, 2026. A $35 finance fee is included in each payment.
Finance Agreement
I understand that auto-pay is required for the Ten-Pay schedule and that my payment will be automatically deducted on the 1st of each month. I understand that I have committed to all ten payments, regardless of absence or withdrawal, and required to keep a bank account or credit card active and in good-standing on file for the entire 2025-2026 school year.
Refund Policy
*
By checking this box, I understand that my obligation to pay my child's tuition is unconditional, and that no portion of tuition or fees, be it paid or outstanding, will be refunded nor canceled unless executing a formal withdrawal (see Withdrawal Policy). If a refund is due, in accordance with the Withdrawal Policy, it will be processed within 90 days.
Withdrawal Policy
*
By checking this box, I understand that a 60-day written notice of withdrawal is required to process a request to be released from this contract, . I understand that my deposit is non-applicable to this time period and that I will continue to be responsible for my tuition payments for the entirety of the 60-day period. By checking this box, I agree to the Withdrawal Policy.
Late Payment Policy
*
By checking this box, I understand that any payment not received by the due date outlined in my Tuition Payment Schedule, as well as any declined payment, will incur a $25 per day fee until the balance is paid in full. I understand that any returned check or returned bank debit transaction will result in an additional $25 fee. I understand that, should any balance remain outstanding after 45 days of the original due date, Piper Preschool has the right to discontinue enrollment.
Late Pick-Up Policy
*
By checking this box, I understand that my child’s schedule is set forth in my Enrollment Schedule. I understand that if I am not enrolled in Early Care and/or Extended Care, a fee of $20/hour for coverage outside of my child’s Enrollment Schedule will be charged. I understand that a $60 late pick-up fee will be added to my account if my child is picked up after 5:00pm.
Separation Policy
*
I understand that my child's transition schedule will be comprised of a series of playdates, and that one parent or caregiver must be present the entire time. I understand that any additional separation strategies will be determined individually and as needed (i.e. gradually extending hours). By checking this box, I acknowledge and agree to the Separation Policy.
Code of Conduct
*
By checking this box, I understand that Piper Preschool reserves the right to discontinue enrollment in the event of a breach of this agreement and/or failure to adhere to the Parent Code of Conduct, as outlined in the Parent Handbook.
Annual Fees
*
I understand that Annual Fees of $1000 are applied to Campus Safety, Earthquake Supplies, Materials Costs, and Piper Parent Association (PPA), including parent education programs, faculty support, community activities, and family events. I understand that Annual Fees are non-refundable and non-transferable, regardless of absence or withdrawal.
Security Fee
*
I understand that a Security Fee of $325 contributes to the cost of increased security, including a professionally-trained guard, on-call service, and perimeter monitoring and assessment. I understand that the Security Fee is non-refundable and non-transferable, regardless of absence or withdrawal.
Enrollment Completion
*
Checking this box, submitting my payment, and signing below signifies that I have read, understand, and agree to all terms and policies listed throughout this contract. I have viewed and agree to the School Calendar and Parent Handbook, and understand that Piper reserves the right to make changes.
Enrollment Deposit and Annual Fees
Coupon Amount
Family Code
Signature
*
Enrollment Deposit and Annual Fees
*
prev
next
( X )
USD
Description
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Welcome to the Jungle
Should be Empty: