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I,_____________ parent's name, parent/legal guardian of child's name ________ request that the administration of the above noted medication be provided. I understand that the service will be provided by a person with no medical or nursing training. All training will be parent's responsibility. I agree to provide Butler's Early Literacy Academy, LLC with an updated medical statement if there is any change in the Physician's instructions with respect to medication. I hereby release Little Barn Academy, its employees and contractors from all manner of actions, causes of actions, lawsuits, damage or injuries, however caused, arising out of the administration or failure to administer medication as provided herein.

CONSENT

INTERVIEWS

PARENTS MAY DISCUSS CONCERNS WITH THE SCHOOL. AN APPOINTMENT IS REQUIRED TO ENABLE A DISCUSSION TO BE CONDUCTED UNDISTURBED

RULES & REGULATIONS

Toddler Care (2-Year-Old) Program

Subscription
$814

3-Year-Old Care (Preschool)

Subscription
$616

Infant Care Program/6 weeks to 12 months

Subscription
$1100

Toddler Care (1-Year-Old) Program

Subscription
$880

4-Year-Old Care (Pre-Kindergarten)

Subscription
$594

5-Year-Old Care (Pre-Kindergarten)

Subscription
$550

Summer Camp

Subscription
$508

Meal Plan

Subscription
$100

Non-Refundable Registration Fee: Please add. If the registration fee is not paid, the application will not be processed.

$65

Monthly amount payable for each age group, if applicable.

School fees only

Payments are the 1st of every month

All fees must be paid no later than Monday by 11:59pm to avoid interruption in service

I, the parent hereby understands how the payment plan works and commit to adhere to our agreement of payment as stipulated above.

Parent/Guardian responsible for school fees:

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