For Emergencies only, I give my consent for my child(ren) to be transported and supervised by the Elite Learning employees.

I give / do not give permission to Elite Learning to videotape, photograph or audiotape of my child(ren) based on my response in "Permission to release media?" above in the "FAMILY INFORMATION" section

For emergency medical care, if I cannot be reached to make arrangements, I authorize the Elite Learning employees to take my child(ren) to the Physician and Emergency Medical Care Facility provided on this form. If your child needs any medication such as Epi-pen and/or inhalers, a separate medication must be provided to Elite Learning for use during our After School program.

I acknowledge that the immunizations and/or tuberculosis tests are current and my child(ren)'s immunization, vision and hearing records are on his/her school campus files.

The following documents must be submitted If your child(ren) did not attend pre-kindergarten or a child care facility within one week of admission.

1. Doctor's Statement: I have examined the above-named child(ren) within the one year period and confirm that the child(ren) are eligible to register to the Elite Learning after school program and its activities.

2. A signed and dated copy of a health care professional's state is attached.

3. Medical diagnosis and treatment conflict with the tenets and practices of a recognized religious organization, which I adhere to or am a member of; I have attached a signed and dated affidavit stating this.

4. My child has been examined within the past year by a health care professional and is able to participate in the daycare program. Within 12 months of admission, I will obtain a health care professional's signed statement and will submit it to the child-care operation.

1. All parents/guardians are required to pay registration fees and the first month's tuition (prorated if applicable). If you leave Elite Learning (E.L.) and wish to return, you will be considered a new applicant and must register again and pay the registration fee. Accounts will automatically be charged for the aforementioned fees, but payments must be made via Parent Portal. Registration Fees are $50 per child or $75 for an entire family (2 or more kids); registration fees are non-refundable/non-transferable.

2. Parents are responsible for all tuition and fees outlined below or applicable to their accounts, and for keeping their information current. Parents must select from only one of our two payment options at the time of registration. All payments whether online or mailed must be received by the 1st of each month.

3. Options for Payment

a. Auto-Payment by debit or credit card. When registering online, parents input their card information. The account is automatically deducted each month on the 1st (or if a weekend, on the next business day).
b. Payments by paper check or money order. This choice requires an initial deposit of one-month tuition, plus the registration fee and the first month's tuition (prorated if applicable). The deposit will be used as payment for the child's last month in the program.

Paper checks or money orders must be mailed to the main office.
Make checks payable to:
Elite Learning
9303 W. Sam Houston Pkwy S.
Suite 155
Houston, TX 77099
(Please include student's full name on the payment)

4. Discounts: Discounts cannot be combined.
• 10% off Sibling discount.
• 10% off Military/ Veteran discount.
• School employees may have special discounts based on specific agreements with the campuses/districts.
• Documentation may be requested to verify any and all discounts.

5. The parent/guardian will be required to enter the building when picking up their child. For your child's protection, parents are required to sign out via our secure electronic attendance system. Only authorized adults with a valid ID will be allowed to pick up your child.

6. The parent/guardian agrees to pay a $1 per minute late pick-up fee 5 minutes after the scheduled pick up time. The time is determined by the clock at The After School Program location. Late pick-up fees are added to the account and must be cleared by the next time tuition is due or late fees are applicable for the account holding a balance.

7. Additional Fees: Tuition is due on the 1st of each month, regardless of when the 1st day falls on the calendar. A $30 late payment fee will be charged to accounts that hold a balance on the 5th of each month. NSF (non-sufficient fund) Charge: A $30 fee is charged for all non-sufficient funds/returned checks/credit card chargebacks. In the event of multiple returned items, a parent may be required to pay by money order or their child may be dropped from services for non-payment. I certify that I have read the above tuition information and I will abide by all the requirements listed under Parent Agreement regarding Late Fees, Late Pick-up Fees, Non-Sufficient Fund Charge and Withdraw/Drop Services Policy.

8. Payments not received by the 15th of the month will result in termination of enrollment. Parents who have not contacted Elite Learning main office for payment arrangements will be responsible for making arrangements to pick up their student at school dismissal time.

9. Both my child and I agree that when he or she is participating in the Program, that he or she will cooperate promptly and fully with all directions of E.L.'s personnel. Participation in the program may be terminated for inappropriate student behavior. Any of the following may be grounds for termination: Defiance of authority; disregard for the safety of oneself or others; foul language/gestures; use of derogatory language with respect to race, ethnicity, or origin, and other offenses. Participation in the program may be terminated if parent(s) displays similar inappropriate behaviors, use threatening language or behavior toward staff, or fail to follow sign-in and sign-out procedure.

10. If I intend to withdraw my child(ren) from the program, the Withdrawal Form must be completed a minimum of 10 business days (M-F) before the student's official final day. The monthly tuition is not refundable for withdrawals occurring with less than 10 business days before the student's final day. If I choose to re-enter the program after terminating this agreement, I understand that I must pay all outstanding fees and balances before my child(ren) is placed in the program again.

11. I will make other arrangements for emergency closings, delays, and dismissals. There is no tuition discount for absences, holidays, or other days on which E.L. is closed. If schools are closed due to inclement weather or other special circumstances, the After School Program will also be closed.

12. While every attempt will be made to protect your child's personal property, The After School Program will not be responsible for any articles brought to the program.

13. I will complete all necessary forms before my child attends the E.L. Program. I will notify E.L. of any changes in registration information (e.g. address, phone number, email, etc.). I will pay all outstanding balances or unpaid returned checks from the previous semester or school year prior to my child's registration.

14. I understand that it is my responsibility to provide E.L. with information regarding any special accommodation that my child requires.

15. LIABILITY WAIVER: I agree to hold harmless the Elite Learning, and its employees from any and all loss, damage, liability, cost, or expenses arising out of or resulting from the use of equipment or property owned by or under the control of the E.L. I also understand that the E.L. does not carry insurance to cover participants in the activities in which I, or my child is participating in. I understand there are risks associated with these activities, and I assume the risk of any injuries that I, or my child may sustain during any of the activities. I forever discharge the E.L., and its employees from any lawsuits, damages, claims, or judgments resulting from any personal injuries or property damages that I or my child may sustain while using E.L. property or equipment, or while participating in an activity sponsored by the E.L.

By checking this box I acknowledge that I read the parent handbook and agree to the tenets therein.