2023-2024 Preschool Registration
Tiny Notes Enrichment Center
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Student's Name
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Gender
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Child's Date of Birth
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Parent or Guardian Full Name
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Phone Number
Email Address
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Does your child have any allergies or medical conditions?
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Is your child potty trained? Does your child require assistance?
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Any special accommodations needed?
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Would you like any information regarding our extended services? Tiny Notes accepts insurace and DDA.
Up to date on vaccinations?
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Pediatricians Name & Number
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ALL 3's morning classes are FULL, 4's Morning class is FULL. Currently wait listed. *
Required
Which preschool class are you registering for? (4 hour option is only available for 3-5 year olds)
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Required
If you would like a 4 hour schedule please list what  class your requesting  a 4 hour schedule. The schedule  is 9-1am for morning and 12-4pm for afternoon. 
Would you like to be contacted to schedule a tour?
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Does your child have an IFSP or IEP?
How did you hear about us?
 Emergency Contact #1 (Name & Phone Number)

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 Emergency Contact #2 (Name & Phone Number) *
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I consent to allow my child to be included in photos taken during class activities that may be used for Tiny Notes Music and Movement LLC media accounts and marketing. These are mostly shared on Himama and private parent page. Concerts and special events will be posted the main Tiny Notes page. You child must have a photo release on file before the event.  *
I understand that I must pay a  non-refundable registration fee of $100 and Non refundable, first months tuition at the time of registration to hold my child's spot. All Invoices must be paid within 24 hours of receiving. If you need a payment plan, please contact us. 360-443-2399 *
I understand that preschool tuition is due on the 1st of every month. After the 5th tuition is considered late and a $50 late fee will apply. If tuition is more than 30 days behind, the student will be dropped. The late fee MUST be paid also within the 30 days. If you need any assistance please contact Ms. Melissa. *
I understand that if I decide to withdraw my child from Tiny Notes Preschool Program a 30 day notice is required. If notice is given after the 10th of the month, you will be required to pay the following month.  *
Pick-up, please pick up your child at their scheduled time to be picked up,  promptly. A late fee of $1 a min will be charged,  If a true emergency happens, please call 360-443-2399 to notify staff you will be late. *
I give Tiny Notes Music and Movement LLC consent to seek and accept medical treatment for my child. In case a parent is unable to be reached. Every attempt to contact the parents will be done first.  *
All children will be required to have water bottle or cup with them during school days. You may purchase one to leave at school. If your child does not have one, one will be supplied to you child for the fee of $1 per bottle. *
Any additional comments or concerns?
Waiver and Release of Liability I agree that this Waiver and Release of Liability shall apply to each day I am at Tiny Notes Music and Movement LLC regardless of the date that this form is signed below.This form does not apply to regular class times where staff is responsible for my child. This form is intended for when the children are in parents care on the premises. I agree I will assume the risk and full responsibility for any and all injuries, losses, or damages, that might occur to my child or other family members while on the premises of the preschool or participating in any off-site preschool program or activity; and to the maximum extent of the law, I agree to waive and release any and all claims, suits, or related causes of action against Tiny Notes Music and Movement LLC their owners, officers, employees or agents for injury, loss, death, costs or other damages to me, my heirs or assigns, or third party claims, suits or related causes of action asserted against the preschool arising from my conduct and/or my family’s conduct while participating in the preschool’s programs or activities. I further agree to release, indemnify, defend and hold  Tiny Notes Music and Movement LLC harmless from any liability whatsoever for future claims presented by my child for any injuries, losses or damages. *
Thank you for joining Tiny Notes Music and Movement LLC Preschool. By typing your full name below and submitting this form you are verifying that all of the submitted information above is true and that you are the parent or legal guardian authorized to grant permission for the child to participate. *
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