Member Registration Contract 2022-23

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You will be contacted to make a payment after you complete this contract. This is a legally binding form.

Email *

Primary Parent Name *

Primary Parent Phone *

Please provide both home and cell phone numbers.

Family Address *

Please provide actual and mailing addresses

Name of Your Homeschool and State Registered *

Please give the official name of your home school as registered with your state.

Did you attend an open house in 2022? *

Yes

Parent or Helper Contact Info *

Please provide all email addresses that may be associated with the adults who bring or pick up your children. List name then email and cell phone number.

Please provide an emergency contact name and cell phone number. *

We process future tuition payments by ACH. Please indicate if you will pay in full or in monthly installments. *

Please complete and return this ACH payment plan form: https://docs.google.com/document/d/1_u6zwwuBfpA0qVWD6uDFtfqatAfYdN0SKkDTz74rEDc/edit?usp=sharing You may need to cut and paste this link in your web browser.

I would like monthly tuition installment payments

I will pay in full for the semester

I need to use a credit card to pay. (Note: someone will contact you to arrange this.)

You must agree that you have read the full terms of this contract. This registration contract is legally binding. The full terms of the contract are here: https://docs.google.com/document/d/1kL48Bhb931tQr9yRKk_k_qHaxt1sZd2Y_ZKUB6KYV3k/edit?usp=sharing *

You may need to cut and past the link in your browser.

I agree

Required

Walnut Grove Coop respects member allergies. By enrolling in Walnut Grove Coop, you agree to respect these restrictions. If your family has any severe allergy that may require medical intervention, you agree to report those allergens to staff. *

I agree

Required

Please report any allergens that your family may need to avoid. Please note that dietary restrictions are not considered "allergens" but will be respected though not prohibited.

Please check one box for each child in your family who will be over the age of 3 years and will attend classes, programs, or family events like field trips and parties. You will pay a $50 Member Fee per child. *

Please note that if you have more than four children you will need to complete this form and registration process a second time.

Child 1 - $50

Child 2 - $50

Child 3 - $50

Child 4 - $50

Already paid 2022-23 Member Fee in previous registration contract

Required

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