Small Group Registration Form

School year

Parent & Student Information

Primary guardian first name

Primary guardian last name

Relationship to student

If other, please specify relationship

Primary guardian email address

Primary guardian phone number

Secondary guardian full name (optional)

Secondary guardian phone (optional)

Secondary guardian relationship to student

If other, please specify secondary relationship

Secondary guardian email (optional)

Student full name

Student age

Current learning level

Kiddo's Birthday

Allergies, medical needs, or learning considerations

Help us provide the best support for your child by sharing any important health or learning information.

Program Selection

Please select one or more Small Group programs for your kiddo:

Select Small Group programs

Seedlings- Kinder / 1st Grade

Sprouts- 2nd / 3rd Grade

Blossoms- 4th / 5th Grade

Pathfinders- 6th / 7th Grade

STEAM - Science, Tech, Engineering, Art, Mathematics (ages 8-11)

Ancient Civilizations - Journey through history and discover ancient cultures (ages 10-13)

Junior Writers - Creative and expository writing skills development (ages 8-11)

Social Emotional Learning (SEL) - Building self-awareness, empathy, and social skills (ages 5-7)

Tuition & Payment Options

Choose your preferred payment plan. All tuition is non-refundable and due according to the selected payment plan.

Payment plan

Payment Method

Deposit & Enrollment Confirmation

Important: A $200 non-refundable deposit is required to secure your child's Small Group placement. The deposit will be collected immediately upon form submission and applied toward your total tuition balance. Enrollment is not confirmed until the deposit payment is successfully processed.

Terms & Policies Agreement

Attendance & Commitment: I understand that enrollment is a commitment for the selected term. Missed sessions due to illness, vacation, or personal conflicts are not refundable, and no credits or make-ups are provided.

Instructor Coverage: I understand that while each Small Group has a primary instructor, approved substitutes may be used when needed. If the assigned instructor becomes unavailable, Lotus Learning may assign a qualified replacement or issue a credit toward future programming.

Holidays & Closures: I understand that sessions do not run on pre-scheduled holidays or closure dates, which are factored into tuition and are not refundable.

Late Pickup Policy: I understand that a 10-minute grace period is provided after session end time. Pickups after the grace period incur a $1 per minute late fee, billed/invoiced automatically. Excessive late pickups may impact continued enrollment.

Behavior & Participation: I understand Lotus Learning supports diverse learning needs through developmentally appropriate guidance. Participation in Small Groups requires that the format is a good fit for a student to safely engage and thrive. If the Small Group format is not the right fit, Lotus Learning will collaborate with families to determine appropriate next steps, which may include alternative service recommendations.

Communication Consent: I consent to receive communication via email and text regarding scheduling and updates.

Media Consent (Optional): I give permission for photos or videos of my child for internal use or marketing purposes.

Quarterly Commitment & Withdrawal Policy: I understand that families commit to a minimum of one quarter (three months) at a time. Enrollment automatically continues into the next quarter unless written notice is provided. If a family needs to withdraw from a small group, written notice must be submitted before the start of the upcoming quarter. Notices received after a new quarter has begun will still be financially responsible for the quarter.

Signature

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