Imaginations Learning Academy

Enrollment Form

I (We), ___________________________________, agree to enroll my (our) child, ______________________________________with Imaginations Learning Academy. The first day of enrollment will be _________________. The provider, Melanie Munford, promises to begin care of this child on the above-mentioned date.

Further, I (We) agree to pay the enrollment fee of $___________ that will serve to hold this space until the first day of enrollment. I understand that this fee is due upon signing this form, and that this enrollment fee is nonrefundable whether or not I (We) bring the child for care. I (We) also understand that all necessary paperwork (including the provider’s contract) must be signed and returned on or by the first day of care, and am (are) agreeing to do so.

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Mother/Guardian Signature & Date

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Father/Guardian Signature & Date

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Provider Signature & Date