MANHATTAN BEACH 2023-2024 PIPER MB ENROLLMENT Child's First Name(Required) Child's Last Name(Required) Child's Date of Birth(Required) MM slash DD slash YYYY Child's Gender(Required) Male Female Parent A First Name(Required) Parent A Last Name(Required) Parent A Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Parent A Phone(Required)Parent A Email(Required) Enter Email Once more for the people in the back. Is there another parent in the picture?(Required) Yes No Parent B First Name Parent B Last Name Parent B Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Parent B Email Enter Email Once more for the people in the back. Parent B PhonePolicies and AgreementsProgram Enrollment(Required) I accept Piper's offer to enroll my child in Piper Preschool for the 2023-2024 school year. Separation Policy(Required) I understand that my child's transition schedule will be comprised of a series of playdates, and that one parent or caregiver must be present the entire time. I understand that any additional separation strategies will be determined individually and as needed (i.e. gradually extending hours). By checking this box, I acknowledge and agree to the Separation Policy. Tuition Agreement(Required) Preschool & Pre-K | Monday-Friday | 9am-2pm | $23,000 per year. I understand that upon completing and submitting this contract, I will be securing my child's enrollment with a one-month tuition deposit of $2300, plus Annual Fees* of $1000. I understand that this payment is non-refundable, regardless of my child's absence, withdrawal, or relocation, and will be directly applied to my Total Commitment. I understand that this agreement and deposit must be received by the due date indicated on the email offering enrollment. I understand that if I do not meet the deadline, Piper Preschool will not be obligated to reserve a space for my child. By checking this box, I acknowledge the Tuition Agreement and understand that I am responsible for the Total Commitment. *The term “Annual Fees” includes PPA Dues, Materials Costs ($800), and Earthquake & Safety Supplies ($200). The Preschool Parent Association (PPA) sponsors parent education programs, faculty support, community activities, and family events. Early Care | 8:15am-9am(Required)Early Care is available Monday-Friday from 8:15am-9am, in accordance with the school calendar, and includes supervision on the playground. Children may attend any or all days, and may be dropped off any time after 8:15am. Enrollment is for the entire 2023-2024 school year and is non-refundable. Yes, I'd like to enroll my child in Early Care and authorize Piper Preschool to add $2800 to my Total Commitment. N/A. 9am works for us. Extended Care | 2pm-5pm(Required)Extended Care is available Monday-Friday from 2pm-5pm, in accordance to the school calendar, and includes outdoor play, a community snack, and classroom activities. Children may attend any or all days, and may be picked up any time between 2pm-5pm. Enrollment is for the entire 2023-2024 school year and is non-refundable. Yes, I'd like to enroll my child in Extended Care and authorize Piper Preschool to add $4500 to my Total Commitment. N/A. 2pm works for us. Payment Plan(Required)Select your payment plan below. Accepted methods of payment include check, bank withdrawal, and credit card. Note: Any credit card payment, other than this deposit, will incur a 3% convenience fee. One-Pay: Balance due September 1, 2023. Two-Pay: Equal payments due September 1, 2023 and February 1, 2024. Four-Pay: Equal payments due September 1, 2023, December 1, 2023, February 1, 2024, and April 1, 2024. A $75 finance fee will be applied to each payment. Nine-Pay: Equal payments beginning September 1, 2023 and concluding on May 1, 2024. A $35 finance fee will be applied to each payment. Late Payment Policy(Required) By checking this box, I understand that any payment not received by the due date outlined in my Payment Plan, as well as any declined payment, will incur a $100 fee. I understand that any returned check or returned bank debit transaction will result in an additional $25 fee. I understand that, should any balance remain outstanding after 90 days of the original due date, Piper Preschool has the right to discontinue enrollment. Liability and Refund Policy(Required) By checking this box, I understand the Total Commitment to represent an annual commitment; I understand that my obligation to pay tuition and fees for the entire school year, as outlined above, is unconditional, and that no portion of tuition and fees, be it paid or outstanding, will be refunded nor canceled, and that the timing of payments is not associated with my child’s time of attendance, regardless of my payment plan. I understand all payments are non-refundable. Withdrawal Policy(Required) By checking this box, I understand that I will incur a $2500 Withdrawal Fee in the event of a formal withdrawal. I understand that requests for release must be submitted in writing, and that any prepaid tuition due will be calculated in accordance to the submittal date. Physician's Report(Required) I agree to submit an electronic copy of LIC701 Physician's Report, as it is required by law to be on file prior to attendance. Code of Conduct(Required) By checking this box, I understand that Piper Preschool reserves the right to discontinue enrollment in the event of a breach of this agreement and/or failure to adhere to the Parent Code of Conduct, as outlined in the Parent Handbook. Construction Disclosure(Required) In the unforeseen event that the start of school is delayed due to construction, I understand that my tuition will be prorated accordingly. Enrollment Completion(Required) Checking this box, signing below, and submitting my deposit signifies that I have read, understand, and agree to all terms and policies listed throughout this complete contract, agree to its provisions, and that I will be responsible for the Total Commitment, which consists of Preschool & Pre-K Tuition, Early Care, and Extended Care. I have viewed and agree to the School Calendar and Parent Handbook, and understand that Piper reserves the right to make changes. Enrollment Deposit(Required)This enrollment deposit of $3300 includes a tuition deposit and Annual Fees, and will be directly applied to your Total Commitment. Enrollment Deposit Total Credit CardCard Details Cardholder Name Signature Reset signature Signature locked. Reset to sign again Email*