Meridian Learning Enrichment Classes

Meridian Learning Enrichment Classes (25-26)

Meridian Learning Enrichment Classes

"*" indicates required fields

Payment Options

Payment Options:
1) pay for first class and be billed via brightwheel for each class in the semester

Payment Option Selection

Mondays – Book Design

Nov 3 – 24th 2:45 – 3:30

Mondays – Book Design

Book Design is paid all upfront

Number of Children for Monday – Book Design

Please enter a number from 0 to 3.

Tuesdays –

(Monthly) Tuesdays –

Pay for 1st Month and be billed via Brightwheel for remainder of months in semester (i.e. choose Fall Semester, pay for September today and be billed monthly for October, November and December)
Monthly amount varies based upon the number of classes in the month.

Number of Children for Tuesdays –

Please enter a number from 0 to 3.

Wednesdays – Botany Club

2:45 – 3:45

(Monthly) Wednesdays – Botany Club

Pay for 1st Month and be billed via Brightwheel for remainder of months in semester (i.e. choose Fall Semester, pay for September today and be billed monthly for October, November and December)
Monthly amount varies based upon the number of classes in the month.

Number of Children for Wednesdays

Please enter a number from 0 to 3.

Thursdays –

(Monthly) Thursdays –

Pay for 1st Month and be billed via Brightwheel for remainder of months in semester (i.e. choose Fall Semester, pay for September today and be billed monthly for October, November and December)
Monthly amount varies based upon the number of classes in the month.

Number of Children for Thursdays

Please enter a number from 0 to 3.

Friday – Field Trip and Forest Fridays

9:15 am – 2:30 pm

(Monthly) Fridays – Field Trip and Forest Fridays

Pay for 1st Month and be billed via Brightwheel for remainder of months in semester (i.e. choose Fall Semester, pay for September today and be billed monthly for October, November and December)
Monthly amount varies based upon the number of classes in the month.

Number of Children for Fridays – Field Trip and Forest Fridays

Please enter a number from 0 to 3.

Coupon

TRIAL Coupon*

TRIAL coupon is for a single class.

Total Due Today

Parent Information

Parent's Name:

First Last

Mailing Address:*

Street Address Address Line 2 City State ZIP Code

Email address:*

Enter Email Confirm Email

Best Number to Reach You:*

Cell Phone

Home Phone

Work Phone

Cell Phone:*

Cell Phone:

Home Phone:*

Home Phone:

Work Phone:*

Work Phone:

Additional Parent's Name:

First Last

Children's Information & Photo Release

Photo Release Permission

I/We give permission for photos/videos to be taken of:

1st Child's Name (Mondays)*

First Last

1st Child's Date of Birth (Mondays)*

2nd Child's Name (Monday)*

First Last

2nd Child's Date of Birth (Mondays)*

3rd Child's Name (Monday)*

First Last

3rd Child's Date of Birth (Mondays)*

1st Child's Name (Tuesdays)*

First Last

1st Child's Date of Birth (Tuesdays)*

2nd Child's Name (Tuesdays)*

First Last

2nd Child's Date of Birth (Tuesdays)*

3rd Child's Name (Tuesdays)*

First Last

3rd Child's Date of Birth (Tuesdays)*

1st Child's Name (Wednesdays)*

First Last

1st Child's Date of Birth (Wednesdays)*

2nd Child's Name (Wednesdays)*

First Last

2nd Child's Date of Birth (Wednesdays)*

3rd Child's Name (Wednesdays)*

First Last

3rd Child's Date of Birth (Wednesdays)*

1st Child's Name (Thursdays)*

First Last

1st Child's Date of Birth (Thursdays)*

2nd Child's Name (Thursdays)*

First Last

2nd Child's Date of Birth (Thursdays)*

3rd Child's Name (Thursdays)*

First Last

3rd Child's Date of Birth (Thursdays)*

1st Child's Name (Fridays – Field Trips)*

First Last

1st Child's Date of Birth (Fridays – Homeschool Fridays)*

2nd Child's Name (Fridays – Homeschool Fridays)*

First Last

2nd Child's Date of Birth (Fridays – Homeschool Fridays)*

3rd Child's Name (Fridays – Homeschool Fridays)*

First Last

3rd Child's Date of Birth (Fridays – Homeschool Fridays)*

while he/she is participating in Meridian Learning activities. I/We understand that photos/video may be published online, in printed materials and/or for other promotional purposes, but only to help document student work and illustrate Meridian Learning programs. I/We hereby waive any ownership rights, as well as any right that I/we may have to inspect or approve the finished product in which a photographic or video image may be used including the advertising copy or other matter that may be used in connection therewith or the use to which it may be applied.

Children's Medical Information

Does your 1st Child (Mondays) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 2nd Child (Mondays) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 3rd Child (Mondays) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 1st Child (Tuesdays) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 2nd Child (Tuesdays) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 3rd Child (Tuesdays) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 1st Child (Wednesdays) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 2nd Child (Wednesdays) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 3rd Child (Wednesdays) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 1st Child (Thursdays) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 2nd Child (Thursdays) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 3rd Child (Thursdays) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 1st Child (Fridays – Homeschool Fridays) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 2nd Child (Fridays – Homeschool Fridays) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Does your 3rd Child (Fridays – Homeschool Fridays) have any allergies? Specific dietary needs/food sensitivities? Medical conditions?*

Emergency Contact:

Emergency Contact Name:*

First Last

Emergency Contact's Relationship to your child(ren):*

Emergency Contact's Address:*

Street Address Address Line 2 City State ZIP Code

Emergency Contact's Phone:*

Preferred Hospital:*

Name of Family Physician:*

First Last

Family Physician Phone:*

In case of emergency, do we have permission to administer CPR and/or authorize an ambulance to transport your child(ren) to a hospital?*

Yes

No

Emergency Contact Acknowledgement:*

By checking the box, you are agreeing that the information provided for Emergency Contact is accurate.

Registration Policy

We regret that we cannot grant refunds for Meridian Learning Enrichment registrations. If we must cancel a class(es) due to low enrollment, your payment will be refunded.
We reserve the right to cancel classes due to low enrollment. Registrants will be notified via email if classes are cancelled.
Once this agreement is signed and submitted, you are responsible for class registration fees for the entirety of the semester for which you registered unless and until the spot you reserved is filled or Meridian grants an exception.

Waiver

In consideration of the acceptance of my application for Meridian Learning classes, I hereby waive, release, and discharge any and all claims for damages for personal injury, property damages or which may hereafter occur to my child/ren as a result of their participation in said Meridian Learning classes. This release is intended to discharge in advance Meridian Learning, LLC, its officials, officers, employees, volunteers, and agents from liability, even though that liability may arise out of perceived negligence on the part of persons mentioned above. It is understood that some recreational activities involve an element of risk or danger of accidents, and knowing those risks, I hereby assume those risks. It is further understood and agreed that this waiver, release, and assumption of risk is to be binding on my heirs and assignees.

Parent Agreement

Confidentiality

Meridian Learning is committed to protecting the privacy of all families who participate in our programs, as well as the children in the learning environment. With this in mind, we will not discuss confidential information in the presence of children or other parents. If you wish to discuss sensitive issues pertaining to your child, please contact us via email.

Attendance/Punctuality, Inclement Weather and Make-ups

Whenever possible, please give a two (2) hour notice if you are unable to attend class. We regret that we cannot excuse you from payment or grant refunds for absences. Advanced notice of tardiness is appreciated as it may impact the rhythm of the class. If your child’s class is cancelled due to inclement weather or instructor illness, a refund for the cancelled class will be offered.

Participant Behavior

We reserve the right to terminate enrollment at any time should a participant’s behavior/needs, consistently and beyond an initial adjustment period, impact the quality of the environment, interfere with the functioning of the class as a whole and/or endanger the child or others.

Children's Information & Photo Release, Children's Medical Information, Emergency Contact, Registration Policy, Waiver, Parent Agreement Acknowledgement:*

By signing below, you are agreeing that the information provided is accurate and that you have read the Photo Release, Registration Policy, Waiver and Parent Agreement. My signature below indicates that I agree to all of the above provisions regarding my family’s participation in the program(s).

Parent/Guardian Name:*

First Last

Parent/Guardian Signature:*

Parent/Guardian Name (additional):

First Last

Parent/Guardian Signature (additional):

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