Enrollment Form
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Welcome to ! We are so excited to be able to have this wonderful opportunity to teach your child the basics in a unique way, and give them a head start in their educational years. Little Orchard is like no other preschool. Not only do we teach the academic part of preschool, weour programs and curriculum are designed to also help develop their motor, cognitive, social, interactive and independent skills. We are so excited to have this opportunity to be part of your child's life.
LITTLE ORCHARD ONLINE PRESCHOOL ENROLLMENT -
Enrollment for the - online preschool year is in progress. Please return this enrollment form and registration fee ($) as soon as possible as registration is on a first-come first-served basis. Returning your enrollment form and paying your registration fee will hold your student's spot for the upcoming school year. Individuals that have turned in an enrollment form and their registration fee after the class is full can be placed on a waiting list. Although you may or may not be located in the Davis School District in Utah, please be aware that Little Orchard Online Preschool will attempt to closely follow the Davis School District calendar. A calendar of the school year may be provided once it is available when your child is enrolled.Little Orchard Preschool will attempt to closely follow the Davis School District calendar. A calendar of the school year may be provided once it is available when your child is enrolled. Please return your forms and fee to: Via Online at: www.littleorchardpreschool.us Or Via Mail to: In addition to the $ registration fee, the monthly tuition fees are due on or before the first day of class. Further, a payment for the first and last month of the school year must be paid prior to attendance of the first day of class. Please make checks payable to Little Orchard Preschool. If you have any questions please feel free to call the school at
APPLICATION FOR ENROLLMENT
Student's first and last name written and called by at preschool: (i.e. Sam, Samuel, Sammy)
 Birth Date
Parents: Married
Single
relate moms to this enrollment
relate dads to this enrollment

Home Address:
Passphrase:
(This phrase will be used to confirm your identity when you call to talk about your child/account)

Other individuals authorized to be contacted in case of emergency (Name/Phone Number/Relationship):

relate guardians to this enrollment
Medical Conditions/Allergies/Serious Illnesses (Must keep medical status up to date): *
In order to participate at Little Orchard Preschool you must be current on age appropriate recommended vaccinations. We do not accept Exception forms. Are your child’s immunizations current? (Please provide a copy of up-to-date immunization record to the school)
Is your child COMPLETELY potty trained? (Not required):
Schools previously attended:
Briefly describe Your child:
Briefly set goals for your child in the preschool:
How did you learn about :

Signature:
Date:

* Unsafe or unreported medical conditions constitute grounds for denying children access to preschool.
ENROLLMENT AGREEMENT
I, (your name), am the parent or legal guardian of (child's name), whose birth date is
I would like to enroll my child at Little Orchard Preschool for the 2021-2022 school year. I am financially responsible for this child and agree to all of the terms and conditions contained on this Enrollment Agreement. I have enclosed the NON-REFUNDABLE REGISTRATION FEE ($100.00) and request the following program (please indicate 1st and 2nd choices).
Check all that apply:
Regular School Year Classes (one time registration fee $100)

Orientation will be in July. We will call prior to set up an appointment.
Online orientation will be in July. We will call prior to set up an online video appointment.
Your first two payments (for August and May enrollment) are due on or before the first day of class or your child may not attend class. May tuition can only be used for consistent enrollment through May. Please make checks payable to . I understand and agree that the Registration Fee is non-refundable if I am placed on the class list.
Special considerations:
I hereby choose and agree to the following payment option for tuition due. Option 1: I will pay the tuition due each month directly to Little Orchard Preschool. I understand that tuition is due on the 25th day of the month prior to the monthly classes and agree to pay a late payment of $20.00 for any late tuition payment and a $40.00 fee for any returned checks.
Option 2: I will pay the tuition due in full directly to Little Orchard Preschool. If the year’s tuition is paid in full with cash or check on or before July 30th of the school year indicated, a 5% discount will be provided. Please make checks payable to Little Orchard Preschool. You may also pay by cash or by credit/debit card. I understand that my first payment is due on or before the first day of class. The failure to timely make payment will result in refusing admission for the child for the remaining school year. I understand and agree that I am enrolling my child for the entire school year or remainder thereof. If it becomes necessary for my child to withdraw early, I agree to timely notify the school in writing, one month prior to withdrawal. I understand and agree that if I am making monthly payments, my account must be current as of the withdrawal date and any payments already made will be non-refundable. I understand and agree that if I am paying tuition in advance, that those advance tuition payments may be partially refundable. I understand and agree that I am enrolling my child for the online preschool program for the entire school year or remainder thereof. As such, if I wish for my child to attend in person, I understand that there may not be availability for my child at that time. If it becomes necessary for my child to withdraw early, I agree to timely notify the school in writing, one month prior to withdrawal. I understand and agree that if I am making monthly payments, my account must be current as of the withdrawal date and any payments already made will be non-refundable. I understand and agree that if I am paying tuition in advance, that those advance tuition payments may be partially refundable. I agree to pay to Little Orchard Preschool any costs or expenses, including legal fees, relating to or arising out of the efforts taken by Little Orchard Preschool. I further agree to pay 5% monthly interest on any past due balance pursuant to this Enrollment Agreement.
Any child who constitutes a danger to other children or staff of the preschool may be dismissed and denied attendance at the preschool. I understand and agree that if my student is dismissed, only future months payments already paid may be refunded. I agree to pay to Little Orchard Preschool any costs or expenses, including legal fees, relating to or arising out of the collection efforts taken by Little Orchard Preschool. I further agree to pay 5% monthly interest on any past due balance pursuant to this Enrollment Agreement.As my child will be an online attendee, I understand that it is my responsibility to ensure that my child has the technology and supplies necessary to participate and complete the curriculum and that I may be required to assist my child with activities and other curriculum that would generally be provided by a teacher for in person preschool. I also understand and acknowledge that the curriculum will be provided to me, but that it is proprietary to Little Orchard Preschool and may only be used for my child and may not be copied, sold, or used except for the education of my enrolled child. If the curriculum is used for any other purpose, I understand that I will be liable for any damages to Little Orchard Preschool, including, but not limited to legal fees related to or arising out of Little Orchard Preschool’s attempts to protect its proprietary information. The laws of the State of Utah govern this Enrollment Agreement. I also agree to exclusive jurisdiction of the Courts of the State of Utah for any issues that may arise between me and Little Orchard Preschool. I understand and agree with the terms of this Enrollment Agreement. By signing below, you are acknowledging that you are enrolling your child in the online Little Orchard Preschool program. Signature:
Date: (Parent or legal guardian of the child)
Signature:
Date:
(Administrator of Little Orchard Preschool)
EMERGENCY MEDICAL AUTHORIZATION AND RELEASE AGREEMENT I, (name), am the parent or legal guardian of (child’s name). I understand and acknowledge that my child may require first aid and/or emergency medical care for illness or accidental injury occurring at Little Orchard Preschool. In the event that my child should become or appear to become injured or ill, I hereby authorize Little Orchard Preschool to render such first aid to my child as may appear reasonably necessary under the circumstances. Little Orchard Preschool may take such actions as appear reasonable, necessary or in the best interests of my child and other children. I further confer upon Little Orchard Preschool all requisite authority to act in my place and stead in authorizing such emergency medical care or treatment as may be found necessary or advisable by any health care professional. In the event the child should experience a medical emergency requiring professional health care services, Little Orchard Preschool will use reasonable efforts to notify me as soon as possible but will not delay authorization of any medically necessary treatment. In the event that Little Orchard Preschool is required to execute an acceptance of financial responsibility to promptly obtain medical care for my child, I hereby unconditionally guarantee prompt and full payment to Little Orchard Preschool for all medical services rendered. I further agree to reimburse, indemnify and hold harmless Little Orchard Preschool for all medical costs and expenses incurred on behalf of my child and all other sums of any kind related to such medical costs or expenses. I hereby WAIVE, RELEASE AND DISCHARGE ANY AND ALL CLAIMS against Little Orchard Preschool for damages for death or personal injury my child may suffer as a result of (1) any efforts by Little Orchard Preschool to render First Aid; (2) emergency transportation to or from any doctor, hospital or emergency center by Little Orchard Preschool, (3) handling, diagnosis, treatment or care of my child by any doctor, hospital, emergency center, or emergency transport provider; and (4) failure to render or seek first aid or medical care for my child. Each waiver and release contained herein, I make on behalf of myself, my child and any other parent or guardian of my child. By these waivers and releases, I intend to give up my right, my child’s right and the right of any other parent or guardian of my child to assert or maintain any claim or suit against Little Orchard Preschool for the activities or occurrences described herein. I believe and represent that I HAVE LEGAL AUTHORITY TO MAKE THE WAIVERS AND RELEASES CONTAINED HEREIN and I agree to indemnify and hold harmless Little Orchard Preschool for any liability of any kind arising out of any lack of authority on my part to make such waivers and releases.
I have read, understand and agree with the terms and conditions above. Signature:
Date:
Signature: Date: (Administrator of Little Orchard Preschool)
AUTHORIZATION TO PARTICIPATE AT IN THE ONLINE AND RELEASE AGREEMENT
I, fully understand that my minor child (herein after “Participant”) will may be participating in physical and gymnastic activities that will involve motion and speed at Little Orchard Preschoolthrough the Online Little Orchard Preschool program. RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT In consideration of participation in the activities offered by Little Orchard Preschool, parent or legal guardian of Participant represents that he/she understands the nature of the activities and represents that Participant is qualified, in good health, and in proper physical condition to participate in such activities. Participant’s parent or legal guardian who has enrolled participant will keep Little Orchard Preschool advised of any conditions of participant or of any observations or knowledge that he or she may have become aware of, that render participant unsafe in the environment of the preschool. Participant’s parent or legal guardian is aware of and fully understands the risks that may arise within the normal activities of the preschool curriculum. Also, that there may be other risks either not known to me or not readily foreseeable at this time; and Participant and his/her parent or legal guardian fully accepts and assumes all such risks and all responsibility for losses, costs, and damages incurred as a result of Participant's participation in the activities. Participant and his/her legal guardian hereby releases, discharges, and covenants not to sue Little Orchard Preschool, GK Orchards Preschool Bountiful, LLC, GK Orchards Preschool Farmington, LLC, GK Orchards Preschool Kaysville, LLC, GK Orchards Property, LLC, Edward Greenwood, Brittany Greenwood, instructors, administrators, directors, agents, officers, employees, and all other persons assisting in the conduct of any activities, including persons transporting Participant to and from any activity, other participants, any sponsors, advertisers, and owners and lessors and others providing premises or facilities on which any activities take place, (the "Releasees") from all liability, claims, demands, losses or damages on my account caused or alleged to be caused in whole or in part by the negligence of the Releasees or otherwise, including negligent rescue operations; and Participant's parent and/ legal guardian further agrees that if, despite this release, waiver of liability, and assumption of risk, if anyone on behalf of participants parent or legal guardian makes a claim against any of the Releasees, Participant's parent and/or legal guardian will indemnify, save, and hold harmless each of the Releasees from any loss, liability, damage, or cost which any may incur as the result of such claim. Participant’s legal guardian has read this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, and understands that by signing it gives up substantial rights. Participant’s parent or legal guardian has signed it freely and without any inducement or assurance of any nature and intend it be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.
Printed Name of Participant
AND I, Participant's parent and/or legal guardian, understand the nature of the above referenced activities and Participant's experience and capabilities and believe Participant to be qualified to participate in such activities. I, and on behalf of Participant, hereby release, discharge, covenant not to sue and AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS each of the Releasees, and otherwise consent and agree to the terms and conditions of this Release and Waiver of Liability, Assumption of Risk, and Indemnity Agreement. Printed Name of Parent/Guardian
Signature of Parent/Guardian
Date
Printed Name of Administrator of
Signature of Administrator of
Date
AUTHORIZATION AND RELEASE For valuable consideration, the receipt and sufficiency is hereby acknowledged, irrevocable agrees and consents to the terms set forth in this agreement. These terms are as follows:
  1. Little Orchard Preschool may take photographs/video of my child/participant and/or testimonials for their promotional use and they have all ownership interest in these pictures, likeness, title, photographs, motion pictures, video tapes for use in advertisement and promotion for all purposes including use on Little Orchard Preschool web site, FaceBook, Instagram, YouTube, social networking and for all marketing purposes including but not limited to posting on the World Wide Webinternet.
  2. All photographs, photograph negatives, video tapes, film (developed an undeveloped), and other images and or likeness, including but not limited to use of my child’s/participant image or likeness in animation and or other medium and or publication are the exclusive property of Little Orchard Preschool.
  3. I hereby release and forever discharge Little Orchard Preschool, their teachers, agents, representatives and owners from all liability from the use of my child’s/participant’s image in the advertisement and promotion of their business.
I have read and agree to all terms and conditions stated herein.
Dated:
Signature:
Print Name:
Parental Consent: I agree to allow my minor child to appear in the promotion and advertisement on behalf of Little Orchard Preschool. Further, all terms and condition set forth in this Authorization and Release will apply to my minor child.
Dated:
Parent's Signature:
Signature: Date: (Administrator of )
Submit and recieve your enrollment form PDF by email, and please remember to pay your registration fee in order to complete the signup process.
Thank you for your enrollment. A Little Orchard Preschool representative will contact you shortly. If you are not contacted within a week, please contact at .
Contact Us
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Farmington
Address: 218 S 200 W Farmington, UT 84025
Bountiful
Address: 583 W 2600 S Bountiful, UT 84010
Kaysville
Address: 471 South Deseret Dr. Kaysville, Utah 84037 Suite #4
Phone: 385-302-1344
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© Little Orchard, Inc. 2021