Parent's/Guardian's Full Name

Email *

Phone *

Child's Full Name *

Child’s Age Group

Class Option: (Please choose your child’s enrollment type)

Full Time – $200

3 Days (Mon/Wed/Fri) – $165

2 Days (Tues/Thurs) – $130

Drop-In – $XX (Call to Confirm Availability)

Enrollment Start Date:

Are you enrolling more than one child? *

Yes

If you are enrolling multiple children, a 10% discount will be applied to the oldest child's tuition. Use the tuition calculator provided after submitting this form to determine your total.

Upload Birth Certificate or Immunization Records (File Upload)

Zelle Payment Instructions:

To complete your child's registration, please send your payment via Zelle to:

817-902-7497

Be sure to include your child’s full name in the memo section when sending payment.

⚠️ Important: Your spot is not secured until payment has been received and confirmed. You will get a confirmation text or email shortly after we verify your payment.

Final Total to Send via Zelle

Agree to policies *

Yes

By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested. These messages may include appointment reminders, order confirmations, and account notifications among others. Message frequency may vary. Message & Data rates may apply.Reply HELP for help or STOP to opt-out.

Rajen Tech Solutions