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2024/2025 Enrollment Form

Please fill out all required fields.

Child Information

Indicate days your child will be in care
Upload File
Pick Up from School?

Parent Information 1

Parent Information 2

Other family members/people living in the household

Do you need an annual tax statment?

The Commonwealth of Massachusetts Department of Early Education and Care Small & Large Group Transportation Plan and Authorization

Authorization for Release/Pickup

ID must be shown for us to release a child.

My child needs a booster seat.
My child will ARRIVE at the program:
My child will DEPART at the program:

Health Information

Upload File

Attach forms as needed. EX: individual health care plan (IHCP), medication consent forms, doctor signatures.

Does your child take any medications regularly?
Does your child have any chronic health concerns? (asthma, seizures, nose bleeds, allergies, etc.)

First Aid & Emergency Medical Care Consent Form

Please check off what products can be used:

Personal History/Questionnaire

Illness and or hospitalization?
Any speech difficulties?
Is the child receiving any services? (speech, OT/PT)
Special physical conditions, disabilities?
Any developments delays or concerns?

Social/Emotional Development

Other Permissions

I give the Academic Achievement Center permission to take and display my child's photo for the following:
I give permission for my child to Mason Field and the neighborhood near or around the center for field trips.. I understand that staff will be supervise my child at all times.
I hereby grant authorization for the Academic Achievement Center to access and receive all pertinentschool documentation, reports, and communication pertaining to my child. I trust that this informationwill be handled with the utmost professionalism and confidentiality.

Acknowledgements & Agreements




I have read and understood the tuition policy on page 1 of the Academic Achievement Center’s Parent Handbook, which states that tuition is payable in advance and due in full on the first of each month. Statements are not sent out each month. You may pay your fees in full on the first of the month or half on the first and half on the fifteenth. In signing this form, I agree to this policy and commit to making tuition payments accordingly. I also understand that failure to comply with this policy may result in termination of services. In addition, I understand that a 30-day written notice must be submitted if I decide to withdraw my child from the program. 

Thanks for submitting! We'll get back to you as soon as possible.

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