2025-2026 Preschool Registration

We're excited to welcome your child to Tiny Notes! Please complete the enrollment form accurately and thoroughly to ensure a smooth transition. If you have any questions or need assistance, feel free to contact us at 360-443-2399. We're here to help!

Student's First name

Student's Last name

Student's Address

Student's Date of Birth

Month

Day

Year

Student's Gender

Parent/Guardian's Full Name

Parent/Guardian's Phone Number

Emergency Contact #1 (Name and Phone Number)

Emergency Contact #2 (Name and Phone Number)

Name and Number of any individuals allowed to pick up my child:

If someone not listed above will be picking up your child, written permission from a parent/guardian will be required. For the safety of all children, individuals—including parents/guardians—may be asked to provide identification at the time of pick-up.

I understand

Does your child have any allergies or medical conditions? If so, please list them below along with their severity (e.g., airborne, contact, or ingestion allergy) and any additional details we should be aware of.

Is your child potty trained? Does your child require assistance?

Is your child up to date on vaccinations?

Yes

Other

Pediatrician's Name and Number

Does your child require any accommodations or services, such as, OT, Speech, ABA, Respite, 1:1 services, DDA, etc.?

Would you like any information regarding our extended services? Tiny Notes accepts insurance and DDA.

Occupational Therapy (OT)

ABA Therapy (Practitioners strictly practice a play based approach)

Diagnostics with MD (Development Concerns) (off-site)

Does your child have an IEP?

Yes

Are there any items that help soothe or calm your child (e.g., stuffed animals)?

Which class are you registering for?

Little Groovers - 2.5-3 yrs, T/TH: 9:00 am - 12:00 pm, $200/month

Little Movers - 3-4 yrs, M/W/F: 9:00 am - 12:00 pm, $350/month

Little Movers - 3-4 yrs, M/W/F: 9:00 am - 1:00 pm, $410/month

Little Shakers - 4-5 yrs, M-F: 9:00 am - 12:00 pm, $485/month

Little Shakers - 4-5 yrs, M-F: 9:00 am - 1:00 pm, $585/month

Would you like to be contacted to schedule a tour?

Yes

How did you hear about us? If from a friend or family, who referred you?

I consent to allow my child to be included in photos taken during class activities that may be used for Tiny Notes Music and Movement LLC media accounts and marketing.

I agree

I do not agree

I understand that I must pay a non-refundable registration fee of $125 to hold my child's spot at the time of registration. The first months tuition is due on Sept 1st, 2025. If you need a payment plan, please contact us. 360-443-2399.

I understand

Preschool tuition is due on the 1st of every month. After the 5th tuition is considered late and a $50 late fee will apply. If tuition is more than 30 days behind, the student will be dropped. The late fee MUST be paid also within the 30 days. If you need any assistance please contact Ashley Marsh.

I understand the above statement regarding tuition schedule.

I understand

I understand that if I decide to withdraw my child from Tiny Notes Preschool Program a 30 day notice is required. If notice is given after the 10th of the month, you will be required to pay the following month.

I understand

Please ensure prompt pick-up of your child at their scheduled time. A late fee of $1 per minute will be charged. In case of a genuine emergency, kindly call 360-443-2399 to notify our staff of your expected delay.

I understand

I give Tiny Notes Music and Movement LLC consent to seek and accept medical treatment for my child in case a parent is unable to be reached. Every attempt to contact the parents will be done first.

I agree. (By checking this box, I agree for my child to receive medical treatment.)

I do not agree

All children will be required to have a water bottle or cup with them during school days. You may purchase one to leave at school. If your child does not have one, one will be supplied to you child for the fee of $1 per bottle.

I agree

Are there any court or custody documents that we need to be aware of? Example: If a parent is not allowed to pick up.

Yes

Other

Any additional comments or concerns?

Waiver and Release of Liability

I agree that this Waiver and Release of Liability shall apply to each day I am at Tiny Notes Music and Movement LLC, regardless of the date this form is signed below. This form does not apply to regular class times where staff is responsible for my child. This form is intended for times when children are in the care of their parents or guardians while on the premises.

I acknowledge and accept that Tiny Notes Music and Movement LLC has jungle gym equipment and other play structures on the premises. I understand that the use of this equipment involves inherent risks, including but not limited to, falls, collisions, and other accidents that may result in injury. I agree to assume all risks and full responsibility for any injuries, losses, or damages that might occur to my child, myself, or other family members resulting from the use of this equipment.

To the maximum extent permitted by law, I waive and release any and all claims, suits, or related causes of action against Tiny Notes Music and Movement LLC, including its owners, officers, employees, or agents, for any injury, loss, death, costs, or other damages arising from the use of any equipment, play structures, or facilities, whether on the premises or during off-site programs or activities.

I further agree to indemnify, defend, and hold harmless Tiny Notes Music and Movement LLC, its owners, officers, employees, or agents from any and all liability, including claims, suits, or causes of action asserted by third parties, that may arise from injuries, losses, or damages caused by my conduct, my child’s conduct, or the conduct of other family members while participating in the preschool’s programs, activities, or use of equipment.

I specifically understand and agree that Tiny Notes Music and Movement LLC is not responsible for supervising, inspecting, or ensuring the safe use of jungle gym equipment, play structures, or similar apparatuses when children are under the care of their parents or guardians. All use of such equipment is at my own risk, and I am solely responsible for ensuring the proper supervision and safety of my child and any accompanying family members.

I further release, indemnify, defend, and hold harmless Tiny Notes Music and Movement LLC from any liability whatsoever for future claims that may be presented by my child, myself, or other family members for any injuries, losses, or damages arising from the use of any equipment, facilities, or participation in activities.

I have read, understand, and agree to the above waiver and release of liability.

I agree. By checking this box the above named parent or guardian agrees to terms and conditions of the liability waiver.

Thank you for joining Tiny Notes Music and Movement LLC. By signing below and submitting this form you are verifying that all of the submitted information above is true and that you are the parent or legal guardian authorized to grant permission for the child to participate.

Parent/Guardian Signature

Registration Fee

$125