Please Fill Out the Form to Begin Your Child's Registration

Thank you for your interest in Rooted in Learning Academy! Please enter your information below.

Parent Name *

2nd Adult Name

Contact Phone *

Text Opt-in *

By checking this box I agree to receive email and SMS text communications and promotions from Rooted in Learning Academy about 5 messages a month. SMS text and data rates may apply. I may opt-out at any time by replying STOP. View Terms and Conditions at https://rootedinlearningpreschoolonline.com/privacy

Email *

Address *

City *

State *

Postal code *

Country *

How did you hear about us? (If referral, please list name)

Child 1 Full Name *

Child 1 Date of Birth *

Child 1 Gender *

Male

Female

Which Rooted in Learning program are you interested in for your child?

Child 2 Full Name

Child 2 Date of Birth

Child 2 Gender

Male

Female

What are some of your 2nd child's interests?

What do you look forward to the most regarding your 2nd child's preschool education?

Is there any additional information you would like to share regarding you or your 2nd child?

To keep our online preschool running smoothly, please agree to all of these policies:

I understand that after signing up, I will need to schedule a FREE initial assessment within 3 days to receive the full benefit of the 1 week trial. I further understand that after my family completes the assessment, it may take Rooted in Learning Preschool Academy up to 24 hours to send instructions on how to access the preschool classes.

I understand that I am signing up for a free 7-day trial, and that if I don't cancel before my trial ends, my card will be charged for the weekly preschool tuition. I understand that my initial payment will process 10 days from the time I checkout, allowing 3 days for my child's assessment to be completed, followed by a 1-week trial. I understand that all fees paid aren't refundable, and I can cancel anytime.

Following the assessment, I understand that I will need to log my child into the Zoom classroom, but I do not need to stay during class time. However, I understand that Rooted in Learning Preschool Academy is not a babysitter, and that if my child is misbehaving during online preschool, that the teacher will talk to me about finding a solution to help my child not misbehave.

Parent Agreement *

I agree to all of the policies listed on this form.

Parent Signature *

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Date Signed *

What are some of your child's interests?

What do you look forward to the most regarding your child's preschool education?

What are your child's interests?

What do you look forward to the most regarding your child's kindergarten education?

What grade is your learner currently in? *

Which of the following subject(s) are you interested in receiving more information on? *

English/Language Arts

Mathematics

Is there any additional information you would like to share with us regarding you or your child?

I understand that my next step is to meet with the Rooted in Learning Administration team and I must schedule my family's commitment free consultation within the next 10 days. Please initial below. *

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