The Village Tehachapi Enrollment Request Form

For your student's safety, it's best to to have a visual of your student for staff to reference in case of emergencies. This will also be used to create School IDs for High School Students.

Please enter which classes and/or tutoring subjects, days, and times you're interested based on your selections above.

Please enter which classes and/or tutoring subjects, days, and times you're interested based on your selections above.

Registration I attest that I am financially responsible for the student enrolling in this course. A one-time $25 registration fee per student is required to enroll in courses at the Village. Unless waived during early registration, this financial commitment is accepted in a private payment only and due at the time of enrollment to secure your student's space in any courses. Failure to pay registration will result in your student being dropped from the courses requested. Monthly Tuition I understand that this is an ongoing course that runs from August - May over the course of multiple months. Full monthly tuition is due on the first of every month August-May. All holidays and breaks are calculated into tuition. A $15 late fee will be added if we do not receive payment by the 10th of each month. If we don't receive payment by the 30th of the following month, your student will be withdrawn from the class and you will need to re-register with an additional registration fee. Charter School Funds You attest that you are responsible for following all charter school guidelines including but not limited to: placing orders on time, assuring that your school has approved funds and has funds available, following appropriate attendance policies, and maintaining communication with both the Village and your school for any requirements, etc. We cannot allow your student(s) to attend classes unless we have approved certificates the month BEFORE your student is enrolled. If you miss this deadline or fail to meet any school requirements needed for funding, you will be expected to pay privately for these classes in order for your student to attend. Withdrawing From Classes If your student chooses to withdraw from classes, we require a 30-day notice to allow us to notify students on the waiting list and provide notice of openings to the public. Unless we receive this notification, we understand that your student is continuing classes for the next month and will either expect to receive payment or a certificate by the first of each month. If we do not receive a certificate, you will be expected to pay privately for any classes your student attended. If not paid, your student will be immediately withdrawn and may be placed on the waiting list. If you take a financial break from any monthly classes due to vacation, etc. without payment, 30 days notice is expected, and reregistration will be required to re-enroll in courses. Family Discounted Rates/Bundles In order to receive the family bundle rate (not available for High School Courses), we are requiring a full year commitment. You attest that your financial commitment is $225 per student for the entire 9 months ($2025 per year). If Charter funds are used, you are agreeing to budget this amount of planning funds. If you run out of funds, you agree to pay privately. Please note that bundles ARE NOT eligible for CTT funding, so all discounted rates MUST COME OUT OF enrichment planning funds. If you need monthly payment options, it is your responsibility to contact us to make these arrangements. If not, you will be billed for the difference and failue of payment may result in being sent to a collection agency. By checking the box below, you are agreeing to the Financial Responsibility Agreement

I understand and agree that I am releasing not only The Village Tehachapi, but also the officers, agents, and employees of The Village Tehachapi. I understand and agree that this Waiver/Release will have the effect of releasing, discharging, waiving, and forever relinquishing any and all actions or causes of action that I, or my child, may have or have had, whether past, present or future, whether known or unknown, and whether anticipated or unanticipated by me or my child, arising out of participation in the Activities. I understand and agree that by signing this Parental Authorization and Waiver/Release of Liability, I am assuming full responsibility for any and all risk of death or personal injury or property damage suffered by me and/or my minor child while participating in any and all chosen activities at The Village Tehachapi and its affiliates. I understand and agree that by signing this Parental Authorization and Waiver/Release of Liability, I am agreeing to release, indemnify, and hold harmless The Village Tehachapi and their officers, agents, and employees from any and all liability or costs, including attorney fees, associated with or arising from participation in the Activities. I understand that this Waiver/Release of Liability will be binding on me, my spouse, my heirs, my personal representatives, my children, and any guardian ad litem for said children. By checking the box below, you are agreeing to the Parental Authorization and Waiver/Release of Liability

COVID-19 RISKS: I understand that is my responsibility to ensure that my family and child are following all local, state, and federal health guidelines in order to participate in activities. I acknowledge that participating in activities during a health pandemic, despite following all guidelines, may increase my risk of exposure to COVID-19 and other illnesses and may result in my child contracting COVID-19 and/or other illnesses, which may spread to me and my family, which may result in severe illness, hospitalization, and/or death. By signing hereon, parent/guardian waives liability against and holds harmless The Village Tehachapi and its staff, volunteers, vendors, agents, and any other individuals relating to the contraction of COVID-19 or other illnesses to the student or his/her family. I certify that my child is physically, mentally, and emotionally able to participate in the above activities in which s/he freely chooses to participate. In consideration of being permitted to participate in said activities, I hereby voluntarily release The Village Tehachapi from any and all liability resulting from or arising out of my child’s participation. Illness Policy Agreement I have read the Village sickness and illness policy in relation to COVID-19 and agree to follow all guidelines as well comply with The Village Tehachapi enforcing all health mandates including but not limited to temperature and symptom checks, social distancing protocols, and mask enforcement. I understand that I and/or my child will be asked to leave if not following these policies without refund or make-up. By checking the box below, you are agreeing to the Illness Policy Agreement

I understand that the Village Tehachapi may take photos or videos of my student participating in activities. I acknowledge that these photos or videos are property of the Village Tehachapi and may be used on platforms such as advertisements and/or social media and/or local news sources. I, nor my student, have any rights to these photos. I can however opt-out of allowing myself or my student to be photographed by checking below.

At The Village Tehachapi, we are committed to creating a safe, respectful, and inclusive environment where children, teens, families, and staff feel welcomed and supported. Respect for All -Treat others with kindness, patience, and empathy. -Listen actively and speak thoughtfully. -Celebrate authenticity and differences in culture, ability, background, identity and perspective. -Use respectful language—unkind remarks will not be tolerated. Safe & Supportive Environment -Help keep our spaces physically and emotionally safe. -Be mindful of mixed ages in our community. -Use materials and shared spaces responsibly. -Report unsafe behavior immediately. -Physical aggression or destruction of property is not permitted. Arrival and Departure High School: May transport between locations but must notify staff when leaving. Middle School: Supervised between locations. Cannot leave campus without adult. Elementary: Parents must meet at gate for pickup. Responsibility & Participation -Arrive on time and prepared. -Take ownership of behavior and learning. -Follow staff directions cooperatively. -Stay within designated areas. Collaboration & Creativity -Allow room for mistakes and growth. -Support each other with patience. -Respect creative work and learning styles. -Share tools and space graciously. Family & Community Engagement -Parents are partners in our learning environment. -Communicate openly with staff. -Contribute positively to the community dynamic. Consequences for Violations -Verbal reminder -Parent/guardian meeting -Personalized Behavior Plan -Temporary or permanent dismissal at the discretion of The Village staff By checking the box, you AND your student have read and agree to the Code of Conduct

I also understand that this Parental Authorization and Waiver/Release of Liability is valid for the duration of time that my student participates in the activity or for 1 year from the date of signature. By typing my full name, this acts as a legally binding electronic signature to this document.