Wholistic Learning Resources
Online Registration Form, Grades 1-8
All rights reserved. Copyright 2010.
Registration Instructions:                                                                        Click here for Pentathlon Registration
  1. Indicate payment option (SSCS, VIE charter or self-pay; if you are with another charter, please call Sandi.)
  2. If sending in deposit for full-day program, mark applicable box (near the bottom).
  3. If you have more than 2 students, complete form, submit and then reset form to register remaining students.
  4. Questions? Call Sandi at (916) 606-0799 or e-mail.
* Required Field
Parent last name:
Parent first name:
*
*
Phone number:
Email:
 *
*
*
 Student 1 Last Name:   
    
Student 1 First Name:   
*
Student 1, birthdate
 *
*
*
 Male
Age:
 Grade:
Female
1. Choose full-day program or
individual classes for Student 1.
Full-day program price of $765
reflects a $75 discount.
Full Day:

Handwork/ Folk Dancing

Science (5-8) or Math (1-4)

Choir / Flute

Watercolor Painting/ Art

Spanish

Drama
*
Subtotal
2. Enter Subtotal
3. Enter multiple class discount if applicable (Must register
for 3-5 classes. Not applicable to full-day program which is
already discounted.)
4. Deduct an additional 10% if you are a Self-Paying family.
5. Add any flute fees:
*
Total, Student 1
6. Enter Total for Student 1
Student 2 First Name
Student 2 Last Name
Student 2 birthdate:
 *
 *
 Male
Age:
Grade:
Female
Full Day:

Handwork/ Folk Dancing

Science (5-8) or Math (1-4)

Choir / Flute

Watercolor Painting/ Art

Spanish

Drama
1. Choose full-day program or
individual classes for Student 2.
Full-day program price of $765
reflects a $75 discount.
*
Subtotal
2. Enter Subtotal
3. Enter multiple class discount if applicable (Must register
for 3-5 classes. Not applicable to full-day program which is
already discounted).)
4. Deduct an additional 10% if you are a Self-Paying family.
5. Add any flute fees:
Total, Student 2    
                          
*
6. Enter Total for Student 2
*
TOTAL AMOUNT DUE, Students 1 & 2    
                          
Cancellation Policy: Wholistic Learning Resources reserves the right to cancel a class when required
minimum enrollment is not met. Earliest notification will be given and the participant may choose either a
full refund or a credit for future class registration.

    If you wish to cancel a registration, you must notify the WLR Program Director in writing at
    sandi@wholisticlearninresources.net one week in advance of the first scheduled class of the
    session in order to receive an 80 percent credit for future classes or an 80 percent refund.
    Cancellation after the first class meeting will be allowed a 75 percent refund or credit.
    Cancellation after the second class meeting will be allowed a 60 percent refund. No refunds or
    credits will be given after third class meeting. Refunds or credits are not issued for classes not
    attended. Credits are good for up to one year. All requests to cancel any registration must
    be received in writing (send to sandi@wholisticlearningresources.net).
I have read and agree to the WLR Cancellation Policy. Enter an X in the box to the left
to indicate your agreement to the WLR Cancellation Policy.
WLR recommends that you print this page before hitting the SUBMIT button below.
*
In addition to the Cancellation Policy above, please read and complete the forms listed
below. You may mail them to P.O. Box 19676, Sacramento, CA 95819; or you may fax them
to (916) 706-2655. Or, bring completed forms to the first day of class.

1) Conditions of Participation (1 per family)
2) Emergency Contact form (1 per student)
3) Waiver/Liability Release form (1 per participating student required by Liability Insurance carrier.)
*
 PAYMENT TYPE
(choose one):
 Self-Pay:
(Mail check to address below)
Charter School (type
in name of school):
Comments: Please include any special needs
your student(s) may have, including allergies.
Self-paying families
Mail check or money order to:
Wholistic Learning Resources
P.O. Box 19676
Sacramento, CA 95819
Charter families: if you need a flute, include
as part of the total (rather than as a separate item)
for your P.O./Voucher request.

Horizons and Visions in Education
Charter families:
Your registration is not complete until you submit
voucher(s) for each class your student is registered
for. Be sure to BRING Voucher to the FIRST
DAY OF CLASSES.
South Sutter Charter School families:
Your registration is not complete until the P.O. is
received by WLR. Contact your teacher today to
request the P.O. Be sure to give your ES the
TOTAL AMOUNT DUE including any flute costs.
You may wish to PRINT THIS PAGE for your records before hitting
'Send.' Be sure to notate TOTAL AMOUNT DUE for your records.
Questions? Call Sandi at (916) 606-0799.