Wholistic Learning Resources
Online Registration Form, Grades 1-8
All rights reserved. Copyright 2010.
Registration Instructions:
  1. Choose classes for each student and manually fill in subtotal, applicable discount(s), materials fees and total amount due.
  2. Indicate payment option (SSCS, VIE charter or self-pay; if you are with another charter, please call Sandi.)
  3. If sending in deposit for full-day program, mark applicable box (near the bottom).
  4. If you have more than 2 students, complete form, submit and then reset form to register remaining students.
  5. Questions? Call Sandi at (916) 606-0799 or e-mail.
* Required Field
Parent last name:
Parent first name:
*
*
Phone number:
Email:
 *
*
Last Name, Student 1:  
        
First Name, Student 1:  
        
*
*
Male
Student 1, birthdate
Female
*
1. Choose full-day
program or individual
classes for Student 1.
Folk Dancing ONLY.
Reminder: flutes required for the music
class. Estimated cost $10-$65 depending
on the class.
Enter Items #2-5 manually.
2. Enter Subtotal
Subtotal
*
3. Enter applicable discount(s):
COUPON CODE
COUPON CODE DISCOUNT
Multiple class discount: Deduct $50.00 IF registering for 3-5 classes.
(does NOT apply to FULL-DAY rate)
10% Discount for Self-Paying families
4. Enter Materials fees:
Handwork ($10):
Painting ($10):
5. Enter Total for Student 1
*
Total, Student 1
Student 2 First Name
Student 2 Last Name
Student 2 birthdate:
Male
Female
1. Choose full-day
program or individual
classes for Student 2.
Folk Dancing ONLY.
Reminder: flutes required for
the music class. Cost estimate
$15-60.
Enter Items #2-5 and
TOTAL AMOUNT DUE manually.
2. Enter Subtotal
Subtotal
3. Enter any applicable
discounts.
COUPON CODE
COUPON CODE DISCOUNT
Multiple class discount: Subtract $50.00
IF registering for 3-5 classes.
(does NOT apply to FULL-DAY rate)
10% Discount for Self-Paying families
4. Enter Materials fees:
 Handwork ($10):
 Painting ($10):
5. Enter Total for Student 2
Total, Student 2
*
TOTAL AMOUNT DUE
(Add Totals for Student 1 & Student 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
    [email protected] 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 [email protected]).
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.
*
*
 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
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 AMOUNTS for each class including
MATERIALS FEES.
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 the BRING Visions Voucher to
the FIRST DAY OF CLASSES.
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.
If you do not already have the forms listed below on file with WLR,
Or you may fax them to (916) 706-2655.

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.)