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Home
About
What is a Montessori School?
Preschool, Kindergarten, & Elementary Curricula
Staff
Programs
Transition Class
Primary Class
Elementary
Montessori Summer Camp
Alumni
News
Events
Admissions
Contact
2022-2023 Enrollment Application
Apply online for admission to Riverbend Montessori School.
Enrollment Form: 2022-2023
"
*
" indicates required fields
1
General
2
Consent
3
Medical
4
Admissions
5
Additional Info
6
Registration Fees
7
Financial
8
Commitment
Student Information
Enrollment Type
*
New Student
Re-Enrollment
Child’s Full Name
*
First
Middle
Last
Date of Birth
*
MM slash DD slash YYYY
Gender
*
Male
Female
Age on 9/1/2022
*
Race
*
American Indian
Asian
Black
Hispanic
Native Hawaiian
White
Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Number of Guardians
*
How many parents or legal guardians does this child have?
1
2
Guardian 1 Information
Guardian 1 Relationship
*
Father
Mother
Legal Guardian
Guardian 1 Name
*
First
Last
Guardian 1 Occupation & Employer
*
Guardian 1 Business Phone
*
Guardian 1 Cell Phone
*
Guardian 1 Email
*
Guardian 1 Facebook Email
only if different from primary email address
Guardian 2 Information
Guardian 2 Relationship
*
Father
Mother
Legal Guardian
Guardian 2 Name
*
First
Last
Guardian 2 Occupation & Employer
*
Guardian 2 Business Phone
*
Guardian 2 Cell Phone
*
Guardian 2 Email
*
Guardian 2 Facebook Email
only if different from primary email address
Additional Family Information
Are Parent’s divorced?
*
Yes
No
Who has custody?
*
Emergency Contacts
*
Relative or Friend who can be contacted in case of emergency (cannot be a parent). Add multiple by clicking the
⊕
icon.
Name
Phone
Relationship
Address
Add
Remove
Pick Up Authorization
*
The following persons (in addition to parents/guardians listed above) are authorized to pick up my child from Riverbend Montessori School. Add multiple by clicking the
⊕
icon.
Name
Relationship
Phone
Add
Remove
Number of Siblings Enrolled at Riverbend Montessori for 2022-2023
*
0
1
2
Name of sibling attending Riverbend Montessori for 2022-2023
*
First
Middle
Last
Siblings Class for 2022-2023
*
Transition
Primary 1
Primary 2
Lower Elementary
Upper Elementary
Name of sibling attending Riverbend Montessori for 2022-2023
*
First
Middle
Last
Siblings Class for 2022-2023
*
Transition
Primary 1
Primary 2
Lower Elementary
Upper Elementary
Siblings NOT attending Riverbend Montessori
Add multiple by clicking the
⊕
icon.
Name
Age
School
Grade
Add
Remove
Relatives or Others Living in the Home
Add multiple by clicking the
⊕
icon.
Name
Relationship
Add
Remove
Language(s) other than English spoken in the home
Consent
Snacks
*
I understand that AM and PM snacks will be served to my child while in care.
I Understand
Field Trips
*
Only applies to K-6th grade
I hereby give consent for my child to be transported and supervised by the operation’s employees on field trips
I do not give consent for my child to be transported and supervised by the operation’s employees on field trips
N/A - my child is younger than Kindergarten age
Water Activities
*
Includes sprinkler play, splashing / wading pools, water table play
I hereby give consent for my child to participate in Water Activities
I do not give consent for my child to participate in Water Activities
Receipt of Parent Handbook
*
Please download the Riverbend Montessori Parent Handbook which includes policies for discipline and guidance, arrival, dismissal and fees.
Download the Parent Handbook
I Acknowledge Receipt
Photo Release Policy
*
I acknowledge receipt of the Riverbend Montessori Photo Release policy as written in the Parent Handbook.
I Acknowledge Receipt
Photo Release Permission
*
I give permission for photos of my child to be used
I give permission except for Social Media use
I do not give permission for any photos of my child to be taken except for group pictures only
I do not give permission for any photos of my child to be taken and used
Emergency Care Information
Emergency Care Type
*
In the event I cannot be reached to make arrangements for emergency medical care, I authorize the person in charge to take my child to:
Physician
Medical Care Facility
Name of Physician
*
Name of Emergency Medical Care Facility or Hospital
*
Phone Number
*
Address
*
Street Address
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Emergency Care Transportation
*
I hereby give consent for my child to be transported and supervised by the operation’s employees for emergency care
I do not give consent for my child to be transported and supervised by the operation’s employees for emergency care
Emergency Medical Care Consent
*
I give consent for the facility to secure any and all necessary emergency medical care for my child.
Emergency Medical Care Consent
*
I give consent for the physician/facility to secure any and all necessary emergency medical care for my child (sign below).
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Health Information
Health Care Providers Statement (HCPS)
*
I will provide Riverbend Montessori the signed and dated Health Care Professional’s Statement (HCPS) on or before the first day of admission. I understand that my child will not be permitted to start school until this form is signed and returned.
Download HCPS Form
I Agree
Immunization Policy
*
All children who enter Riverbend Montessori have been immunized per the Texas Minimum State Vaccine requirements for child care.
I Agree
Immunization Record
*
I will provide Riverbend Montessori with a copy of my child's most current immunization record signed or stamped by their Physician on or before the first day of admission. I understand that my child will not be permitted to start school until this information is provided.
I Agree
Does your child have diagnosed allergies?
*
Yes
No
Allergy and Anaphylaxis Emergency Care Plan
*
I will provide Riverbend Montessori the signed and dated Allergy and Anaphylaxis Emergency Care Plan (FARE) on or before the first day of admission. I understand that my child will not be permitted to start school until this information is provided.
Download the FARE form.
I Agree
Special Needs
*
Does your child have any special needs, such as environmental allergies, food intolerances, existing illness, previous serious illness, injuries and hospitalizations during the past 12 months, any medication prescribed for long-term continuous use, and any other information which caregivers should be aware of?
Yes
No
Special Needs (Please Specify)
*
Disallowed Foods?
*
Yes
No
Disallowed Foods (Please Specify)
*
Vision and Hearing Screening
Who must be screened:
4 years old by September 1st
Kindergartners
First time entrants to Riverbend Montessori (4 years through 6th grade)
1st, 3rd, 5th graders
Exam Results
*
I will provide Riverbend Montessori with a copy of my child's screening results
My child will have their hearing & vision screening at Riverbend Montessori (at an additional cost). A Permission slip will be sent home closer to the screening date
Signature of Parent or Legal Guardian
*
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Additional Information
For new students only
Unusual Behavior
*
Special Interests
*
What made you choose Riverbend Montessori as the school for your child(ren)?
*
Why Riverbend?
Expected Benefits
*
Exit Grade Level
*
Exit School Type
*
Other Schools
*
Goals
*
Academic Concerns
*
Social Concerns
*
Classroom Assignment
*
REGISTRATION & SECURITY DEPOSIT
Yearly Registration Fee
*
I understand that there is a yearly registration fee of $200 or $250 per family with two or more siblings. I agree that this fee is due with the enrollment form, and once a space is offered and accepted, the fee becomes
nonrefundable
.
I Understand
Security Deposit
*
I understand that a security deposit equal to one-half of one month’s tuition is due once an offer is made and accepted and it is
nonrefundable
. Payment of the Security Deposit secures my child’s enrollment. For re-enrolling families this amount is due at the time of registration.
I Understand
Security Deposit Withdrawal
*
I agree that during the 2022-2023 school year, if I provide one month’s written notice of withdrawal, the security deposit will be applied to any outstanding tuition with the balance returned; otherwise it will be applied to May 2023 tuition.
I Agree
Tuition Schedule
*
I understand that tuition may be paid in one yearly payment or in ten equal installments, August through May.
I Understand
Payments when Absent
*
I agree that I am responsible for the entire monthly payment, regardless of the number of days absent.
I Agree
Returned Check Policy
*
I understand that a fee of $25.00 will be charged on all returned checks.
I Understand
Late Fee
*
I understand that a fee of $20 will be assessed for tuition paid after the 15th of the month.
I Understand
Late Pick Up Fee
*
I understand that a $10 late pick up fee will be assessed after the last car in the line up has left for half day students. Full day students will be charged the after school care fee after the last car in the lineup has left.
I Understand
FINANCIAL AGREEMENT
Class
*
Transition Class (18 months - 3 years old)
Primary Classes (3 - 6 years old)
Elementary Classes
Transition Class
*
5 Half Days (Monday - Friday) 9:10 am - 12:00 pm
5 Full Days (Monday - Friday) 9:10 am - 3:00 pm
Payment Plan
*
Annual ($9030)
Monthly ($903)
Payment Plan
*
Annual ($9650)
Monthly ($965)
Primary Classes
*
3-6 years old
Half Day (Monday - Friday) 9:00 am - 12:00pm
All Day (Monday - Friday) 9:00 am - 3:15 pm
Kindergarten (Monday - Friday) 9:00 am - 3:15 pm
Preferred Class
*
Primary 1
Primary 2
No Preference
Payment Plan
*
Annual ($8040)
Monthly ($804)
Payment Plan
*
Annual ($10,090)
Monthly ($1009)
Payment Plan
*
Annual ($10,090)
Monthly ($1009)
Parents are required to purchase a Nap Sack for all children (under 4 years old) who are full day students. Nap Sacks can be purchased through the Front Office at the beginning of the school year.
Activity Fee
*
Required for ages 4 (full day only) through Kindergarten
Annual ($500)
Per Semester ($250)
N/A
Elementary Classes
*
Lower (1st - 3rd Grade) 8:45 am - 3:45 pm
Upper (4th - 6th Grade) 8:45 am - 3:45 pm
Grade Level
*
1
2
3
4
5
6
Payment Plan
*
Annual ($10,730)
Monthly ($1073)
Payment Plan
*
Annual ($10,990)
Monthly ($1,099)
Activity Fee
*
Required for all Elementary grades
Annual ($575)
Per Semester ($287)
Please note:
All students seeking to enroll in Elementary and who are new to the school are required to take an assessment test. The test fee is $50 and is non-refundable.
Extra Hours
There is a $1.00 late fee per minute/ per child for pick-up after 5:30 pm
Before Care (7:00 am to 9:00 am)
After Care (3:15 pm to 5:30 pm)
Before Care
*
Monthly ($100)
Daily ($10)
After Care
*
Monthly ($150)
Daily ($15)
Billing Email Preference
*
Which email address should we use for billing purposes?
Guardian #1
Guardian #2
Other
School Year Commitment
Enroll for Complete School Year
*
It is my intention to enroll my child for the complete school year, unless there are significant reasons for early withdrawal from school.
I Agree
Early Withdrawal Consequences
*
I understand that early withdrawal procedures are in the Parent Handbook and will have financial consequences.
I Understand
Financial Responsibility
*
Once my child has been offered a place at Riverbend Montessori, I understand this completed enrollment form, Registration Fee and Security Deposit secures my child’s admission and creates an assumed financial responsibility for the entire school year.
I Understand
Parent Signature
*
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