Miss Lilli’s Registration & Contract

First Semester: 

First Semester:  Sept. 12, 2022 – January 09, 2023


Miss Lilli’s Registration & Contract

First Semester:  Sept. 12, 2022 – January 09, 2023


Parent/Guardian ________________________________________________                    

Student      _____________________________Date of Birth ____________                       

 Student      _____________________________Date of Birth ____________           

 Student (s) _____________________________Date of Birth ____________                 


Address ______________________________________________________         

City/State/Zip   ________________________________________________         

 Home phone   _________________  Cell phone  _____________________               

Parent’s e-mail ________________________________________________                  


Circle the names of the classes your children are taking and write each child’s name next to the intended class:                 Charter Price: 

All Things Fun, 60 mins/wk, $250.00 per semester                       Charter Price $275.00 

            Meets Mondays 9:00-10:00

 Bragging Rights, 60 mins/wk, $250.00 per semester.                  Charter Price  $275.00 per semester

Meets Mondays 10:00-11:00


Rational Bible, 60 min/wk, $250.00 per semester                        Charter Price:  $275.00 per semester

            Meets Mondays 11:00-12:00


 Total class fees for first semester:   ________

Students dropping the course after registration and payment and prior to the start of the course, can expect to receive a refund, minus a $25 administration fee.

Students wishing to drop after the fourth week of class will not receive a refund.

Parents of charter school students are ultimately responsible for the tuition in the event that the charter school refuses to pay.


Family Payment Plan spread over 4 months, add $15 billing fee   +____      $15 billing fee


Total Due ____________


For payment plan:


I  _______________________________  (parent’s name) commit to paying:________


For a payment plan, divide your total into 4 equal payments.

$________  in September                                          


$ ________ in October                                                                                              

$________ in November                                           

$________ in December



Make all checks payable to:

Lilli Witczak

679 W. Sierra Madre Blvd.

Sierra Madre, CA 91024