Tuition Payment Form

Tuition is due on the first business day of each month. Payments received after the tenth will incur a $15 late fee.

Parent/Guardian Name

*

Parent/Guardian Email

*

This address will receive a confirmation email

Child's Name (First & Last)

*

Credit/debit card transanction fee is 2.9% + $0.30. Please choose the appropriate amount below. If you prefer, you may pay tuition by cash or check.

Regular Price

Payment

Other Amount 2 Day Class ($190.67) 3 Day Class ($262.70) 5 Day Class ($411.90)

Amount

10% Military or Multiple Children Discount

Payment

Other Amount 2 Day Class ($171.63) 3 Day Class ($236.46) 5 Day Class Option ($370.74)

Amount

25% Kirkmont Church Member Discount

Payment

Other Amount 2 Day Class ($143.07) 3 Day Class ($197.10) 5 Day Class ($309.00)

Amount

Additional notes or comments

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Tuition is due on the first business day of each month. Payments received after the tenth will incur a $15 late fee.

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