NWLA2015900 E. Pecos Rd. Suite 8A 
Chandler, AZ 85225

Phone: (480) 248-6125










2017-2018 Makers Club Enrollment


Maker activities not only engage and excite kids but can spark interest in STEM and the arts, as well as develop their creative capabilities. All activities will be supervised by New World Learning Academy Staff Members and held in a structured and safe environment.


Students will have an opportunity to participate in many different activities which will include:


• Staff facilitated 'hands-on' activities          • Technology, Engineering and interdisciplinary projects

• Arts and crafts                                          • Outdoor play


Child Information                                                                                                                  Registration Date:                                       


First Name:                                                              M.I.         Last Name:                                                                                           

Name child prefers to be called:                                                  Gender:  [  ] Male   [  ] Female     Date of Birth:                                                  

Child’s Address:                                                                                                                                                                                     

                                Street Address                                                                                                                          City                                           State                                            Zip

Mother’s Name:                                                                                      Father’s Name:                                                                    

Home Phone:  (       )                                                                               Home Phone:  (       )                                                            

Office Phone:  (       )                                                                               Office Phone:  (       )                                                            

Cell Phone:  (        )                                                                                                Cell Phone:  (        )                                                                                

Email:                                                                                                      Email:                                                                                       

Please mark the days per week and times your child will attend the Makers Club After-School Program:


¸     One Hour

¸     Two Hours

¸     Two and Half Hours


Late Pickup

Emergency Care


3:00 p.m. – 4:00 p.m.

3:00 p.m. – 5:00 p.m.

3:00 p.m. – 5:30 p.m.



$90 / month

$175 / month

$210 / month


$5.00 per 10 minutes

$11 / hour


Payment is due on the 1st of each month. A late payment fee of $15.00 will be assessed after the 15th of each month.


Emergency Information

Doctor:                                                              Phone:                                 Dentist:                                   Phone:                             

Life Threatening Illness or Allergies:                                                                                                                                                     

Emergency Procedures to follow: (All medications must be turned into the office and all forms signed by parent/doctor prior to enrollment)


Emergency Contact Name:                                                                      Relationship:                                                                             

Work Phone:                                                              Cell Phone:                                          Home Phone:                                                                                                                

Office Use Only

Date: ________________  Check#/CC: ________________ Amount: ______________  Fee: __________ Class: ______________  






The following people are authorized to pick up my child:




Work Phone

Cell Phone


















I hereby give my child permission to participate in the 2017-2018 Makers Club After School program at New World Learning Academy(NWLA). In addition, I authorize NWLA to take my child to the doctor or hospital for an emergency treatment which may be necessary if none of the above persons can be reached.



Please check your preferred payment option:

¸        Pay by check monthly – due 1st of the month. Late fee of $15 after the 5th of the month.

¸        Automated checking account deduction – Please complete the ACH form

¸        Pay by Credit Card Monthly (minimum $50 transaction)


I hereby release New World Learning Academy from, and waive my right to make a claim against NWLA, for any liability or damage arising from any injury sustained by my child while participating in any NWLA program or event.


Failure to Pay: The parent agrees to pay the aforementioned tuition and fees as specified, time being of the essence with respect thereto. In the event of non-payment of any funds due thereunder, New World Learning Academy, LLC reserves the right to cancel this agreement and to exclude Child from participating in the instruction. The unpaid balance shall accrue thirty days from and after the due date, until paid in full at the interest rate of 1.5% per month. The annual percentage rate shall be 18% in the event that it becomes necessary for New World Learning Academy, LLC to employ a collection agency and/or an attorney for collection of any amounts due under this agreement. Parent agrees to pay all the costs and expenses incurred by New World Learning Academy, LLC. Delinquent accounts will be sent to a company or lawyer employed by NWLA for collections management. If payment is still delinquent at the end of the second month, the student’s attendance will be suspended on the 1st day of the next month. Placement is lost if balance is not brought to a current status by the 30th of that month (in February, 28th).


The parent understands and agrees that the Child’s placement is not secured until all enrollment forms and fees have been turned into the office.


New World Learning Academy may use photographs, reproductions, and/or sound recordings of my child(ren) for the purpose of school programs, advertising (both in print and online), and miscellaneous curriculum uses.



Parent Signature:                                                                                                                                     Date:                                           



Please return to the front office, 900 E Pecos Dr. Suite 8A Chandler, AZ 85225


For more information, please call (480) 248-6125