J4TH Recurring Tuition Payment Form

PARENT / GUARDIAN INFORMATION: *

	Parent / Guadian's Name	Complete Address	Phone Number
Parent / Guardian 1
Parent / Guardian 2

You authorize regularly scheduled tuition and other charges to your checking / savings account
or credit/debit card. You will be charged the weekly tuition fee for each tuition billing period.
You agree that no prior notification will be provided. You can access your account statement
online at any time via our childcare management app, Brightwheel.

I / We Parent/Guardian 1* and Parent/Guardian 2 , authorize(s) Just 4 Kids
Preschool to charge my bank account or credit / debit card on the first day of each week for
payment of my child’s tuition. I / We agree that I / We will set up the Auto Pay feature using the
Brightwheel app prior to my child’s expected start date.

I / We understand that a convenience fee % will be charged per transaction when using a credit
card. ACH and / or Checking / Savings account is FREE of charge.
Parent / Guardian 1 Signature*

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Date*

MonthDayYear
Date
Parent / Guardian 1 Email*
To receive a copy of this Authorization Form, please provide us your email address.
Parent / Guardian 2 Signature

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Date

MonthDayYear
Date
Parent / Guardian 2 Email
To receive a copy of this Authorization Form, please provide us your email address.
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Just 4 Kids Preschool's Recurring Tuition Payment Authorization Form