Kids Kollege
Request for Age Variance
Parent’s name: ____________________________________________________________________
Child’s name: _____________________________________________________________________
Child’s age: _______________________________________________________________________
Requested class: __________________________________________________________________
Class ID: ________________________________ Class Dates: ______________________________
Instructor: _______________________________________________________________________
Reason for requested variance: _______________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
I understand that Kids Kollege will, in general, consider exceptions up to 4 months from the stated age in
the Continuum and this will be approved by both the instructor and the CLC Director or Assistant
Director. I understand that Kids Kollege is willing to make exceptions to stated ages but is unable to
handle problems that arise from exceptions. If any reasonable problems or complaints arise related to
my child in the above class, I understand that I will be asked to remove my child from the class by the
CLC Director or Assistant Director. If requested to remove my child, I understand that Kids Kollege will
offer another appropriate class if available; if an appropriate class is not available, I will receive a prorated refund after the first day but I will not receive a refund of supply fees.
Parent’s signature: ____________________________________________Date: __________________
Note: Children under four years old are welcome to attend Kids Kollege after they turn four. Kids
Kollege does not make exceptions to this age requirement.
For office use only:
For office use only:
Date contacted instructor:
Instructor response:
DateDirector/Assistant
contacted instructor:
_________________________________________________
CLC
Director
Approval:
Instructor
Response:
______________________________________________________
Parent notified:
CLC Director/Assistant Director Approval: ______________________________________
Parent Notified: __________________________________________________________