For the full year 2023, revenue of $2.4 billion, representing growth of 20% with adjusted earnings per share of $2.84, expanding 9% over 2022. In our Full Service child care segment, revenue increased 15% in the fourth quarter to $447 million. The drivers of this growth were enrollment and pricing with centers that have been opened for more than 1 year expanding enrollment at a high single-digit rate in Q4 and averaging 58% to 60% occupancy. In the U.S., year-over-year enrollment increased 10% in these life centers with double-digit growth in our younger age groups and mid- to high single-digit growth in preschool age groups in Q4. Outside the U.S., enrollment increased at a mid-single-digit rate in the fourth quarter compared to Q4 of 2022.

Although the operating environment in the U.K. continues to be challenging and a headwind to the performance of the overall Full Service segment, enrollment growth in the U.K. increased -- improved modestly in Q4 compared to Q3, and we have seen that progress continue into the early part of 2024. At the same time, we continue to rationalize our portfolio in the U.K. to ensure focus on centers with the greatest long-term viability and improved momentum in regaining operating profitability over time. In our Dutch and Australian operations, enrollment was in line with our expectations in Q4, and both portfolios continue to upgrade with occupancy levels averaging above 70%. Let me now turn to Back-Up Care, which delivered an outstanding quarter to finish the year.

Revenue increased 24% to $135 million on strong utilization across our more than 1,100 clients. Traditional network use trended higher than our expectations as we ended the year. Using Bright Horizons Centers, network centers and in-home were all strong, and these use cases continue to be the primary drivers for the Back-Up business. We do continue to see solid growth across all care types. We're encouraged by the growth opportunity from the newer use cases that we have introduced in the last couple of years as this broader portfolio enables us to serve a wider set of eligible client employees. 2023 was a tremendous year for backup care. We saw record interest and record use. I'm very encouraged by our ability to capture demand and operationally deliver for families in need of care.

As I mentioned earlier, we reached an important milestone in 2023, surpassing $500 million in revenue. For context, Back-Up Care was a $300 million business in 2019. And over the last 4 years, its contribution to the company's revenue and profitability profile has grown significantly, along with its impact on families, employees and clients. Even as Full Service continues its enrollment and earnings recovery, Back-Up Care is poised to be a structurally larger contributor to our go-forward earnings profile, and we are very excited about the continued growth opportunity in this segment. Our education advisory business delivered revenue of $34 million in the quarter. Notable new client launches in the quarter for EdAssist and College Coach, including -- included Norfolk Southern, Standard Chartered and Verisign.

The transformation of this segment is underway and focused on meeting the evolving upskilling and reskilling needs of employers and their employees. We continue to believe in and are investing against the large opportunity available in this market. As we turn to 2024, I want to take a moment to thank every member of the Bright Horizons family as well as our client partners who invest in these important services. We made great progress this past year across many dimensions of our business. This could not have been achieved without their dedication and commitment to our core mission in delivering the highest quality education and care to children, families, learners and our employer partners. A special shout out to our teachers who cared for the children of the San Francisco 49ers in Las Vegas during the big game this past Sunday.

A great example of how we support working families to integrate work and life. I believe we executed well against our near-term goals in 2023 while also making investments to strengthen our foundation to drive our success in the years to come. We made significant progress in rebuilding our staffing levels, increasing enrollment, expanding capacity and capabilities to support backup growth and in the continued build-out of the infrastructure for our One Bright Horizons vision. We entered 2024 on a solid footing and with good momentum, and we expect to see revenue growth of approximately 10%, resulting in revenue of $2.6 billion to $2.7 billion. On the earnings side, we are projecting adjusted EPS in the range of $3 to $3.20 per share. With that, I'll turn the call over to Elizabeth, who will dive into the quarterly numbers and share more details around our 2024 outlook.

Elizabeth Boland: Great. Thank you, Stephen, and hi to everybody who's able to join us today. To recap the fourth quarter, overall revenue increased 16% to $616 million. Adjusted operating income of $64 million or 10.3% of revenue increased 15% over Q4 of '22, while adjusted EBITDA of $99 million or 16% of revenue, increased 10% over the prior year. We ended the quarter with 1,049 centers, adding 4 new centers and closing 18 centers in the fourth quarter. To break this down a bit further, Full Service revenue of $447 million, was up 15% in Q4 at the high end of our expectations on increased enrollment in pricing. Enrollment in our centers opened for more than 1 year increased in the high single digits across the portfolio. As Stephen mentioned, occupancy levels averaged in the range of 58% to 60% for Q4 as expected and consistent with Q3 levels, given typical enrollment seasonality.

U.S. enrollment was up 10% and international enrollment increased in the mid-single digits over the prior year. In the center cohorts that we have discussed previously, we continue to show improvement over the prior year period. In Q4, our top performing cohort, defined as above 70% occupancy, improved from 25% of our centers in Q4 of '22 to 36% of our centers in Q4 of 2023. Our bottom cohort of centers, those operating under 40% occupied, represents 18% of centers as compared to 20% in the prior year period. Adjusted operating income of $13 million in the Full Service segment, increased $1 million over the prior year. Higher tuition, higher enrollment, tuition increases and improved operating leverage were largely muted by a $12 million reduction in support received from the ARPA government funding program over the prior year.

As Stephen previewed, we are taking steps to rationalize our footprint in the U.K. to better position our portfolio and to improve operating performance over time. Specifically, we've closed 12 centers in the U.K. in 2023, including 3 locations in Q4 and have currently identified an additional 20 to 30 centers to close over the next 12 to 18 months. As we've discussed on prior calls, the U.K. Full Service business had operated at margins in the high single digits in the years leading up to the pandemic, but has been unprofitable in the last several years, losing approximately $30 million in adjusted operating income in 2023. We expect the reduced operating costs associated with the footprint rationalization along with improved staffing and enrollment gains in the remaining portfolio to drive the improved operating performance in the later part of '24 and then into 2025.

We will continue to focus on optimizing the portfolio in this new operating environment. with a particular eye on the impact of expanded tuck-in support for younger children, which is focused on defraying some of the cost of care for family. Turning to Back-Up Care. Revenue grew 24% in the fourth quarter to $135 million, well ahead of the expectations we had to finish the year and adjusted operating income was 30% of revenue or $41 million, growing 25% over the prior year. As Stephen detailed, used volume was higher than we anticipated with strong use across care types, particularly on the traditional center and in-health care. Lastly, educational advising segment reported $34 million of revenue and delivered operating margin of 29%. Our EdAssist and College Coach businesses grew revenue by 6% in the fourth quarter to $32 million, while the Sittercity Marketplace business declined, resulting in an overall 2% growth in this segment for the quarter.

Interest expense increased $2 million to $13 million in Q4, excluding the $1.5 million per quarter that we had both in 2023 and in the second half of 2022 related to the deferred purchase price on our acquisition of Only About Children. The structural tax rate on adjusted net income increased to 28.3% in the quarter, an increase of 200 basis points over Q4 of '22. Turning to the balance sheet and cash flow. For the year, we generated $256 million in cash from operations compared to $188 million in 2022. We invested $130 million in fixed asset investments and acquisitions in 2023. In '22, we had invested $270 million, including the acquisition of Only About Children. We ended 2023 with $72 million in cash and a leverage ratio of 2.5x net debt to EBITDA, down from 3.25x at the end of 2022.

Before I move on to guidance, I wanted to touch on a minor change in our segment reporting that the change will impact the growth comparisons in both our ed advisory and back up segments. Effective for the first quarter of 2024, we have moved to reporting Sittercity from ed advisory and other to the Back-Up Care segment to better reflect our operating structure. For clarity, we recast the prior year quarterly segment revenue and associated operating income comparisons in the 8-K filed with our earnings release. Our 2024 Back-Up Care and Ed Advisory revenue guidance does reflect growth off of the 2023 restated comparisons. So now moving on to our 2024 outlook. In terms of top line, we currently expect 2024 revenue to be $2.6 billion to $2.7 billion, which translates to growth in the range of 8% to 12%.

At a segment level, we expect Full Service to increase roughly 8% to 12% on enrollment gains and tuition increases. Back-Up Care increased 10% to 12% with higher use and Ed Advisory to grow in the mid-single digits on expanded participation. In terms of earnings, we expect 2024 adjusted EPS to be in the range of $3 to $3.20 per share. Similar to last year, there are some discrete items affecting our reporting margins and earnings growth rates in '24, specifically related to the end of ARPA funding and interest expense. In the full year 2024, we expect those 2 items to account for an approximate $0.55 a share headwind to growth for the full year, reflecting the last claims from approximately $34 million ARPA funding for P&L centers that we received in 2023 and an estimated increase of $10 million in interest expense.

As we look specifically to Q1, our outlook is for total top line growth in the range of 10% to 12%, again, with Full Service at that same rate, 10% to 12%, and Back Up growth of 10% to 15% and Ed Advisory in the mid-single digits. In terms of earnings, we expect Q1 adjusted EPS to be in the range of $0.42 to $0.47 a share. And regarding the discrete items that I mentioned above, we expect to have $3 million more in interest expense and a $15 million headwind from the ARPA support we had received in Q1 of 2023. We do expect a year-over-year earnings headwind from these 2 items to ease as we move through the year with the combined headwinds falling from $18 million in Q1 to approximately $12 million headwind in each of Q2 and Q3 and then only $2 million by the time we get to Q4 of '24.

So with that, Paul, we are ready to go to Q&A.

Operator: [Operator Instructions]. Our first question is from Andrew Steinerman with JPMorgan.

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