Student Name
*
A separate form is required for each student.
First Name
Last Name
Student Birthdate
*
MM
DD
YYYY
Parent Name 1
*
First Name
Last Name
Parent Occupation 1
Parent Phone 1
*
(###)
###
####
Parent Email 1
*
Parent Name 2
First Name
Last Name
Parent Occupation 2
Parent Phone 2
(###)
###
####
Parent Email 2
Mailing Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Emergency Contact Name 1
*
First Name
Last Name
Emergency Contact Phone 1
*
(###)
###
####
Emergency Contact Name 2
First Name
Last Name
Emergency Contact Phone 1
(###)
###
####
Additional Student Notes
*
Nickname, Preferences, Etc
Extended Care
*
Check one:
Student's Primary Care Physician
Physician Phone Number
(###)
###
####
Preferred Hospital
Student's Siblings
Parental Volunteering
Are you willing/able to volunteer for special in-school events and programs?
Parental Volunteering Skills
Do you have the ability to:
Parental Agreements
*
Annual tuition is divided into 9 installments, due on the first day of each month, from September to May. These may be either mailed or handed to authorized staff members. After the 1st day of each month, a $40 late fee must be added to the tuition and the child may not attend until the balance is paid in full. In the event of a bounced check, a $40 fee must be paid and ALL future payments must be made in cash. Mailed checks must ARRIVE by the 1st of each month.
A one-time annual registration fee of $75 is required to enroll a child. It is strictly non-refundable under any circumstances. An annual snack/activity fee of $40 (preschool) or $65 (K-2nd) is due before a child may start as well.
Children should be picked up on time: Morning class by 11:30am (with lunch by 12:30), Afternoon class by 3:30pm. The first 5 minutes of lateness will be excused. After that time (after 11:35am/12:35pm or 3:35pm) a fee of $1 per minute will be charged, regardless of the circumstances. If the school is called IN ADVANCE to notify of a possible lateness, the $1 per minute charge will be waived in favor of a .50 cents per minute fee. $3 per minute for any time after 5:30pm for aftercare kids.
In the event a child is withdrawn from the school, any unused tuition paid previously (behond the month of withdraw) will be refunded. If the amount to be refunded exceeds $300, the refund will be paid in 3 installments. (Scenario: A tuition is paid for the semester or year in advance. A larger sum of money is often used for an expensive piece of equipment and therefore not immediately available in the budget for a refund). Once again, refunded tuition only applies to families that have paid for multiple months or yearly tuition.
If any money is paid in cash, it must be handed in person to Mr. Dodds or Cindy McKerracher and they must be notified it is cash and issue an immediate receipt, or the school will assume no responsibility in the event of its loss. Please keep your receipts in a safe place at home, as it is your only proof of payment.
I state that my student is up to date on all inoculations. I agree to let him/her go on field trips (K - 2nd Grade), and to emergency medical treatment. I also allow my student's image to be used in social media posts, and any/all promotional uses. I further understand (all boxes must be checked):
Parental Volunteering Skills 2
Do you have any special skills/talents (musical instruments, dance, interesting occupation, cool vehicles, etc) that could be showcased for the children or utilized for special in-school events?