PROGRAM REGISTRATION

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1 PROGRAM REGISTRATION Thank you for considering Summit Christian Learning Center for your Child s Care and Education. Summit Christian Center s purpose is to connect people with God and others, leading them to become fully devoted followers of Christ, who are expressing His life in their world. This purpose statement is the bedrock of our Children s Ministry and our Learning Center. Our program is designed to nurture young children, to stimulate their spiritual, physical, cognitive, creative development, and to encourage positive self-esteem and social interaction. We serve children ages 6 weeks-pre K. Children are placed in classrooms according to age range and Kindergarten entrance date. Summit Christian Learning Center programming operates September 2015-May 2016 with separate summer programming available. NEISD school calendar and holidays will be observed, as well as 2 scheduled Teacher in Service Training Days. Spaces will be assigned with required enrollment paperwork, current immunizations and payment of registration and supply fees. We offer High Reach curriculum for infants and toddlers, and the A Beka curriculum for ages 3 and up. A Beka provides Christian schools with outstanding curriculum built on a foundation of academic excellence and Christian character training. Our curriculum is designed to meet the individual needs of each child in a warm and nurturing environment, emphasizing the building of autonomy and problem-solving abilities in the following areas: Music and Movement Physical and Natural Science Language Arts Mathematical Concepts Cooking Gross and Fine Motor Coordination Creative Arts and Crafts Dramatic Play Our learning goals for our preschool aged children include the following: Participating as part of a classroom community: o being respectful of others and property o sharing information o listening o taking turns Developing social competence: o building relationships with peers and teachers o entering and sustaining play o developing empathy for others o learning to negotiate Developing early language and math concepts: o expressing feelings and ideas o making attempts at writing o recognizing symbols (starting with the children's names) o exploring math concepts through manipulation of objects Please contact Cara Fernandez for registration and program information ext We look forward to serving you at Summit Christian Learning Center!

2 ENROLLMENT FORM How did you hear about us? Child s Name Gender Date of Birth / / Address City State/Zip Program Selection: Start Date / / Withdrawal Date / / Father s Name Employer Business Phone Cell Phone Home Church Mother s Name Employer Business Phone Cell Phone Home Church Does child live with both parents? Yes No If no, list whom child lives with and marital status of that parent. Is there a custody order on file? Other children in the family: Name Age School Name School Name School Age Age Emergency Contact and Pick Up (other than parents; ID will be required) Name Address Name Address Name Address Relationship Contact Phone Relationship Contact Phone Relationship Contact Phone I have received and agree to the policies of Summit Christian Learning Center. Signature Date: I understand it is my responsibility to change any information in this enrollment form as needed. By this signature I am verifying that this information is true and correct to the best of my knowledge. In consideration for my child being allowed to participate in activities at Summit Christian Center, I hereby release, discharge, indemnify and agree to hold harmless Summit Christian Center, it s directors, officers and employees, agent and all volunteer personnel from any and all liability for personal injuries and or damages, injury or illness that my be suffered by (Child Name) We further agree to indemnify and hold harmless Summit Christian Center, it s directors, officers, employees, agent and all volunteer personnel for any claim and or damages, or its agents are required to pay as result of any injury or damage including reasonable attorney fees, litigation expenses and courts costs. Signature Date

3 MEDICAL INFORMATION AND RELEASE FORM Child s Name Child s Physician Date of Birth / / Physician Address: Phone My Child has NO special/medical needs, injuries, or allergies (Environmental, food and medical) My Child has special/medical needs, injuries, or allergies (Environmental, food and medical) Please List Below: Please answer all of the following questions, if yes please describe: Does your child have any hearing or speech difficulty? Yes No Is your child taking any medication? Yes No Does your child have asthma or wheezing? Yes No Does your child have epilepsy? Yes No Does your child have febrile (fever) seizures? Yes No Is your child allergic to insect bites or stings? Yes No Has your child ever had chicken pox? Yes No Has your child had allergic skin reactions? Yes No Has your child been hospitalized or had a Medical condition in the last 12 months? Yes No Any other surgical or medical information? Yes No My child s immunizations / health records are current. I have provided Summit Christian Center with a copy of current records and Physician Statement Request form (see attached) My child will not be accepted into care until current shot records are received, Physician Statement must be received within one week of start date. Signature In the event that I cannot be reached to make arrangements for emergency medical treatment at the time of illness or accident, I hereby authorize Summit Christian Center to take my child to the closest emergency room. Signature Date PARENT NOTIFICATION OF CUSTODY ISSUES We cannot legally prevent a child from being picked up by a parent or person designated by a parent. If parents are legally separated or divorced, we cannot restrict the days or times parents pick up their children. Parent must be responsible to adhere to their custody agreement and or decide between themselves which days and times each of them will pick up their child. Summit Christian Learning Center is legally obligated to release the child to their parent. If a parent as no legal right to pick up their child, or has a restraining order in effect, the school MUST HAVE A COPY OF THE COURT ORDER stating such on file. Otherwise, either parent may check the child out of the school with proper identification. I have read the above statement regarding pick up custody issues of legally separated or divorced parents. This form should be signed regardless of your marital status. You signature states that you understand Summit Christian Learning Center Policy regarding custody issues. Child(ren) Names: Parent / Guardian Signature: Date:

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5 PROGRAMMING AND PRICING SHEET INFANT PROGRAM: 6 WEEKS TO 17 MONTHS Monday/Wednesday/ Friday $400 per month, $400 Annual Supply Fee September-May 8am-2pm Monday/Wednesday/ Friday $550 per month, $550Annual Supply Fee September-May 7am-7pm Tuesday/Thursday $300 per month, $300 Annual Supply Fee September-May 8am-2pm Tuesday/Thursday $400 per month, $400 Annual Supply Fee September-May 7am-7pm Monday-Friday $210 per week, $250 Quarterly Supply Fee Year round 7am-7pm PRESCHOOL PROGRAM: 18 MONTHS PRE K5 Monday/Wednesday/ Friday $350 per month, $350 Annual Supply Fee September-May 8am-2pm Monday/Wednesday/ Friday $500 per month, $500 Annual Supply Fee September-May 7am-7pm Tuesday/Thursday $250 per month, $250 Annual Supply Fee September-May 8am-2pm Tuesday/Thursday $350 per month, $350 Annual Supply Fee September-May 7am-7pm Monday-Friday $185 per week, $250 Quarterly Supply Fee Year round 7am-7pm Extended care is available for part time children when requested in advance & space permitting. All reservations must be pre-approved by administration. All current enrollment paperwork must be completed and one file at the time of the drop in. DAILY DROP-IN RATE, 7AM-7PM WHEN AVAILABLE: HOURLY RATE: $60 Infant Rate (6 Weeks to 17 Months) $8.00 per hour $50 Preschool Rate (18 Months to 5 Years Old) ALL FEES ARE NON-REFUNDABLE Parent Signature: Date: OFFICE USE ONLY: Annual Registration Fee of $100 per child. Early Bird Discount of $50 off Registration Fee if registered by March 15, % Sibling Discount on oldest child s tuition. 10% Family Discount off 3 or more children in care 10% Military, First Responder and Educator Discount on total tuition. (Parent or Guardian only, current ID required) 10% Summit Church Member Discount (Parent or Guardian only, Must complete New Member Class) Interested in Pre-reserved Extended care available for $8.00 per hour, (no partial hour reservations, per child, per hour, space permitting.) Full Time Program Assessing Supply Fees weekly ($25 added to weekly tuition) Staff Member Discount Staff Name: Date:

6 TUITION & FEE AGREEMENT Child s Name: Date of Birth: Mother s Name: Father s Name: Payment for FULL TIME program is due on Monday of the current week. Tuition is payable whether or not my child attends. If tuition and or late fees are not paid by Friday, I understand that my child cannot return to care the following Monday until paid, and a late fee of $25 per week will be assessed for late payment. Tuition payments will be made through the Summit Christian Center iaccount system, by check, cash, or by credit card. A Registration Fee is due per child, per year. I understand that a Supply Fee is due at the beginning of each quarter and the first fee is due at the time of registration (September-November, December-February, March-May, and June-August) I understand that Fees are non-refundable and are not pro-rated for Holidays or partial absence. Half Priced week tuition payments are available if your child is in our care 1 day or less during the week. Parent Initials Weekly tuition rate Registration Fee Quarterly Supply Fee $ Payment for the PART TIME program is due on the first of each month. Tuition is payable whether or not my child attends. If tuition and or late fees are not paid on the 5th of the month, I understand that my child cannot return to care the following day until paid, and a $25 late fee will be assessed for late payment. Tuition payments will be made through the Summit Christian Center iaccount system, by check, cash or by credit card. A Registration Fee is due per child, per school year. I understand that a Registration and Annual Supply Fee are due at time of registration. I understand that Fees are non-refundable and are not pro-rated for Holidays or absence. Parent Initials Monthly tuition rate Registration Fee $ Annual Supply Fee $ Meal service is available for a fee. Pre-Ordered Lunch will be served each day for a fee of $3.00. A menu will be available monthly. Children may also pack a lunch of comparable nutritional value to the school lunch. (Parents Initials) Meals will need to be selected and paid for on Monday of the last week of each month. Meal fees are non-refundable. (Parents Initials) Day of lunch is available if ordered before 9:00am for a cost of $4.00. (Parents Initials) In the event that my child did not provide a lunch or preorder a lunch, a substitute lunch will be provided and meal fee of $10.00 will be added to my account, and will be due on Friday of that week. (Parents Initials) During summer months and holiday times, an activity fee may be charged. Activity fees are for additional activities outside our normal planned curriculum. Parent will be notified 30 days in advance of activity fee options. (Parents Initials) Late pick up fees are assessed at the rate of $1.00 per minute beginning at 2:05 for part time children and 7:05 for full time children. (Parents Initials) In the event I choose to end my relationship with Summit Christian Learning Center and withdraw my child, a two week written notice will be given. (Parents Initials) Parent Name: Parent Signature: Date:

7 PHOTO RELEASE FORM Dear Parents, During the school year, opportunities arise to provide positive information and publicity about our programs and events to the general public or specific audiences. In some cases, we may receive requests from the news media or professional persons to interview, photograph, and/or film students for news or non-profit publications, television or radio broadcasts, or for educational information and training or various publications and brochures printed by the Summit Christian Center. Permission is needed for your child to be the subject of any news media publicity or included in our publications. Please sign this form and return it to the Learning Center, where it will be kept on file for future reference. I give Summit Christian Center permission to use my Child Picture and First Name in: Newsletters/ Classroom Website Summit Social Media Local Television Ads None of the above *No last names or other personal information will ever be used* Child s Name Parent s Signature Date

8 DATES OF CLOSURE Full Time Program Hours of Operation Summit Christian Learning Center has Full Time Programming Monday-Friday from 7am-7pm, year round. We will be closed on the following days in observance of Federal Holidays, Christian Holidays, Local Holidays, Holiday Breaks and Teacher In-Service Days. (Initials) September 7, 2015 (Labor Day) (Initials) September 25, 2015 (Teacher In-Service Day) (Initials) October 12, 2015 (Columbus Day) (Initials) November 26-27, 2015 (Thanksgiving Holiday) (Initials) December 24-25, 2015 (Christmas Holiday) (Initials) January 1, 2016 (New Year s Day Holiday) (Initials) January 18, 2016 (Teacher in-service day) (Initials) February 15, 2016 (President s Day) (Initials) March 25, 2016 (Good Friday) (Initials) April 22, 2016 (Battle of the Flowers) (Initials) May 30, 2016 (Memorial Day) (Initials) July 4, 2016 (Independence Day) (Initials) September 5, 2016 (Labor Day) Part Time Program Hours of Operation Summit Christian Learning Center has Part Time Programming Tuesday/Thursday, Monday/Wednesday/Friday, or Monday-Friday 8am-2pm. We will be closed on the following days in observance of Federal Holidays, Christian Holidays, Local Holidays, Holiday Breaks and Teacher In-Service Days. (Initials) Part Time Programming is from September 2, May 27, 2016 (Initials) September 7, 2015 (Labor Day) (Initials) September 25, 2015 (Teacher In-Service Day) (Initials) October 12, 2015 (Columbus Day) (Initials) November 26-27, 2015 (Thanksgiving Holiday) (Initials) December 18-January 1 (Christmas Break) (Initials) January 18, 2016 (Teacher in-service day) (Initials) February 15, 2016 (President s Day) (Initials) March 14-18, 2016 (Spring Break) (Initials) March 25, 2016 (Good Friday) (Initials) April 30, 2016 (Battle of the Flowers) Parent Name: Parent Signature: Date:

9 ALL ABOUT ME! Attach recent photo of child here Childs Name: Age: Eye color: Hair color: Has your child attended school before? If so where? What type of programming? What concerns do you have about your child in his/her adjustment to school? In what ways would you like to see our program help your child? Special Aptitude, Hobbies or Interests: Favorite song: Favorite food: Favorite book: Favorite toy: Favorite place to visit: Best time of day: People that live in my house: Special people in my life: Family pets: Please describe a typical day in the life of your child, daily routines, eating and sleeping schedules, activities, outings, etc.

10 Learning to communicate and cooperate with other children and adults is an important part of your child s Learning Center experience. Any information you can provide about your child s abilities and style of communication and cooperating will be helpful to us in meeting the needs of your child. How does your child respond to new people? Is he/she shy around strangers or does he/she appear happy and curious? How does your child behave in play situations with others? Does he/she enjoy observing children play? Does he/she prefer to play next to another child or to share activities with other children? How does your child show you that he/she has truly become comfortable with a stranger, whether an adult or child? What techniques do you use to help your child feel comfortable with your visitors at home? What kinds of activities does your child enjoy with his or her favorite people?

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