Effort Baptist Church 7820 Thomas Jefferson Parkway Palmyra, VA

Transcription

1 Effort Baptist Church 7820 Thomas Jefferson Parkway Palmyra, VA Family Information Form Family Last Name: Child Enrolling: Child Enrolling: Season Child Enrolling: Family Information: Complete Physical Address: Mother s Name: SS# Cell# Employer: Tel #: Father s Name: SS# Cell# Employer: Tel #: Children live with: Mother Father Both Other Marital Status of Parents Emergency Contacts: In case of emergency, sudden illness, or circumstance requiring a child to be picked up from one of our programs, the parents/guardians will be the first to be contacted. In the event we are unable to reach a parent/guardian, we will contact one of the individuals you have authorized below to pick up your child. I grant personnel from Effort Baptist Church and affiliated programs, permission to obtain medical attention for my child(ren) in case of emergency. Signature Printed Date Photograph/Video Release: I /we grant permission for Effort Baptist Church and affiliated programs to take photographs and video recordings of my/our child. We understand that these may be used for promotion, on our website, marketing, advertising, yearbook, student and parent presentations, or for training purposes. The video/photograph footage will not violate the rights of any organization or person. I/We release Effort Baptist Church and affiliated programs from any and all present and future claims for compensation or liability. Children will not be identified by name without explicit approval.

2 Student Pick Up Information: In case of emergency, sudden illness or other circumstances requiring a child to be picked up from school, the parents or guardians will be the first to be contacted. In the event we are unable to reach a parent/guardian we will contact one of the individuals you have authorized below to pick up your child. The following individuals are authorized (in addition to those listed above) to pick up children from Effort Baptist Church and affiliated programs: Statement of Acceptance: By way of this application, we agree and understand that, if accepted into the program(s) at Effort Baptist Church, that we will abide by the rules in the parent/student handbook, we will be responsible for, and pay the tuition for the program(s) in which our children are enrolled. We understand that this is both a moral and financial obligation and agree to exhibit a Christ-like position in our relationship with teachers, staff, church, and community in general. Permission to Participate and Transportation: I give permission for my children to participate in all activities and to use any and all of the play equipment. I give permission to designated employees of Effort Baptist Church and affiliated programs to transport my child to off-site activities. For Office Use: Date Application Received Deposit Received Copy to Program Copy to Finance Entered in ST Tuition Agreement Verified ST/TA/ Parent Letter

3 Our Offerings Early Drop Off Service Age 2 ½ through 12 Age specific groups 7am 9am After School Program Ages 2 ½ through 12 Until 6pm daily In age specific groups Available to Fluvanna Public School, Effort Christian School, & Effort Preschool students Fluvanna students arrive here from public school transportation or from Effort Students spend their afternoon in a supervised, structured & supportive environment Full Time or Part Time (Full time 4-5 days per week or Part time 1-3 days/week) RED DAY Program (Really Extra-Fun Day) NEW this year, coverage when Effort Christian School, Preschool and Fluvanna Public schools are not in session. See attached list Available to Effort School, Preschool and Fluvanna public school students Purchased Red Days expire at end of each public school year and are not refundable Preschool Program Age 2 ½ through 5 Whole & Half Day Sessions - Five, four, three, or two days per week. Customized to your child s needs and your schedule K 4 Program (4 year old program) Year Round or Seasonal Programs o Year Round (12 months) o School Season (9 months) o Summer Session (3 months); Includes Vacation Bible School Effort Christian School Kindergarten through Grade 6 Five Days a week Christian private education Stellar academic program focusing on all modalities of learning Tailored mosaic of curriculum for enhanced education Summer Day Program (Completed Kindergarten through age 12) Monday Friday activity filled program (9:00 am-6:00 pm) Early Drop off available for working families (7:00 am 9:00 am) Grade specific groups Summer Bridge Academics

4 Enrollment Information 1. We require a completed application for each child, in each program, each year. 2. We require an official copy of your child s up to date immunization form or an immunization waiver form prior to first day of attendance. 3. A copy of your child s birth certificate is necessary prior to first day of attendance. Tuition Information 1. Tuition is based on an annual commitment and is calculated by the program. We do not pro-rate monthly tuition amounts, should your child s schedule change mid-month. Changes made prior to the 25 th of the month will be effective on the 1 st day of the next billing cycle. 2. We no longer require a registration application fee. The first month s tuition is due and payable upon acceptance into the program in order to hold your child s spot. This payment will be applied to the last tuition payment for the annual program. a. Families who have previously participated in our programs and have a good payment record have the option to request a waiver of this requirement. Please submit a waiver request in writing and submit with the application. 3. There is a non-refundable curriculum fee of $225 for students enrolled in Effort Christian School, grades K-6 th. The curriculum fee is due upon acceptance into the program for new students and due with an application for returning students. 4. School Tuition paid in full, in advance (prior to start date) will receive an approximate 5% discount, which can be designated to a scholarship fund. 5. We offer a sibling discount of 10% for the PS or School tuition portion only of the highest child for families with multiple children enrolled in either school or preschool. Financial/Payment Information 1. Payments are due on the first day of each month, beginning in first month of each program. 2. We use Smart Tuition for billing and receiving payments. Smart Tuition utilizes automatic bank withdrawal for tuition payments. Parents are able to check their account online 24/7. Once your child(ren) s registration form has been processed, you will receive a tuition agreement and login information for your Smart Tuition account. Parents who pay for their tuition in full at the time of registration will not need to login to Smart Tuition. Payments are not accepted at the church. 3. A $50 late fee will be assessed on past due accounts on the 5 th day of the month. Delinquent families shall be required to make future payments via credit card in order to stay enrolled in Effort Programs. 4. Families with outstanding past due balances will be unenrolled beginning on the 7 th day of the month. 5. Collection efforts will be pursued for any unpaid tuition. In the event that any tuition debt is written off, you will receive a 1099-C for the amount forgiven, and that amount will be reported to the IRS as taxable income to you. 6. Returned payments will incur a $50 return check charge by Smart Tuition, and all future payments will be required to be paid via credit card for the remainder of the school year. 7. A limited number of scholarships are available on a case by case, as needed basis. Applications are made through 8. Non-payment in one program will result in forfeiture of further participation in other Effort Baptist Church Programs.

5 ENROLLMENT FOR (Name-one form per child, copy as needed) Application Date: Child s Date of Birth: Age: EFFORT CHRISTIAN PRESCHOOL Age 2 ½ Through Age 5 Year Round (12 months) School Season (9 months) Summer Session (3 months) Early Drop Off Service (7:00am 9:00am) Preschool Whole Day (9:00am 3:00pm) Half Day (9:00am 12:00) Days Per Week: Mon Fri Mon Tues Wed Thur Fri PS After Care (3:00pm 6:00 pm) Days Per Week: Mon Fri Mon Tues Wed Thur Fri EFFORT CHRISTIAN SCHOOL Kindergarten Through 6 th Grade Grade Enrolling Into Early Drop Off Service (7:00am 9:00am) Red Program Days Block of 18 days Block of 10 days As Needed EFFORT BAPTIST CHURCH SUMMER DAY PROGRAM Completed Kindergarten Age 12 Early Drop Off Service (7:00am 9:00am) Summer Day Program (9:00 am 6:00 pm) EFFORT BAPTIST CHURCH AFTER SCHOOL PROGRAM Kindergarten Through 5 th Grade After Care (3:00pm 6:00 pm) Days Per Week: Mon Fri Mon Tues Wed Thur Fri Red Program Days Block of 18 days Block of 10 days As Needed List any information we may need to know about your child(ren) (medication, allergies, food restrictions, developmental concerns, etc.) Our goal is to provide care to or educate all children; however, we are not staffed to accommodate children with profound needs. We reserve the right not to accept children we are not qualified to serve. Please be specific with child s name and information.

6 Program Rate Sheet Preschool (Year Round) Days Per Week Cost Per Month Cost Per Month Cost Per Month Cost Per Month Early Drop Off $ 70 $ 70 $ 70 $ 70 Whole Day $ 520 $ 460 $ 360 $ 260 Half Day $ 260 $ 240 $ 210 $ 175 PS After Care $ 155 $ 155 $ 100 $ 100 School (August 11, 2014 May 22, 2015) Cost Per Month X9 Early Drop Off $ 70 Tuition $ 475 $225 annual curriculum fee $4065 to prepay in full Summer Day Program (May 27, 2014 August 8, 2014) 11 Week Program $ 1, Week Early Drop Off $ 180 Up to 2 weeks vacation credit can be given with advance notice at $ 110 per week After School Program (August 11, 2014 May 22, 2015) Cost per Month Full Time (4-5 days/wk) $ 155 Part Time (1-3 days/wk) $ 100 Red Program Days Cost Block of 18 $ 630 Block of 10 $ 350 A la Carte (as needed) $ 40

7 RED DAYS X=available School Preschool 10/13/2014 X 11/26/2014 X X 12/19/2014 X 12/22/2014 X X 12/23/2014 X X 12/26/2014 X X 12/29/2014 X X 12/30/2014 X X 12/31/2014 X X 1/2/2015 X X 1/19/2015 X X 2/16/2015 X X 3/16/2015 X 3/30/2015 X X 3/31/2015 X X 4/1/2015 X X 4/2/2015 X X 4/6/2015 X