A GREAT START TO THE DAY

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1 A GREAT START TO THE DAY GREATER BURLINGTON YMCA Before School Program Essex Elementary

2 WELCOME TO Y BEFORE SCHOOL The Y knows kids. And we understand the needs of working families. Our Before School programs offer an affordable, enriching and recreational afterschool experience at convenient locations in elementary schools throughout the state. The Y employs skilled professional staff who model Y character traits: caring, honesty, respect and responsibility. The Y programs are fully licensed and most are enrolled in the Vermont State STARS Program. And since it s the Y, a nonprofit organization with a longstanding track record of nurturing the development of children, you know it is an organization you can trust with the care of your child. WHAT TO EXPECT Our programs blend recreation and physical activity with a daily focus on literacy, STEM and arts activities. We even provide homework help! Y Before School families also enjoy a special 25% discount on family memberships at the Greater Burlington YMCA and the Winooski Y. SCHEDULE AND CALENDAR The Y schedule corresponds with your child s school day. Open at 7:00 a.m. until the start of the school day. During school break we offer school-based full day vacation camps open to all school age children. When the school is closed or has a delayed opening due to inclement weather, the Y Before School program is closed as well. TUITION Y Before School tuition is $8 a day per child. Five days is just $40 per week. Tuition is the same regardless of school closings or a child s absence. Y FOR ALL Everyone belongs at the Y, regardless of ability to pay. Thanks to the generosity of donors to our Y Annual Campaign, we offer partial School Age scholarships for qualifying families. Look online for our guidelines and financial assistance application. Go to gbymca.org. REGISTERING IS A SNAP Online and paper registration opens for current Y families and siblings on April 7th. Paper applications will be mailed to each current family and a link to register will be sent via . Starting on May 5th, new enrollees can register using a paper application at the Y in Burlington. Online enrollment will open to the public on May 7th. All registration happens on a first come, first served basis. Want to start the first week of school? Then get your application materials into the Y by August 14th. Processing applications takes a minimum of five days. Current child care accounts must be in good standing in order to enroll in the year. AS SIMPLE AS 1, 2, 3 1. Complete and sign the enclosed registration or enroll online (please see dates above). Unfortunately, faxed and ed applications cannot be accepted. 2. If enrolling using a paper application, send a completed registration form along with the EFT form, a non-refundable $30 processing fee and your first weeks tuition will be applied to the account information provided upon registration. Applications can be mailed to: Greater Burlington YMCA, 266 College Street, Burlington, VT If you choose to enroll online, filling out the EFT will be part of the online application. 3. You will receive a confirmation within 10 business days. Parent handbooks are online or we are happy to send you a copy upon request. QUESTIONS?? Contact Julie Peterson at or gbymca.org. gbymca.org ENROLLMENT OPTIONS You may enroll your child in 1, 2, 3, 4, or 5 days a week. Enrollment is on a first-come basis and spots can fill up fast! The Y also reserves the right to cancel a program by July 3rd if there is insufficient enrollment interest. Enroll now to ensure the Y s presence in your school.

3 IMPORTANT INSTRUCTIONS Y BEFORE SCHOOL REGISTRATION FOR ESSEX ELEMENTARY Financial assistance is available; call , or visit gbymca.org, for more information. Return this form along with the EFT form. A $30 annual processing fee and first weeks tuition will be applied to the account provided during registration. PLEASE COMPLETE THE PAYMENT INFORMATION BELOW: A valid EFT Authorization Form is required for all Child Care program participant(s), including all financial assistance recipients, in order for your registration to be complete. Please charge my annual processing fee of $30 and first week s tuition using the billing information on my EFT Authorization Form enclosed. My annual processing fee of $30 and first week s tuition is not required because I will receive financial assistance from the State of Vermont Department of Children and Families. (A valid certificate must be enclosed for payment to be waived.) I am receiving financial assistance through another third party: My application for financial assistance through the Y is enclosed. Please visit gbymca.org for an application. Please charge my annual processing fee of $30 and first week s tuition to secure my child s placement while the Y financial assistance is determined. My annual processing fee of $30 and first week s tuition is not to be charged until my financial assistance has been determined. I understand my child s spot will not be secured until that time. 1. Child s grade as of Fall 2015: 2. Program site: 3. School child attends: Same as program site Other: 4. Please select the enrollment plan(s) and tuition below. Number of days is per week; tuition is per child: 5 days: $40 4 days: $32 3 days: $24 2 days: $16 1 day: $8 5. Please circle which days your child(ren) will attend: M T W Th F 6. Personal Information Child s Name: DOB: Age: M F Address: Home Phone: City: ST: Zip: Parent/Guardian Name: Employer: Work Phone: Cell Phone: Parent/Guardian Name: Employer: Work Phone: The following people have permission to pick up my child: 7. Emergency Contacts (if parent/guardian cannot be reached) 8. Medical Information Allergies: Cell Phone: Dietary Requirements: Current Medications: Physician s Name: Dentist s Name: Insurance Company: Address: Phone: Address: Phone: Policy Number: Please check one: Immunization record enclosed I give permission for Y staff to access my child s immunization record through the Vermont Immunization Registry 9. Parent/Guardian Authorization I,, parent/guardian of the above participant,, authorize him/her to attend a YMCA BeforeSchool program and to take part in all activities. In case of emergency, the YMCA staff has my permission to give first aid or to take the participant to a physician for treatment. I hereby give my permission to the site director or to the YMCA staff to call a doctor for medical or surgical care for my child. Should an emergency arise, I understand that a conscientious effort will be made to locate me or an emergency contact before any action is taken, but I agree to accept any expense associated with such an emergency if it is not possible to locate me in advance of treatment. I give permission for people I have listed to pick up my child. I understand that these people will be asked for identification if not recognized by Y staff and that no one other than those listed may pick up my child. I also understand that both parents may add names to or delete names from the list. I acknowledge that I have read and understand the Financial Policies in the Y BeforeSchool Brochure. I understand that if my account falls delinquent, I am responsible for all fees accrued, including the cost of collections activities, and that this delinquency could result in my child losing a spot in the program. Signature: Date: OFFICE USE ONLY: SA APPROVAL: ENTERED BY: DATE: START DATE: CANCEL DATE:

4 EFT AUTHORIZATION FORM I hereby authorize the Greater Burlington YMCA to automatically transfer my periodic childcare tuition payment from the checking, savings, or credit card account listed below for Parent/Guardian Name(s): Child s Name: PLEASE CHOOSE ONE: Use information and payment schedule currently in place Checking Account (must attach voided check or copy of) Savings Account (must attach savings deposit slip) Credit Card Account (VISA, MasterCard, American Express) Credit Card Number Expiration Date Card ID (On back Visa & MC, front of AMEX) PLEASE CHOOSE ONE: Weekly transfer, to occur every Friday for the following week Monthly transfer, to occur the 1st business day of the month If I decide or need to make any changes to the provided information, I will notify the Greater Burlington YMCA to ensure my child care account does not fall into arrears. I understand if my payment is declined, the Y will attempt to reprocess it one time before contacting me. I have read and understand the Greater Burlington Y Financial Policies. Name Billing Address City Phone# (For questions or clarification) State Zip Code Signature Date Return the authorization form to Graham Gowen Greater Burlington YMCA 266 College St Burlington, VT or Jon Robbins Greater Burlington YMCA 266 College St Burlington, VT or

5 GREATER BURLINGTON Y CHILD CARE FINANCIAL POLICIES Who to Contact about Billing Questions: Graham Gowen Jon Robbins Business Office Supervisor Business Office Representative Tuition Payment Process: Payment must be made by credit card or bank draft from a checking or savings account. You may choose to have your payment processed every Friday for the following week or on the first day of the month. If your payment is declined, the Y will attempt to reprocess the payment one time before contacting you. Please note that we will not accept payment by phone or by check or cash unless pre-authorized due to special circumstances. Please submit a Child Care EFT Authorization Form with your program application to the Y at 266 College Street, Burlington, VT You may also fax the EFT Form to the attention of Graham Gowen at Failure to Make Payment: If your payment declines and the account is not paid in full and communication is not made with the Business Office Supervisor, the Y reserves the right to cancel your enrollment in the program. The child s enrollment in any other Y program (e.g. vacation camp, summer programs, etc.) will not be permitted until the account is paid in full. It is the sincere wish of the Y that none of the above steps will need to be taken. We appreciate you keeping your account up to date. Please contact the Y immediately if your financial circumstances change and you are unable to make your tuition payments. Vermont State Child Care Assistance: Families receiving financial assistance from the State of Vermont are responsible for confirming that the Y receives a valid certificate and for paying the balance due until a certificate is received. Families are responsible for their co-pay to the Y (the difference between tuition and financial assistance) as well as any remaining balance if eligibility is terminated. All of the payment due dates and payment policies apply to families receiving financial assistance. Financial Assistance: In keeping with the Y s commitment to serve families regardless of their ability to pay, full and partial scholarships may be available to those who qualify for tuition assistance. We welcome you to contact our Business Office Supervisor, Graham Gowen, at about eligibility requirements. Tuition for School Closings and Absences: Your tuition starts the first partial or full week of school and continues through the last scheduled week of school. Your weekly tuition amount remains constant during weeks when school is scheduled to be in session. There are no refunds or pro-rations for absences, partial weeks (e.g. the first week of school), full-day closings or emergency closings (e.g. snow days). Please refer to your program handbook for payment polices and refunds specific to your childcare program. Withdrawals & Schedule Changes: If you choose to withdraw from a program, you are required to give the Y a two week advance notice for Y School Age programs. Tuition paid beyond the two-week will be refunded. Registration fees are non-refundable. Cancellation is not permitted after May 27, 2016 for programs that follow the school year calendar. Schedule changes are handled by the Director of School Age Programs, Julie Peterson at Change requests are based upon program space and staffing availability. Flexible Spending and Tax Receipts: Now you can log into your account anytime throughout the year at gbymca.org and obtain payment receipts. Our tax ID number is and it will appear on the receipt. For information on how to log into your account, contact the business office at or call member services at For more information about the Greater Burlington Y childcare programs, please visit our website: gbymca.org.

6 GREATER BURLINGTON YMCA 266 College Street Burlington, VT (YMCA) gbymca.org GROW WITH US! The Y provides children with a safe, enriching environment to spend their time before the school bell rings. Y Before School compliments the day by offering STEM and literacy activities as well as the arts and outdoor play. We nurture friendships and teach community service. As a non-profit organization, the Y is an organization you can trust with the care and nurturing of your child.

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