St. Mark’s Preschool
6730 N 17th Street
Tacoma, WA 98406
253-752-4929
www.smlutheran.org
REGISTRATION AGREEMENT FOR 2015-2016
I (we) hereby enroll my (our) child ______
Birth date______Member of St Mark’s Lutheran Church______
(10% discount)
In St Mark’s Preschool for the following class: (circle one)
2 ½ - 3 ½ Class ($125.00/month)
Tuesday/Thursday 9:15-11:15
Child must be 2 ½ years old by August 31st
3 - 4 Class ($155.00/month)
Monday/Wednesday/Friday 9:15-11:15
Child must be 3 years old by August 31st
Pre-Kindergarten ($275.00/month)
Monday-Thursday 9:15-12:00
Child must be 4 years old by August 31st.
at the rate of $______per month to be paid in 9 equal monthly payments. The total tuition cost
will be______.
PLEASE READ CAREFULLY
1. I (we) have paid or enclosed the $75.00 non-refundable, annual registration fee.
2. No make-up days are permitted for absences due to sickness, public holidays or personal reasons. Tuition is charged on a yearly basis and all 9 installments are for the same amount even though there may be holidays or vacation days.
3. Tuition payments are payable to St. Mark’s Preschool and are due on the 1st class day of each month. A late fee of $10.00 will be assessed if payment has not been received by closing time of the 10th. If tuition is more than 15 days late, the child will not be allowed into class without a payment plan approved by the Director.
4. A two week notice is required if you are withdrawing your child for any reason. For any refund in tuition, we must have notice in writing two weeks before you withdraw your child, otherwise, we will charge you a full month’s tuition.
5. I (we) consent to have my (our) child participate in walks around the church grounds. I (we) will be notified of all field trips and will fill out a permission slip for each trip.
6. I (we) consent to the use of photographs of my (our) child on bulletin boards and other school uses (excluding internet).
7. In the event my child my child becomes ill or sustains injury while in the care of St Mark’s Preschool, the following procedures will be followed: a. Emergency first aid will be provided. b. Parents will be notified. c. I give my consent to take my child for emergency treatment.
8. Basic Services Provided. St Mark’s Preschool is an outreach of St. Mark’s Lutheran Church Ministry. Its operation is non discriminatory, admitting all children 2 ½ - 6 years old, without regard to race, color, religion, national origin or ancestry. The program is creative and child oriented with a blend of open and traditional structuring designed to involve the total child: intellectually, physically, socially, emotionally and spiritually. Innovative educational practices are used, combined with warmth and sensitivity, to help each child derive the maximum potential from his/her early years.
9. Termination. This agreement will be terminated when the child leaves this school with a two week notice from the school or parent/guardian.
10. I understand that my child must be toilet trained to be in preschool. Our preschool does not have diaper changing facilities.
11. There is a late fee of $5.00 for each five-minute increment after pick-up time.
12. I give permission for my child’s name, address and phone number to be included in the preschool directory. This directory is given to preschool parents only.
13. I agree to provide snacks for my child’s class on the day assigned. This day will appear on the class calendar sent home on the first day of each month.
14. I agree to keep my child home from school in case of illness and to notify the school of any communicable diseases.
Parent/Guardian Signature______Date______
Director Signature______Date______
Note: The original copy of this will be placed in the child’s file at St. Mark’s Preschool. A photocopy will be given to the parent.
Parent/Guardian’s Names______
Mother’s Home Phone______Work Phone______Cell Phone______
Father’s Home Phone______Work Phone______Cell Phone______
Address______
e-mail address ______
(used for newsletters and reminders)
Child lives with ______
EMERGENCY CONTACTS or Others who will pick up child (Please complete in full)
Name______Phone______
Relationship to child______
Name______Phone______
Relationship to child______
Health Information Sheet
Child’s Name______
Class: (please circle) 2 ½ - 3 ½ 3’s & 4’s Pre-K
Allergies:______
Food Restrictions:______
Does the Child need an Epi-pen? ______
Is your child under a doctor’s care for any health issues? If yes, please explain.
______
Does your child take any medication on a regular basis? ______
If yes, please list: ______
Does your child have any other issues the teacher should know about? (Anxiety, Hyper-activity, etc)?
______
Are there any other stresses in your child’s life? (ie: death in the family, divorce, etc?)
______
Child’s Physician: ______Phone:______
*Please attach a copy of your child’s most current immunization records.