Joyful Noise Preschool Partners Inc.P.O.Box 1927

2018/2019Sandy, Or 97055

503-668-7827

Student’s Name______Birthdate______

Other Name student goes by______(on nametag, papers, etc)

Gender: Male / Female

1ST YR STUDENTS

____MON/WED AM9:00AM-11:30AM1ST YR

____TUES/THURS AM9:00AM-11:30AM1ST YR

2ND YR STUDENTS

____MON/WED AM9:00AM-12:00PM2ND YR

____TUES/THURS AM9:00AM-12:00PM2ND YR

FRIDAY OPTIONAL DAY FOR ALL CLASSES

**(monthly themes along with reinforcement of letters andnumbers)**

____OPTIONAL FRIDAY CLASS AM9:00AM-11:30AM

CONTACT INFORMATION

Parent’s Name(s)______Custodial parent(if divorced)______

Address______City______State_____Zip______

Mailing address if different from above:

______City______State_____Zip______

E-mail address:______

Home phone______Cell______Work______

Church attending______Affiliation______

How did you hear about Joyful Noise? ______

EMERGENCY CONTACT(other than parent):Name______

Home phone______Cell phone______

Relationship to student______

***Office use only—Date______Book fee paid______Reg. fee______Supply fee______

Tuition paid in advance______Date______

Joyful Noise Preschool Partners Inc.

Financial Agreement Form 2018/2019

Tuition: (Tuition can be paid in full or for your convenience, 9 monthly equal payments can be paid beginning Sept 1-May 1.)

Preschool classes 1st yr------$990/yr or……...$110/ mo (2 day)

Preschool classes 1st year with Friday------$1350/yr or ……$150/mo (3 day)

Preschool classes 2nd yr------$1125/yr or------$125/mo (2 day)

Preschool classes 2nd year with Friday------$1485/yr or------$165/mo (3 day)

Military Parent family discount: 10% off tuition

Sibling Discounts: 10 % off the lesser tuition each month.

Fees: (per child)

  1. Supply Fee (NON REFUNDABLE)------$35.00 Preschool
  2. Registration Fee (NON REFUNDABLE)------$50.00 Preschool
  3. Book Fee (NON REFUNDABLE)------$50.00 1st yr/ $60.00 2nd yr

ALL FEES ARE REQUIRED TO HOLD A STUDENTS SPOT AND ARE NON-REFUNDABLE.

Snack Policy: Each family is asked to bring in snack for the class at the beginning of the month or add an additional $5.00 to tuition each month.

Terms of Payments:_____INITIAL HERE

Payment schedule:

  1. Payments are due on the 1st of each month (Sept.-May)
  2. Any dishonored check by a bank or other institution for any reason including insufficient funds or closed account will result in a returned check fee of $30.00
  3. There is no prorating of tuition for any reason including sick days, snow days, holidays, breaks, vacations.)
  4. May tuition must be paid by the 10th to participate in graduation.

Delinquent tuition:

a. Tuition paid after the 10th of the month will incur a late fee of $25.00

b. Tuition that is not paid by the 20th of the month will result in dismissal if other arrangements have not been made.

  1. Students are not allowed to return until all tuition and late fees are paid.

Late Pickup Charges:

  1. Students picked up more than 5 minutes late will be charged $5.00 for every 5 minutes. Payment is due upon pickup of child.

Withdrawal of student:

  1. To withdraw your child from school we require a 30 day notice. Tuition is to be paid until that date. Books remain property of the school and will not be given out.

I/WE UNDERSTAND AND AGREE TO FOLLOW THE OUTLINED PROCEDURES FOR PAYMENT

PARENT SIGNATURE______DATE______

HEALTH HISTORY FORM

JOYFUL NOISE PRESCHOOL

Student’s Name (print)______Birthdate______

Insurance Company______Policy/Id Number______

Health History:

Please (x) any of the following conditions your child has experienced and circle Yes/No

___Hearing Problems When?______Tubes?______

___Vision Problems? Wears glasses? Yes/ No Contacts? Yes/No

___Allergies-List______

______

What happens?______

___Is Epi-Pen prescribed for allergies? Yes/ No (If yes, parent must provide)

___Bee sting allergy? What happened?______

___Asthma-Is an inhaler used? Yes/ No How often?______

___List of medications taken for asthma______

___Diabetes?______Medication for diabetes?______

___Seizures?______What type?______Last seizure______

Medication taken for seizures______

___Hospitalizations – For what?______

___Episode of loss of consciousness? ______When?______

___Bone/Joint problem or fracture?______

Any recurrent medical problem or illness of which you want us to be aware of?______

List any activity restrictions:______

List all prescription and over the counter meds your child takes regularly______

_____MY CHILD IS HEALTHY AND HAS NO MEDICAL CONCERNS.

PERMISSION FOR MEDICAL TREATMENT

In the event the parents/legal guardians on this form cannot be reached, I hereby authorize staff of Joyful Noise Preschool Partners Inc. to consent on my behalf for emergency medical care for my child. I agree to assume financial responsibility for all expenses associated with the emergency care and or transportation for my child. I agree not to hold Joyful Noise Preschool Partners Inc. or its employees liable for any injury or losses related to the emergency care my child receives.

Physicians Name______Phone______

Location of office______

Mother name______Phone______

Signature______Date______

Work address______Work phone______

Father name______Phone______

Signature______Date______

Work address______Work phone______

Legal guardian______Date______

Signature______Phone______

Work address______Work phone______

Neighbor or relative______Phone______

If your child is in the custody of one parent please indicate.

Joyful Noise Preschool Partners Inc.

CONSENT FOR RELEASE OF STUDENT PHOTOGRAPHS:

Throughout the school year, we compile photographs for a video of your child’s class. At graduation, the video is shown and each student receives a copy for a small fee. If you give Joyful Noise Preschool permission to photograph your child for this purpose, please check the appropriate line and sign below. If you do not want your child photographed, please indicate by checking the appropriate line and sign below. Joyful Noise Preschool will not use your child’s photographs for any other purposes.

______I DO give permission to Joyful Noise Preschool to release photos in dvd form to my childs class at the end of the school year.

______I DO NOT give permission to Joyful Noise Preschool to release photos in dvd form to my childs class at the end of the school year.

Parent Signature______Date______

Student Name______

JOYFUL NOISE PRESCHOOL

RELEASE FORM

Child’s Name______

Parent’s/Guardian Names______

Address______

City______St______Zip______

Home phone______Work______

Cell Phones______

Dear Parents:

It is EXTREMELY important for your child’s safety that we know who they can be released to after school. Please know that we CANNOT RELEASE TO ANYONE WHO IS NOT ON THIS LIST.

Only those named below are authorized to pick up______(students name) other than listed parents/guardian from above.

1.______Relationship______Phone______

2.______Relationship______Phone______

3.______Relationship______Phone______

4.______Relationship______Phone______