OFFICE USE ONLY
Interviewed____Age Group______Reg Fee______Ck#______Amt.pd at reg______Birth Cert______
Tuition______Snack Fee______Supply Fee______Health Form______Chg of clothes______
Pymt Pol_____ Handbk/photo form______Pick-up Plan____ Get. Know You______Med Not______
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FALMOUTH BAPTIST CHURCH WEEKDAY PRESCHOOL
302 Colonial Avenue, Falmouth, VA 22405 540-373-8050
falmouthbaptist.net
ENROLLMENT APPLICATION
Please answer all questions on this form and return it to the Church Office with the non-refundable registration fee. Checks should be payable to Falmouth Baptist Church.In accordance with our State Regulations, you will need to present your child’s birth certificate or legal proof of birth for verification in the church office when you return the application form.PLEASE NOTE THAT YOUR CHILD’S HEALTH FORM MUST BE ON FILE BEFORE AUGUST 1, 2017.
REGISTRATION FEES:
Paid by February 28, 2017-- $60.00 Paid after April 1, 2017-- $80.00
Paid by April 1, 2017-- $70.00 Paid after August 1, 2017 --$100.00
Child’s Full Name: ______Sex: Male or Female
Name you wish us to use: ______Birth date: ______
Street Address: ______Phone: ______
City/Zip Code: ______
Mother’s Name ______Father’s Name: ______
Address (if different): ______Address (if different):______
Place of Employment: ______Place of Employment: ______
Occupation: ______Occupation: ______
Work phone: ______Work phone: ______
Cell Number: ______Cell Number: ______
Religious Affiliation: ______Religious Affiliation: ______
Email address: ______Email address: ______
Parents’ Relationship to each other: ______Married ______Divorced ______Separated ______Single
(If divorced, a copy of the Divorce Decree noting guardianship, days of visitation, etc. must accompany this form.)
Person(s) with legal custody of child (relationship): ______
Name of child’s doctor: ______Phone: ______
Does your child have any allergies (including food allergies) or medical problems that teachers need to be aware of? ______Please explain: ______
Does your child have any behavioral issues that we need to be aware of? ______
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How did you hear about us? ______Did someone refer you?______
*Each child will be given a two-week trial period to adjust to the new classroom environment, teachers, schedules, rules and regulations. At the end of this trial period, the director may ask you to withdraw your child if he/she is not able to comply with his/her new schedule.
PLEASE READ THE INFORMATION ON THE REVERSE SIDE, INITIAL AND SIGN
In order to assure that parents clearly understand the procedures and policies of Falmouth Baptist Preschool, we ask all parents to read the following information. Please initial each blank to indicate your understanding and acceptance.
Please sign the form at the bottom. Thank you!
It is the responsibility of the parent/guardian to make sure all forms are on file before school begins. STATE REQUIREMENTS FOR ADMISSION: (Children with incomplete files will not be permitted to enter class)
• Application form (all questions completed)
• State medical form completed and signed by your physician and returned to the office by August 1, 2017. You are responsible for making sure that your child has received the required immunizations.
• Legal proof of birth must be presented for witness in the office when you return your application form. A copy will be made in the office and the original will be given right back to you.
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POLICY FORM – 2017-2018
___ 1. Parents are responsible for payment of fees on time. Tuition is due on the first school day of each month. A late fee of $10.00 per week will be added to tuition not paid within seven (7) days of the due date. You will receive a Payment Policy form explaining this policy in your orientation paperwork.
___ 2. There is no reduction of fees for absences or vacations or missed days due to inclement weather.
___ 3. The enclosed medical form must be completed and signed by a physician and returned to the church office by August 1, 2017. Please note that this form must be on file in the office before the child will be admitted to classes which begin September 6, 2017. NO MEDICATION CAN BE ADMINISTERED TO A CHILD DURING SCHOOL HOURS. The only medication we give is the EPIPEN for an allergic reaction. See the Director for this paperwork and it must be filled out by your child’s doctor and returned before preschool starts. Note: Your child will need to have a complete physical if he/she has not had one within the past year.
___ 4. Your child(ren) need to be kept home from school with the following: those with fever, diarrhea and/or vomiting in previous 24-hour period. You must notify the Director of any confirmed illness so a notice may be posted outside of the classroom. I will email the teacher or call the church office if my child will be absent from school.
___ 5. Parents need to inform the office of changes in address, phone numbers, employment locations, emergency information, or any changes in family situations.
___6. I understand that:
a. I must walk into the building and to the classroom door with my child each day and make certain the teachers know he/she is there. Older siblings (under 18) are not to bring in or pick up children. School begins at 9:00 a.m. You must be at school by 9:15. Children will not be accepted after 915 a.m. once the front door is locked.
b. I, or a responsible designated adult, will walk into the building and wait in the hallway to pick up my child(ren).
c. I understand that I am responsible for complete supervision of my child prior to and after school.
___ 7. Parents are expected to pick up children PROMPTLY at 12:00 noon. Please be on time to pick up your child. At 12:05 you are considered late. A late fee of $5.00 will be charged for each five minutes teachers are asked to keep your child beyond 12:00 noon. ($1 per minute if it hasn’t reached a five minute period) If lateness becomes an issue the director will be notified. Teachers have other responsibilities and obligations. This fee is to be paid in cash, directly to the teacher that stayed with your child, when you pick up your child that day. Please call the church office and let the secretary know if there is a problem.
___ 8. Parents need to provide transportation to and from all locations for field trips. Teachers cannot transport students in their private vehicles.
___ 9. Children need a complete change of clothing left at school. All items must be labeled with their name.
___ 10. SNOW POLICY: Parents are responsible for acquiring information about school closures. If Stafford County Schools are closed for inclement weather then we are closed. If Stafford goes in late, no matter how late, we operate from 10 to 12. You may also receive an email from your teacher.
___ 11. The director is to be notified at least two weeks in writing when a child is to be withdrawn from the program. Parents must obtain a WITHDRAWAL NOTIFICATION form. Parents are required to pay for tuition until the office receives this information. Children withdrawn before the 15th of the month will owe tuition for half of the month. Those withdrawn after the 15th will owe tuition for a full month.
___ 12. I understand and agree to abide by these rules and regulations.
A Parent Handbook will be given to each family at Orientation. The handbook is available to view online at falmouthbaptist.net with additional information and policies of the preschool.
Date: ______Signature of Parent/Guardian: ______