The Learning Playhouse

The Learning Playhouse

208 North Providence Road

North Chesterfield, VA 23235

(804) 560-7808

learning-playhouse.net

Requirements for our School Age Program

Completed Application

Child’s Information

Parent Information

Physician’s Information (Name, Address, and Telephone Number)

Two Emergency Contacts(Address and Telephone Number)

Current Physical Examination with Immunization Record

School Entrance Health Form

Blanket Permission Form

Picture/Video Release Form

The Learning Playhouse

208 North Providence Road

North Chesterfield, VA 23235

Fee Schedule 2018

Class / Tuition
Preschool – Two’s Class (or any Child not toilet trained) / $176/Week
Preschool / $169/Week
Before & After School / $108/Week
School Closed / $0/Day
Early Release/Delay / $0/Day
Spring & Christmas Break / $166/Week
Snow Day / $0/First Day (School is CLOSED and TLP is OPEN) and $10/Day Afterward(Per Storm)
Head Start / $118/Week
Before Only or After Only / $85/Week
School Closed / $15/Day
Early Release/Delay / $10/Day
Spring & Christmas Break / $166/Week
Before OR After Drop-In / $15/Day
Snow Day / $0/First Day (School is CLOSED and TLP is OPEN) and $15/Day Afterward (Per Storm)
Head Start / $95/Week
School Age Summer Program / $166/Week
Includes in-town field trips, breakfast, lunch, & snack when at school
School Age/Preschool Drop-In(if available) / $45/Day
Before or After Drop-In(Not Enrolled) / $25/Day
Non-Attendance Notice Fee(After School Program) / $10/Day
Before/After Weekly Drop In Fee / $150/Week

Fees

Registration / $50/Child
Returned Check / $25/Check
Late Payment(Effective Wednesday at 6:00pm) / $10/Week
Late Pick Up / $5/First Fifteen Minutes; $5/Every Five Minutes Afterward

Other

Vacation / Preschool
One Week per Year
School Age
One Week per School Year and
One Week during the Summer
Sick Time / Half Rate
Attendance of two days or less during a week(Maximum of 4 times a year)Holidays are considered a day of attendance.

The Learning Playhouse

Child Enrollment Form

Child Information

Last Name / First Name / Middle Name / Nickname / Sex / Birth Date
Street Address / City / State / Zip / Home Phone
Allergies/Chronic Physical Problems/Diseases/Pertinent Information/Special Accommodations Needed
If Child Attends School Program (Name and Location) / Previous Child Care

Parent/Guardian Information

Father / Place Employed / Business Phone
Business Address / Cell Phone
Home Address / Home Phone
Mother / Place Employed / Business Phone
Business Address / Cell Phone
Home Address / Home Phone
Person(s) or Agency Having Legal Custody of Child
Home Address / Home Phone
Business Address / Business Phone

Emergency Information

Child’s Physician / Address / Phone
Persons to Contact if Parents Cannot be Reached (MUST BE LOCAL) / Complete Address / Relationship / Phone
(1)
(2)
Persons Authorized to Pick Up Child
Person(s) NOT Authorized to Pick Up Child*

*Appropriate paperwork such as custody papers shall be attached if a parent is not allowed to pick up the child

(Over)

Agreements

1. The parent will fill out a blanket permission form for the child to participate in field trips and other activities.

2. The Learning Playhouse agrees to notify the Parent/Guardian whenever this child becomes ill, and the Parent/Guardian agrees to pick the child up thereafter as soon as possible.

3. The Parent/Guardian authorizes the Learning Playhouse to obtain immediate medical care if any emergency occurs when he/she cannot be located immediately.

4. Parent/Guardian receives, reads, and remains in compliance with handbook/policy. ______(Initial)

5. The Parent/Guardian agree to inform the center within 24 hours or the next business day after this child or any member of the immediate household has developed a reportable communicable disease, as defined by the State Board of Health, except for life threatening diseases which must be reported immediately.

6. In the event that your account is turned over to a collection agency, you will be responsible for all collection costs including reasonable attorneys’ fees. ______(Initial)

Signatures

Parent/Guardian / Date
Administrator / Date

Date of Admission: ______Date Withdrawn: ______

______

Proof of Child’s Identity (OFFICE USE ONLY)

Type of Document / Birth Date / Certificate Number / Date Issued
Place of Birth / Previous Child Care / Date Document Viewed
(Initial)

Date of Notification of Local Law-Enforcement Agency (when required proof of identity is not provided): ______(Date)

Proof of the child’s identity and age may include a certified copy of the child’s birth certificate, birth registration card, notification of birth (hospital, physician or midwife record), passport, copy of the placement agreement or other proof of the child’s identity from a child placing agency (foster care and adoption agencies), record from a public school in Virginia, certification by a principal or his designee of a public school in the U. S. that a certified copy of the child’s birth record was previously presented or copy of the entrustment agreement conferring temporary legal custody of a child to an independent foster parent. Viewing the child’s proof of identity is not necessary when the child attends a public school in Virginia and the center assumes responsibility for the child directly from the school (i.e., after school program) or the center transfers responsibility of the child directly to the school (i.e., before school program). While programs are not required to keep the proof of the child’s identity, documentation of viewing this information must be maintained for each child.

The Learning Playhouse

208 North Providence Road

North Chesterfield, VA 23235

(804) 560-7808

learning-playhouse.net

Hours of Operation:7:00am – 6:00pm

Class Offered:

PreschoolFull Time Only

(Two Years Old – Five Years Old)Tuition Includes:

Age Appropriate Curriculum
Academic Materials
Spanish Class
Sign Language Class
Breakfast
Lunch
Afternoon Snacks

Program Includes:

Structured Classroom Activities
Reading Program for Pre-K Class
Math Curriculum
Arts & Crafts
Thematic Weekly Lessons
Drama & Music
Field Trips
Spanish
Sign Language

______

School Age

(Five Years Old – Twelve Years Old)

Tuition Includes:

Breakfast
Snack
Transportation
Homework Supervision

Program Includes:

Homework Supervision
Daily Playground Activities
Arts & Crafts
Indoor Centers & Skill Activities
Field Trips (When School is Closed)

Learning Playhouse

208 North Providence Road

Richmond, VA 23235

(804) 560-7808

Breakfast/Lunch/Snack Menu

Monday / Tuesday / Wednesday / Thursday / Friday
Breakfast / Mixed Cereal w/
Fruit
Milk / Waffles
Banana
Milk / Biscuit w/Fruit jelly
& Butter
Milk / Cinnamon Rolls
Milk / Oatmeal
Milk
Lunch / Hot Dogs
French Fries
Apple Slices
Cookies
Milk / Chicken in Rice
Peas
Orange Slices
Pudding
Milk / Spaghetti w/meat
Bread w/butter
Peaches
Salad
Milk / Chicken nuggets
Mashed Potato
Green Beans
Pears
Milk / Bologna Sandwich
Mixed Veggies
Pineapple
Milk
Snack / Tortilla Chips With Cheese
Carrots
Fruit Juice / Pretzels
Raisins
Water / Vanilla Wafers
Pineapple
Lemonade / Animal Cookies
Apples
Fruit Juice / Figs Bars
Craisins
Lemonade
Monday / Tuesday / Wednesday / Thursday / Friday
Breakfast / Bagel with Cream Cheese & Jelly
Milk / Cereal w/Fruit
Milk / Blueberry Bread
Milk / Pancakes
Milk / Cinnamon Toast
Fruit
Milk
Lunch / Fish Sticks
Egg Noodles
Green Peas
Applesauce
Milk / Beanie Weenies
Broccoli w/Cheese
Fruit Cocktail
Crackers
Milk / Macaroni & Cheese
Green Beans
Peaches
Milk / Turkey Wraps
Veggie Straws
Oranges
Pudding
Milk / Pizza (pep.& cheese)
Corn
Pears
Milk
Snack / Saltine Crackers w/Apple Butter
Water / Oreo Cookies
Raisins
Fruit Juice / Goldfish
Cucumbers
Lemonade / Graham Crackers
Banana
Water / Cheese Balls
Apples
Fruit Juice
Monday / Tuesday / Wednesday / Thursday / Friday
Breakfast / Biscuits w/butter & Fruit Jelly
Milk / Cereal
Milk / Waffles
Milk / Cinnamon Rolls
Milk / Bagel with Cream Cheese & Jelly
Milk
Lunch / Hot Dogs
Baked Beans
Apple Slices
Pudding
Milk / Grilled Cheese
Chips
Pears
Mixed Veggies
Milk / Chicken Noodle
Soup
Carrot Sticks
Crackers
Fruit Cocktail
Milk / Spaghetti w/meat
Bread w/ butter
Peas
Applesauce
Milk / Bologna Sandwich
Potato Chips
Oranges Slices
Corn
Milk
Snack / Cheese Crackers
Craisins
Fruit Juice / Popcorn
Pineapple
Lemonade / Cookies
Bananas
Water / Chex Mix
Raisins
Lemonade / Animal Cookies
Apples
Fruit Juice
Monday / Tuesday / Wednesday / Thursday / Friday
Breakfast / Cereal
Fruit
Milk / Blueberry Bread
Milk / Pancakes
Milk / Oatmeal
Milk / Cinnamon Toast
Banana
Milk
Lunch / Chicken Noodle
Casserole
Corn
Apple Slices
Milk / Pigs in a Blanket
Green Beans
Fruit Cocktail
Milk / Beef-a-roni
Peas
Buttered Bread
Peaches
Milk / Cheese Sandwich
Tator Tots
Oranges
Jell-O
Milk / Ham Sticks
Pasta w/cheese
Salad
Pears
Milk
Snack / Goldfish
Pineapple
Water / Cookies
Bananas
Fruit Juice / Cheese-It
Raisins
Lemonade / Honey Pretzels
Carrots
Water / Saltine Crackers w/
Strawberry
Preserves
Fruit Juice

The Learning Playhouse

208 North Providence Road

North Chesterfield, VA 23235

(804) 560-7808

learning-playhouse.net

Picture and Video Release Form

I consent to having my child’s picture and/or video appear on the Learning Playhouse’ website. I understand that I may have any picture or video of my child removed at any time.

I DO NOT want my child’s picture and/or video to appear on the Learning Playhouse’ website.

______

Child’s NameParent’s Signature

The Learning Playhouse

208 North Providence Road

North Chesterfield, VA 23235

(804) 560-7808

learning-playhouse.net

Blanket Permission Form

I give my child, ______my permission to participate in Field Trips and other extracurricular activities conducted by the Learning Playhouse.

I understand that I will be notified in advance the time, date, location, and a list of things that I need to provide for each trip or activity.

If I wish for my child not to participate in a certain planned trip or activity, I will notify the teacher verbally or in writing ahead of time.

______

Parent or Guardian Signature Date

Mom Dad

Work Number: ______Work Number: ______

Cell Number: ______Cell Number: ______