Summer Admissions Application

Please Print this Page, Fill out the form and Turn into the CC Office

Summer Admissions Agreement
	_____	_________
	REG	FEE PAID

______________________________________	________________	________________
Name	Birth-date	Grade in School

I agree to comply with the rules and regulations of Country Christian School as specified in the ADMISSIONS, POLICIES AND PROCEDURES HANDBOOK issued by the school. [_____] (Please initial to acknowledge receipt of Handbook.)

1. CCS will provide the following basic services:
	· A planned activity program including arrangement for utilization of available community resource i.e., ( visitors). · Operating school hours are 6:45 a.m. to 5:30 p.m. · The school does not provide food services. Parents/Guardians must provide a morning snack and lunch for all children. The school will provide an afternoon snack in the after school program. · One qualified, licensed teacher for each fifteen (15) children.
2. The school provides optional services that are seasonal in nature and will be announced in the monthly newsletter.
	· Holidays: CCS is closed during all major holidays for morning instruction. Day care will be provided on some holidays for children of working parents that are enrolled on a full-time basis. (See Handbook for exceptions.) However, children who are enrolled in the morning sessions may come during these holidays for an additional fee. Siblings of our students may also attend during holiday sessions for an additional fee.
3. Payment Provisions.
	· Basic Rate (see price pamphlet)
4. Registration Fees: New Students $150.00-$225.00–Returning Students $80.00
5. Material (see price pamphlet)
6. Tuition checks should be made payable to Country Christian School (CCS).
	· A two-week notice is required before withdrawing a child from this school; if you fail to do so your account will be charged for a full month. · Registration Fees: New Students $150.00–$225.00 Returning Students $80.00. · Country Christian School shall provide at least thirty (30) calendar days written notice to the parent or authorized representative prior to any basic rate change. · Refunds on registration fees are not provided to clients. · Optional services will be posted and written in the monthly newsletter one to four weeks in advance of the service offered.
7. Enrollment Schedule:
	· Days of the week for enrollment: M___T___W___TH___F___· I will bring my child at ____________a.m./p.m.· I will pick my child up at ____________ a.m./p.m.· Other_____________________________________________________ (Arrangements can be made for children to stay as late as 5:30 pm, with prior permission from the teacher and director for a fee of $5.00 per hour.)
8. Late Fee for After School Care: The Ourgang program closes at 5:30 p.m. Please be prompt in picking up your child(ren). We recognize that emergencies do occur; therefore, IF YOU CALL BY 5:15 p.m. to notify the school, the late fee will be waived with a grace period of five minutes. However, if you do not call, you will be billed $1.00 per minute.
9. Late Fee for After School Care: The Ourgang program closes at 5:30 p.m. Please be prompt in picking up your child(ren). We recognize that emergencies do occur; therefore, IF YOU CALL BY 5:15 p.m. to notify the school, the late fee will be waived with a grace period of five minutes. However, if you do not call, you will be billed $1.00 per minute.
10. This agreement may be terminated with a fifteen (15) day written notice.
11. Licensing for Day Care:
	· The Department of Licensing Agency, according to California State Law, shall have the authority to interview children or staff and to inspect and audit child or facility records without prior consent. The licensee shall make provisions for private interview with any child(ren), or any staff member, and for the examination of all records relating to the operation of the facility. · The Department of Licensing Agency shall have the authority to observe the physical condition of the child(ren), including conditions which could indicate abuse, neglect, or inappropriate placement. · Original or photographic reproduction of all children’s records shall be retained for at least three years following termination of service to the child.

Please place your signature in the space below to indicate your agreement to comply with the admission policies stated herein.

____________________________________________________________	________________
Parent Name	date
____________________________________________________________	________________
Administrator	date
____________________________________________________________	________________
Sponsor’s Name	date
____________________________________________________________	________________
Spouse’s Name	date

Address____________________________________________________________

Home Phone #__________________________

Work Phone #__________________________

Cell Phone #__________________________

Summer Admissions Application

Summer Admissions Agreement