Re-Enrollment Application

Re-Enrollment Application 2012 - 2013 School Year

Campus I Preschool

Timberlake Christian Schools 21397 Timberlake Road Lynchburg, VA 24502 434-239-5219 Fax: 434-239-4676 www.tcs4u.org

Mr. Charles Williams Interim Administrator [email protected]

Mrs. Karla H. Werner Preschool Director [email protected] A Solid Foundation – Academically and Spiritually

Welcome back to TCS! Re-enrollment Process

Thank you for another opportunity to minister to your family. Enclosed you will find the necessary forms to complete re-enrollment for the 2012 - 2013 school year. Your promptness in returning these forms will enable us to prepare effectively.

1. Submit the completed application forms, including the signed Statement of Cooperation and Financial Agreement, along with the non-refundable Registration Fee.

2. Resolve any outstanding accounts. All past due accounts must be paid before re-enrollment(s) are accepted.

3. Submit the accompanying items as soon as possible, but no later than July 1, 2012, to reserve a place for your child:  Completed Emergency Contact Form  If your child has received any new immunizations since last school year, please provide us with a new immunization record.

POLICY OF NON-DISCRIMINATION Timberlake Christian Schools admit students of any race, color or national and ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students of the Schools. The Schools do not discriminate on the basis of race, color, or national and ethnic origin in the administration of their educational or admissions policies, hiring, or their scholarship, loan, or other schools-administered programs. As a Bible-believing institution, this policy of non-discrimination does not extend to areas of religious conviction or a lifestyle contrary to Scripture (Romans 1:21-27, I Corinthians 6:9-20).

2 3 Preschool Information 2012 - 2013 School Year Our preschool program is designed for children over 2 yrs of age. Note: 2 yr olds cannot start at TCS until they have had their 2nd birthday. Children over 2 years of age must reach the appropriate age by September 30th in order to be enrolled in that program. Registration Fee for Preschool: $50.00 if paid on or before April 16, 2012 $75.00 if paid after April 16, 2012 Registration fees are paid at the time of enrollment and are non-refundable. 2 Year Old Tuition Schedule One Payment 9 monthly pymts * (due Aug. 15th) (Aug. 15th – April 15th) 3 Half Day – MWF $1,503 $167 5 Half Day $2,520 $280 5 Full Day $4,320 $480

3 & 4 Year Old Tuition Schedule One Payment 9 monthly pymts * (due Aug. 15th) (Aug. 15th – April 15th) 3 Half Day – MWF $1,278 $142 5 Half Day $2,070 $230 5 Full Day $3,870 $430 *All monthly tuition payments must be paid using FACTS (automatic payment plan). DISCOUNTS:  MULTI-STUDENT – Families with more than one full day student are eligible to receive a $306 discount off the total tuition for their second and subsequent children. The oldest child pays full price.  TBC MEMBER - TCS offers a discount to TBC Members. Please visit the school website, tcs4u.org, for more details. PLEASE READ CAREFULLY: Only full day preschool tuition includes before and after school care. The full day preschool program is open all school year, but will be closed for some school holidays. TCS will provide a list of dates at the beginning of the school year showing days when no care is available. These dates will also be listed on the school calendar included in the summer mailing.

Half day preschool classes will be closed for a fall, Christmas and spring break, as well as any days the full day preschool is closed. Please see the Campus I calendar for specific dates. An optional summer program is available for June, July and August for those that require year-round care. More information is available in the Summer Day Camp information packet.

*** Our 2012 - 2013 school year will begin on Monday, August 20, 2012 ****

4 Re-Enrollment Application 2012 - 2013 School Year Campus I – Preschool

Date:______Student’s Name:______First Middle Last Entering Class (circle one): 2YR 3YR 4YR Circle one: 3 day Half Day 5 day Half Day 5 day Full Day

*Please note: There are limited spots available for 4 yr old 3 day Half Day

Birthday:______Male  Female  Address: ______Street City State Zip Code County

Home Phone: ______Cell phone: (Father #) ______(Mother #) ______Father’s Name: ______Mother’s Name: ______Address: ______Address: ______Employer: ______Employer: ______Business Phone: ______Business Phone: ______Marital Status: ______Marital Status: ______□ Email: ______□ Email: ______* check the box next to the Email address that should be used for general Email announcements

Church Attending:______

Do you attend regularly? Yes  No  Office Use Only

TCS occasionally uses pictures of projects, events and students on our website, Date Received: ______brochures or twitter account, @TCS_tornadoes, to highlight our programs. I give Registration Fee Pd my permission for TCS to use my child’s picture in these media. Amt. $ ______Yes  No  Cash _____ Check #_____

Medical Forms 2 & 3yr olds only: Is your child toilet trained? Yes  No  (4 yr and older must be toilet trained to attend) Birth Certificate ______Emer. Contact Form Statement of Cooperation Financial Agreement

Accepted: ______Notified: ______Notes:

5 Timberlake Christian Schools 2012-2013 Emergency Contact Information

Student’s Name Birthdate Address Age City/County Home Phone

Mother’s Name Address Work Phone Cell Phone Email Please check your preferred method of contact

Father’s Name Address Work Phone Cell Phone Email Please check your preferred method of contact

Three people to contact if Parent(s) cannot be reached who are authorized to pick up your child Name Phone Relationship Name Phone Relationship Name Phone Relationship *If more space is needed, please use the back or attach another paper.

Is there anyone NOT legally authorized to pick up your child? (All appropriate paper work must be on file.) ______

Allergy Information: Is your child allergic to anything and what is his/her reaction? (Please include any foods or medications.) ______

______

Medical Release Form: Permission is granted for our/my child to receive emergency medical attention in case of an accident, injury or illness.

Father’s Signature: ______Mother’s Signature: ______

Family Doctor: ______Phone: ______

6 Preschool Statement of Cooperation between TCS and Parents

Parents: please initial beside each item and sign at the bottom.

___ I pledge my loyalty to the aims and ideals of the school and, following Biblical principles, will bring any questions and criticisms directly to the proper school authority. ___Understanding that fees do not cover the actual cost of educating my children, I recognize that my participation is needed in prayer and support. ___In case of accident or serious illness I request the schools to contact me and I agree to pick up my child within a reasonable amount of time. If unable to reach me, I hereby authorize the school to call my physician and to follow his instructions. If it is impossible to contact the physician, the school may make whatever arrangements necessary for the benefit of my child. ___I understand that my child will be expected to participate in field trips and other school- sponsored activities. ___I understand that if I pick up my child after 5:45pm, I will incur a $10.00 fee for every half hour or portion of a half hour, that I am late. This service is for emergency use only. ___I understand that the school reserves the right to dismiss my child if he or she does not cooperate with the educational process. If my child is dismissed for any reason, I will be responsible for the tuition through the final month of attendance. ___Since tuition is a yearly fee broken into monthly payments, I understand that if I withdraw my child from school during the school year I am liable for the remainder of the tuition due and payable during the school year. I understand that all money owed to the school must be paid before diplomas, report cards, medical information, or transcripts can be released. ___ I understand that there is no refund for days not attended due to the fact that there are still costs that are incurred regardless of whether or not my child is here.

Statement must be signed by BOTH parents (if child resides with both) or legal guardian.

Father’s Signature: ______Date: ______Mother’s Signature: ______Date: ______Legal Guardian: ______Date: ______

7 FAMILY Financial Agreement for 2012 – 2013

Student’s Name(s) ______Grade(s)______Date______We, the parents or guardian, agree to enroll the above named student for the school year 2012 – 2013 and agree to pay to Timberlake Christian Schools the following tuition/extended care fee of: $______(pay in full) OR $______(per month) We understand that all tuition/fees must be paid by one of the following options (check one): □ Pay 100% of tuition/fees by check to TCS or via FACTS by 8/15/12 □ Make 9 monthly installments (starting 8/15/12) via FACTS □ Make 11 monthly installments (starting 6/15/12) via FACTS □ Make 18 BI-MONTHLY installments on 15th AND the last business day of the month (starting August 2012) via FACTS FACTS is an automated payment system that will be processing all monthly tuition payments for TCS for the 2012-2013 school year via an automatic draft from a checking, savings or credit card. We understand that there is a 2.5% convenience fee associated with the credit card option only.

 I / We promise to pay the above selected payment amount in its entirety to Timberlake Christian Schools.  TCS is a non-profit ministry and your payment is used to help us continue to do our Lord’s work. These payments must be paid by the due date to keep the account in good standing.  Any payments that cannot be processed by FACTS on the 15th of the month will be accessed a $25.00 late fee by TCS, in addition to the fees charged by FACTS and our bank.  We understand that our student will be unable to start school unless we have paid our tuition in full or we have set up a monthly payment agreement with FACTS.  We understand that TCS will no longer be accepting CASH payments for tuition and will no longer be processing credit cards for any payments in the school office.  The student listed on the account that becomes past due by 30 days is subject to dismissal from Timberlake Christian Schools until the account is made current.  All signed contracts with Timberlake Christian Schools are legal and binding through the dated period assigned to each.  In the event contracted parties request early withdrawal of a student from the schools, the full amount of the contract is due before we can release any student records.  Early Contract Termination will be considered by the Executive Committee only by Business Office Use Only written request (stating detailed circumstances) before its monthly meeting. All payments or prepaid payments are due through the date of the Executive committee’s Tuition release of the contract. G/L (Discount)  The Executive Committee has full authority over all contracts and withdrawal requests, and may or may not grant a request. In the event a request is granted, a $50 fee will be assessed for each student contract, payable before the release of any student records. Should the Executive committee vote not to release the contract, the full amount of the contract must be paid per the contract agreement.  *We understand that diplomas, report cards, medical information, or transcripts cannot be released if our account is past due.  I have read and agree to the financial agreement dated above.  Signed by both parents (if child resides with both) or legal guardian.

Father’s Signature: ______Total Mother’s Signature: ______# Pymts Monthly Legal Guardian: ______Pymt *Parent/Guardian must initial next to this line. Start Date

□ Invoiced □ Sent to FACTS