Mansfield Village Before/After School Program (MVP)

Mansfield Village Before/After School Program (MVP) Federal ID# 21-6000168 ENROLLMENT AGREEMENT

1.I am enrolling my child/children ______while I am working. I will give one month's notice of withdrawal from the program. Payment of the $45 registration fee and September's tuition , which are both non- •refundable, is due by July 30th. There is no early payment discount for September.

2. I am responsible for monthly payments to be paid by the 25th of each preceding month. Payments received after the 5thof the month will be assessed a $25.00 late fee. Payments in arrears two months will result in dismissal from the program. 3. In the event of any absences the MVP office must be notified in writing or via phone call .A finder's fee of $25 will be charged if I fail to notify the school and the MVP Office about my child not attending the After School Program and a search has to be undertaken. This fine is payable on receipt of bill.

4. The fee for pick-up after 6:00 PM is $5 for each 5 minutes or portion thereof. In addition to this fee, the second time I am late, I will be fined $10; the third time $20. These fines are billed directly to me and are payable on receipt. Any further lateness will result in dismissal from the program.

5. There is a $40 processing fee for returned checks. If this occurs a second time, all future payments must be made through payforit.net or by a money order.

6. I will notify the MVP Supervisor of work or home phone number changes for myself and my emergency contacts.

7. I understand that there will be no program on days that Mansfield Township Schools are closed because of bad weather and if school is closed early because of inclement weather or other emergency.

8. I understand that there will be no before school program on days that the Mansfield Township Schools have a delayed opening.

9. The staff will assume full responsibility for my child from the time he/she arrives at the program until dismissal time. Each child will be checked in upon arrival. The child must be signed out by an authorized person over 18 years of age no later than 6:00 PM.

10. I give my permission for my child to participate in walks and field trips. Specific details will be provided.

11. If a medical emergency arises, the staff will first attempt to contact me. If I or the emergency contact cannot be reached, the staff will contact the child's doctor. If the emergency is such that immediate medical attention is necessary, my child may be treated as per the Emergency Care Permission Form.

12. A copy of court-issued documentation such as, custody or restraining orders, must be provided to MVP Supervisor for your child's file.

I agree to adhere to the Mansfield Village Before and After School Care Programs enrollment agreement and procedures listed in the parent handbook and give my child permission to participate fully in these programs. I understand that my failure to abide by any part of this agreement may result in removal from the program. I agree that photographs and films of my child may be used in public relations efforts, but my child's name will not be included without specific permission.

Signature ______Date ______Please send the form, registration fee and form and first month's tuition to: Mansfield Village After School Program, 200 Mansfield Road East, Columbus, NJ 08022.