ROBERT &
DOROTHY LUDWIG
2008-2009
AFTER SCHOOL ENRICHMENT
PROGRAM (ASEP) REGISTRATION FORM
* Each
form must be accompanied by a NON-REFUNDABLE 10% deposit
* Registration
begins
* Registration must occur before
Child’s Name ______________________________________________
Please check off the days you
would like your child to attend:
_____Monday _____Tuesday _____Wednesday _____Thursday _____Friday
Please register my child for
the:
_____Full day program (Pick
up prior to
_____Half day program (Pick
up prior to
Child's Birthday _____/_____/_____
Gender _____Male _____Female
Grade (as of September 2008)
_________ School ____________________________
Street Address: _________________________________________________________
City, State, Zip: _________________________________________________________
Home Phone: _____________________________________________
Parent’s Name:
__________________________ Work: _______________ Cell: _______________
Parent’s Name:
__________________________ Work: _______________ Cell: _______________
Email
Address: _______________________________________________________________________
Please register my child for the:
_____Year Round Child-Care Package, which includes
Center membership, Monday through Friday ASEP, vacation programs, day camp and
camp extended day. (NO REFUNDS FOR UNUSED TIME)
The ASEP program provides services to all children
regardless of sex, race, creed, color, religion, handicap or national origin.
(OVER)
I understand and agree to the following:
1. I will make all tuition payments and
obligations in a timely fashion as specified:
Half the yearly tuition is due in September. The remainder is due in January. Alternate payment plans may be made, such as
monthly payments are also acceptable. There are no reductions or credits for
illnesses, vacations, or Center closings.
2. If my child will not be
attending ASEP on her/his regular day, I will notify the JCC prior to her/his
usual arrival time. Failure to do so may result in my child being removed from the program.
3. The Center will provide me
with a parent manual detailing ASEP policies and schedules.
4. The ASEP calendar is based on the
5. If a behavior problem arises, I understand
that attempts will be made between the staff and the parent to rectify the
situation. If, after these attempts, the
situation continues, I realize that my child may, at the sole discretion of the
Center, be temporarily or permanently removed from the program.
6. In order to enroll my child in ASEP, I must
be a member in good standing of the Schenectady Jewish Community Center.
7. I must notify the School-Age Director if I
plan to withdraw my child before the end of the year. If I remove my child and fail to notify the
Center in writing, I will be responsible for all fees. If I notify the Center in writing, I am
responsible for that percentage of time my child attended, plus an additional
10% of the yearly fee.
8. Early dismissal days are included in my
tuition fees. On early dismissal days
children must bring a lunch. Vacation
days, Jewish Holiday Closings, Snow Days and certain specialty classes are an
additional fee and require pre-registration.
9. I will remit the 10% deposit which is
non-refundable, but is applicable towards the last month of tuition.
10. I understand that there
will be a $20 service charge for any check returned to the JCC.
11. I understand that if I
pick my child up late, I will incur the following fees:
12. There will
be a $10 administrative fee for any changes that you make to your
child’s schedule.
13. I understand that the JCC
is not responsible for any items lost while at the ASEP program.
14. A Copy of this form is
available upon request.
I have read and understand the
registration form in full and agree to all terms.
_______________________________ _______________________
Signature of Parent or Legal Guardian Date