THE ROBERT AND DOROTHY LUDWIG
MIDDLE SCHOOL AFTER SCHOOL
ENRICHMENT PROGRAM (MASEP)
2008-2009
REGISTRATION FORM
*
Each form must be accompanied by
a NON-REFUNDABLE 10% deposit
*
Registration begins
* Registration must occur before
Child’s Name_________________________________________________________
Please check the days you would like your child to attend
MASEP:
____Monday ____Tuesday ____Wednesday
____Thursday _____Friday
Child's Birthday: _____/_____/_____
Gender: _____Male _____Female
Grade (as of September 2008): _________
School: ____________________________
Home Address: _________________________________________________________
City, State, Zip:
_________________________________________________________
Home Phone
Number: ______________________________________
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 MASEP, vacation
programs, travel camp and travel camp extended day. (NO REFUNDS FOR UNUSED
TIME)
The MASEP 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 MASEP on her/his regular day, I will call 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
MASEP policies and schedules.
4. The MASEP calendar is based on the
5. If a
behavior problem arises, I understand that attempts will be made between the
staff, the child,
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 MASEP, I must be a member in good standing, of the
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:
I
will be charged a $1.00 per minute fee/per child after
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 MASEP
program.
14. A copy
of this form is available upon request.
I have read
the registration form in full and agree to all terms.
________________________________
_________________________
Signature
of Parent or Legal Guardian Date