Student name:
Greenbrier Montessori School
Enrollment Tuition Agreement
2008-2009 Academic Year
September 2, 2008 - June 12, 2009
Programs Program Times Yearly Fee Quarterly Monthly
Toddler Program - Ages 2 1/2 - 3 *see note #6
___ Regular Day 8:30 am - 3:30 pm $6500.003 payments of $2123.33 $650.00
___ Full Day 7:30 am - 5:30 pm $7500.003 payments of $2450.00 $750.00
___ Half Day Program 8:30 am - 11:30pm $4950.003 payments of $1617.00 $495.00
Children’s House - Ages 3 - 6
___ Regular Day 8:30 am - 3:30 pm $6150.003 payments of $2009.00 $615.00
___ Full Day 7:30 am - 5:30 pm $7150.003 payments of $2335.00 $715.00
___ Half Day Program 8:30 am - 11:30am $4950.003 payments of $1617.00 $495.00
Lower Elementary Program - Ages 6 - 9
___ Regular Day 8:30 am - 3:30 pm $6700.003 payments of $2188.50 $670.00
___ Full Day 7:30 am - 5:30 pm $7700.003 payments of $2522.00 $770.00
Upper Elementary Program - Ages 9 - 12
___ Regular Day 8:30 am - 3:30 pm $7150.003 payments of $2335.60 $715.00
___ Full Day 7:30 am - 5:30 pm $8150.003 payments of $2662.00 $815.00
Please Select Payment Plan _____ Yearly_____ Quarterly _____ Monthly
ENROLLMENT FEES: Enrollment fees must be paid prior to enrollment; a child is not considered enrolled until all fees are paid. All paid fees, including advanced tuition payments, are non-refundable.
1. A Tuition Deposit of $300.00 (to be applied towards first month’s tuition installment).
2. An annual registration fee of $300.00 for all students.
3. For the Elementary Program - Ages 6 - 12 - a materials fee of $100.00 per student is required.
4. The Tuition Agreement signed by parent(s)/guardian and all enrollment fees.
1. Tuition shall be paid yearly and is not based on how many months or days in a school year. However, a quarterly or monthly installment plan is available. For students enrolling late, GMS may prorate tuition at its own discretion, by reducing the yearly fee. This reduction will not be based on the total months or days remaining in the academic school year. Under no circumstance will June payment be prorated for any student attending GMS. All paid fees are non-refundable.
2. Monthly installments are due on the 1st of each month, beginning August 1st and ending May 1st.
3. Quarterly installments above reflect approximately a 2% discount. Quarterly installments are due and payable
no later than August 1st, November 1st, and February 1st of each school year. A 5% discount is available for
parents who pay the yearly (one) tuition payment.
4. All fees are due regardless of vacation periods during the school year. The 2008-2009 academic year begins in September and ends the second week of June.
5. School will remain open during the Spring Holiday for FULL DAY students only.
6. Students in the toddler program who are not FULLY potty trained will be charged an additional $25.00 per month which will be added to the monthly tuition. It’s the parents’ responsibility to potty train his/her child. Our staff only encourages and assists with potty training. The teacher will determine when the student becomes fully potty trained. When student becomes FULLY potty trained (needs no bathroom assistance), parent will be notified by official letter, at which time the monthly charge of $25.00 will stop. This fee will not be prorated.
7. Payments are due on the 1st of the month. PAST DUE accounts are subject to a late charge of $25.00 per month, to be applied to the current past due amount. GMS does not send out invoices for tuition charges.
8. Waiver or pro-ration of any tuition payments will be at the sole discretion of the school’s Directress.
9. The school’s annual expenses, and consequently a child’s tuition, are calculated on the assumption that children are enrolled for the entire academic year. Therefore, if you choose to withdraw your child from Greenbrier Montessori School, you will remain responsible for 100% of your child’s remaining tuition. Withdrawal resulting from employment transfer from the area served (see Parent Handbook for definition of areas served) by Greenbrier Montessori School requires thirty days written notice, your tuition for the following month and proof of transfer.
10. In the event of default in the payment of any installment, I promise to pay Greenbrier Montessori School all costs of collection, plus attorney’s fees of thirty-three (33) percent. A $35.00 fee will be assessed for any check that is returned by the bank.
11. Greenbrier Montessori School’s Parent Handbook is hereby made a part of this agreement.
This agreement shall supersede all previous communications, representations or agreements, either verbal or written, between the parties. Any changes to this agreement shall be valid only if in writing, signed and dated by both parties.
The parties have executed this agreement this ____________day of ________________________ 20_______.
Student’s Name:_______________________________
Father’s Signature_______________________________ Mother’s Signature__________________________
(or Legal Guardian) (or Legal Guardian)
Directress’s Signature_______________________________
Nneka Okala, Directress
Witness_______________________________
Michelle Hegedus, School Administrator
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FOR OFFICE USE:
Original Enrollment Date: Re-Enrollment Date:
Years in School: Class Assignment:
Registration & Materials Fees: _______________ Deposit Amount: _______________
Page 3 through 7 are hereby made a part of the Tuition Agreement (Page 1 and 2)
AUTHORIZATION FOR PICK-UP
Person’s Authorized to Pick Up Child Anyone Unauthorized to Pick Up Child
1.___________________________ 1. _________________________
2.___________________________ 2. _________________________
3.___________________________ 3. __________________________
4.___________________________
5.___________________________
6.___________________________
If another authorized person is to pick up my child, I will notify the staff in writing and add this person to my child’s authorized pick-up list.
Please include parents/legal guardians on authorized pick-up list.
FIELD TRIP AUTHORIZATION
I hereby give my permission for ______________________ to participate in field trips, nature walks or other walking tours. I understand I will be notified prior to a scheduled field trip, and will be given information regarding transportation, destination, lunch, arrival and departure time. I hereby release Greenbrier Montessori School, their employees and agents from any and all liability for any injuries sustained by my child while preparing for, going to, participating in, or returning from said field trips.
Parents’ Signatures______________________________Date_______________
______________________________Date_______________
EDUCATIONAL AGREEMENT
I agree to allow my child to be photographed and/or videotaped or sound recorded for educational purposes only. This educational data may be used in classroom presentations or for brochures and websites regarding the program.
Parents’ Signatures______________________________Date_________________
______________________________Date_________________
ADDITIONAL CHARGE FOR NON-POTTY TRAINED STUDENTS
I understand that if my child is not potty-trained, an additional charge of $25.00 per month will be added to the tuition. The teacher will determine when your child becomes “fully” potty-trained. When your child does become “fully” potty-trained, you will be notified by an official school letter, at which time the monthly charge of $25.00 will stop. This fee will not be prorated.
Parents’ Signatures_________________________________Date_________________
_________________________________Date_________________
PROOF OF IDENTITY
Proof of child’s identity and age may include: a certified copy of the child’s birth certificate; notification of birth; baptismal record; or school’s record from a public school in Virginia. While programs are not required to keep the proof of the child’s identity, documentation of viewing this information must be maintained for each child.
HEALTH FORM/PHYSICAL EXAMINATION/IMMUNIZATION CERTIFICATION
A Commonwealth of Virginia School Entrance Health Form must be completed and signed by a physician.
COMMUNICABLE DISEASE STATEMENT
I agree to inform Greenbrier Montessori School within twenty-four (24) hours or the next business day, except life threatening communicable diseases which must be reported immediately, after the child or any member of the immediate household has developed a reportable communicable disease, as defined by the State Board of Health.
Parents’ Signatures______________________________Date_______________
______________________________Date_______________
INSECT REPELLENT AND DIAPER OINTMENT POLICY
In the event my child requires insect repellent or diaper ointment, I will complete a medicine authorization form and supply my child’s own insect repellent spray or diaper ointment that will be kept at the school. All non-prescription medications must be labeled with your child’s name and dated.
Parents’ Signature______________________________Date________________
______________________________Date________________
SUNSCREEN POLICY
I hereby grant permission for Greenbrier Montessori School to use sunscreen on my child. Sunscreen will be supplied by the school - Coppertone Water Babies UVA/UVB hypoallergenic Sunblock Lotion, with a minimum SPF of 15. If you supply your own sunscreen for your child, you must make sure it is clearly labeled with your child’s name.
_____I/we grant permission for GMS to use school supplied sunscreen as indicated above.
_____I/we DO NOT grant permission, I/we will provide our own sunscreen for our child.
Parents’ Signature_______________________________Date__________________
_______________________________Date__________________
VISITATION BY PARENTS/GUARDIANS
Pursuant to Section 63.2-1813 of the Code of Virginia, a custodial parent or guardian shall be admitted to any child day program. A child day program is considered one in which a person or organization has agreed to assume responsibility for the supervision, protection and well-being of a child under the age of thirteen, for less than a twenty-four hour period. Such right of admission shall only apply while the child is in the child day program.
CHILD ABUSE POLICY
I understand that pursuant to Section 63.2-1509 of the Code of Virginia, if a staff member of GMS has reason to suspect that a child is an abused or neglected child, we shall report the matter immediately to the local department of the county or city wherein the child resides, or wherein the abuse or neglect is believed to have occurred, or to the Department's toll-free child abuse and neglect hotline.
GREENBRIER MONTESSORI SCHOOL
EMERGENCY CONTACT FORM
I understand that no emergency treatment will be given to my child without parental consent, except in a life-threatening situation. Since informed consent must be given at the time of incident, I understand that I must leave numbers and addresses where I (or my spouse or a responsible adult designated by me) may be reached daily if the numbers below do not apply for that day.
In case of a medical emergency while my child, ___________________________________ is attending Greenbrier Montessori School, I understand the following procedure will be followed:
Also note that the same procedure will be followed if your child is ill or is seriously injured. If a minor injury occurs, you will be notified via the accident/incident form at the end of the day. You will be required to sign the completed injury/incident form on the day of the incident.
1. The school will contact parent(s):
Mother Phone (Work)_________________________ (Cell)______________________________
Father Phone (work)__________________________ (Cell)______________________________
Parents’ Home Phone Number______________________________
Parents’ Address _____________________________________________________________________
2. If neither parent is available, the school will contact these persons:
(We must have two contacts with all information completed)
a.Name __________________________ Relationship to child ___________________________
Address ______________________________________________________________________
Phone (Home) _____________________ (Work) ___________________ (Cell) ____________
Name __________________________ Relationship to child ___________________________
Address ______________________________________________________________________
Phone (Home)___________________ (Work)_____________________ (Cell)_____________
3. The school will arrange for emergency transportation to the nearest emergency medical facility.
When necessary my child will be transported by an ambulance or other such vehicle.
4. The school will contact my child’s physician, Dr. _________________________________________
Dr.’s Phone# ____________________
I hereby authorize the school to follow this procedure.
Parents’ Signature______________________________Date ______________
______________________________Date ______________
Directress ______________________________Date ______________
PARENT’S STATEMENT OF UNDERSTANDING
Please read carefully prior to signing:
I agree to provide accurate information on the application that is hereby made part of this agreement. I agree to be governed by policies of Greenbrier Montessori School, as outlined in the Parent Handbook, and I further agree to the following terms and conditions.
I agree to give four weeks written notice in the event if becomes necessary to withdraw my child from the program. (Refer to handbook for details).
I understand GMS accepts my child on a six (6) week trial basis and are aware GMS may terminate my contract at any time during the probationary period. I also understand no refunds of prepaid monies will be made (Refer to handbook for details).
I agree and understand GMS reserves the right to remove any child from the program. Before removal of the child, the staff will hold a conference with the parent unless the behavior of the child is destructive to himself or the program environment. In that case, the child will be immediately removed and a conference will follow.
I agree that, if the parent(s)/guardian(s) are or become legally separated or divorced I will provide the school with a court child custody order for its files. I agree that the parent(s)/guardian(s) are responsible for notifying school administrator of any subsequent changes in the child custodial court orders.
The parent(s)/guardian(s) further agree that tuition charged is for the entire academic school year and is due regardless of attendance. GMS will be closed for major holidays. GMS will notify the parent of any days the school will be closed due to professional development of staff via the calendar of events.
I hereby certify I am the parents(s)/legal guardian(s) for the above named child and able to make educational decisions for the child. I will keep current the information on my child’s enrollment forms. I will inform the school immediately of new phone numbers, addresses and any changes in my child’s situation.
I understand and agree to fully participate in all aspects of GMS activities, i.e. parent workshops, parent-teacher conferences, etc. If you are unable to fulfill this commitment, please reconsider applying for enrollment.
I will be responsible for seeing that my child arrives to school on time each day. Excessive tardiness may result in the child’s dismissal from school.
I will strive for daily attendance by my child. Excessive absenteeism may result in the child’s dismissal from school.
I understand that GMS follows the Montessori Method of Education. I understand that children are expected to complete a three-year cycle of learning in order to fully experience the benefits of a Montessori education. If you are unfamiliar with the Montessori techniques or the process and philosophy you should acquaint yourself before submitting an application.
I have received a copy of the Parent Handbook from the school and promise to adhere to the policies and rules set by the school. I also understand the expectations and commitment of having a child attend GMS. I will contact the school in a timely manner to discuss any concerns of the school program or staff.
Parents’ Signatures__________________________________Date____________________
___________________________________Date____________________
Directress:___________________________________ Date____________________
POLICY ON PICKING UP A CHILD AFTER CLOSING
The School building is officially closed at 5:30 p.m. every day. If for any reason a child/children is not picked after thirty minutes (30 minutes) of closing, the staff on duty will first contact the parent(s), if they are unable to reach the parents, they will call the people listed on the emergency form, if they are unable to make contact with the people listed on the emergency contact form, they will call the police and the Department of social services.
GREENBRIER MONTESSORI SCHOOL
AUTHORIZATION FOR USE OF E-MAIL ADDRESS
If you would like to receive e-mails regarding school information, please provide the below information and we will add you to our e-mail contact list.
Name________________________________________________
E-Mail Address ________________________________________
___Yes, I would like to be added to GMS’s e-mail contact list
___No, please do not add me to your e-mail contact list
Signature ________________________________________ Date_____________
*Your e-mail address will only be used by GMS for school purposes. Your e-mail address will not be used
for solicitation purposes or be made available to other parties unless prior written consent is given by you.