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THE ARK PRESCHOOL

Enrollment Card

Last_____________________________First____________________Middle__________Birth:mo.___day__yr.____

Mother_____________________________Address____________________________Tel._____________________

SS#_________________________City_____________________________Drivers License #_________________

Father______________________________Address____________________________Tel._____________________

SS#_________________________City_____________________________Drivers License #_________________

Father’s Employer_______________________________________________________Tel.____________________

Mother’s Employer______________________________________________________Tel._____________________

If parents cannot be reached in case of emergency, I authorize the school to call:

Name_______________________________Relation__________________________Tel._____________________

My child has permission to be released to those listed below:

Name_______________________________Relation__________________________Tel._____________________

TUITION FINANCIAL AGREEMENT

I agree to pay the sum of $____________________on the first of each________________for tuition to the Ark Preschool/Kindergarten. Immunization records must be on file. Also statements from child’s doctor stating that child is free from communicable disease and in good physical condition.

Serums required: DPT, Polio, MMR, Hepatitis B, and boosters (up to date).

PRESCHOOL/KINDERGARTEN POLICY

Tuition is due in advance. An extra charge of $5.00 will be made if tuition is more than 5 days past due. Our budget does not allow us to carry past due accounts. No cash refunds are made by The Ark Preschool/Kindergarten.

If a child is absent with tuition unpaid and the absence is unexplained, the child will be dropped after the first week.

ENROLLMENT FEES ARE DUE AND PAYABLE ONCE A YEAR.

PLEASE DO NOT ASK THE SCHOOL TO MAKE EXCEPTIONS TO ANY OF THE ABOVE RULES.

AGREEMENT: I hereby apply for enrollment with The Ark Preschool/Kindergarten and I certify that the information I have supplied is true and accurate. If our account becomes delinquent, I agree to be personally liable for this indebtedness. If this account is over 5 days old, I agree to pay a service charge of $5.00 weekly. If the account is delinquent and goes into collection, I agree to pay all legal fees and costs of collection.

I accept the policy and regulations of the school and release it from any liabilities for injuries and illnesses (on school premises) resulting from conditions or circumstances beyond its control.

Dated________________________Signed___________________________________________________________ Parent and/or Guardian