CHABAD PRESCHOOL of NEW ROCHELLE

 ONLINE REGISTRATION AND TUITION FORM

1149 NORTH AVENUE, NEW ROCHELLE, NY 10804 

914-437-5762    

Please fill out a form for EACH child that you are registering at the school

Child's first AND last name:

Hebrew Name:

Date of Birth:

Please indicate class for enrollment: 18 months, 2s or 3s: 

Please indicate days for enrollment: 9:30-12:20 3 days (M,W,F - available for 18 mos. and 2s class ONLY), 5 days (2s and 3s) :

Please indicate "Magic Hour" for enrollment: 12:20-1:05(available for 2s, 3s and 4s classes) OR enrichment class 1:05-2:30 (available for 3s and 4s classes)

Father's Name:

Mother's Name:

Home Address:

Home Telephone #:

Father's Cell #:

Mother's Cell #:

Emergency Contact Name and Number:

E-mail Address- mother:

E-mail Addresses- father:

 Are parents divorced?

Previous Programs Attended:

Synagogue Affiliation:

Siblings:

Is there any special situation or characteristic concerning your child that is important for the school to be aware of (intellectual, emotional, physical)?

Please indicate if your child has asthma, food allergies or any other medical condition:

Would you be interested in purchasing lunch through the school (approx. $900 per year)?

Would you be interested in van service (approx. $1500 for the year)?

I give permission to use photographs of my child in print materials, on our website and/or e-mails.  Names of children are never listed. Agree or Disagree:

I give permission for my name and telephone number to be included in the class list that will be distributed.  Agree or Disagree

I hereby enroll my child in the Chabad Preschool.  I understand that the registration fee of $175 (waived for registration fee received by February 15th, 2012) plus a $750 tuition deposit (applied toward tuition) are non-refundable.

Parent Name and Date:

CHABAD PRESCHOOL TUITION CONTRACT.  PLEASE FILL OUT A FORM FOR EACH CHILD BEING ENROLLED IN THE SCHOOL.

(I/we) enroll our child for the 2011-2012 school year, subject to the terms of this contract.

Name:                                      Class:                                              Number of Days:                                Tuition $

Registration.............................................$175 (waived if registration is received prior to 2/15/2012)

Administration Fee.....................................$200 (waived if post-dated checks are received by 9/1/2012)

Tuition Deposit (applied toward tuition)..........$750

TUITION

Basic Program - 9:30-12:20:
2 Days: $2750  3 Days: $3600    5 Days: $5075 

Enrichment hours available for 3s: 12:20-1:05: $1200(enrichment days include baking, gardening, messy art, movement) 

Extended Day hours available for 3s: 1:05-2:30: 4 days (M-TH): $1800

NET AMOUNT DUE (total charges less credits & 5% discount for second child)

METHOD OF PAYMENT

One full payment in them amount of $

Two equal payments in the amount of $

ALL TUITIONS ARE NON-REFUNDABLE

ADDITIONAL TERMS AND CONDITIONS:

1. The tuition shown above is based on a check/cash discount amount.  If tuition is to be paid by credit card, please contact Rochel Butman at 914-437-5762 with the credit card information, and this agreement can be adjusted to show the full tuition (adding an additional 3%).
2. (I/We) agree that (my/our) child will not be allowed to attend classes unless tuition is kept current.
3. (I/We) understand that (my/our) child will be unable to attend the Chabad Preschool unless and until the state required good health and immunization certification is received from a physician.
4. Every child is enrolled for the entire school year.  The school cannot issue refunds or credits for illness, holiday, family vacations or early withdrawal.
5. In the event that the school is closed due to or resulting from any emergency or weather situation, there will be no make up days or refunds for days that the school is not in session.
6. The school reserves the right to terminate this agreement if it determines in its sole judgement:
   • that the child's behavior hinders or prevents the school staff from safely supervising the child, or
   • the child is detrimental to himself/herself or to others.
   • If such action is taken by the school, no refund will be made.
7. A recent color photo of your child must accompany your tuition payment.
8. Chabad reserves the right to use the name and photographs or any form of recording of the child for its brochure and promotional materials.

I HAVE READ, UNDERSTOOD, AND AGREED TO ALL CHARGES, TERMS, AND CONDITIONS SET FORTH IN THIS CONTRACT.  I also agree to allow my child to participate in all school activities on or off school grounds. Parent Name and Date: