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(one per child)
EMERGENCY & MEDICAL CONTACT INFORMATION In the event of illness, injury or an emergency where the parents cannot be reached, the following people can be contacted:
MEDICAL INFORMATION
I understand that every effort will be made to contact me in the event of an emergency requiring medical attention for my child. However, in the event of an emergency requiring medical attention for my child, and if I cannot be reached, or when delay would be dangerous to my child’s health, I hereby authorize Beth Jacob Preschool to transport my child to the nearest medical facility and/or hospital. I hereby authorize Beth Jacob Preschool to secure for my child the necessary medical treatment. I shall assume responsibility for payment for services.
Please initial above.
My child is currently taking on-going medication(s) and has the following pre-existing illness, allergies, or health concerns:
Except for first aid, personnel shall not dispense prescription or non-prescription medications to a child without specific written authorization from the child's physician or parent. When applicable, please request an authorization form from the office, or access the authorization form online which will include: date, full name of the child, name of the medication, prescription number, dosage (dates and times) while in school and signature of parent.
I give Beth Jacob Preschool permission to apply one or more of the following topical ointments/preparations to my child in accordance with the directions on the label of the container (initial next box)
Please initial here.
Please list any family members, nannies, babysitters or friends that may be picking your child up from school.
PARENT AGREEMENT WITH BETH JACOB PRESCHOOL
I understand that Beth Jacob Preschool is run under Bright from the Start licensing.
According to Bright from the Start, our state licensing agency, we must have signed parental agreement for mixed age classrooms. Therefore, I agree for my child to be in the same classroom as other children of different ages, for example in the case of early morning drop off or after care.
I understand that before my child starts school that I must provide (or give access to) up-to-date immunization records. (Note: Beth Jacob Preschool has legal and confidential access to all child immunization records.) YOUR CHILD MUST HAVE CURRENT IMMUNIZATIONS TO ATTEND BETH JACOB PRESCHOOL ON THE FIRST DAY THAT HE/SHE WILL ATTEND BETH JACOB PRESCHOOL. BETH JACOB PRESCHOOL CAN ACCESS YOUR CHILD’S CURRENT CERTIFICATE OF IMMUNIZATIONS from the Georgia Department of Public Health (form 3231).
I acknowledge it is my responsibility to keep my child's records current to reflect any significant changes as they occur, e.g., telephone numbers, work location, emergency contacts, child's physician, child's health status, infant feeding plans, carpool retrievers and immunization records, etc
You MUST fill out your child’s schedule below in order for your application to be processed
Full payment via has been mailed and made out to Beth Jacob Preschool. If paying in full now via check, please put check number above.
TUITION AND POLICY AGREEMENT
FINANCIAL OBLIGATIONS: Enrollment is confirmed after receipt of completed application AND the non-refundable application fee ($200 until February 14, after February 14 $300) and financial agreements has been completed. This fee does NOT go towards tuition.
MEMBER RATE: Tuition will be charged at the member rate for families who maintain full membership status and are current in their Beth Jacob dues as of June 2023 when billing for the year is established. Annual financial obligations to Beth Jacob must be kept current throughout the school year. Families who become Beth Jacob members after the start of the school year will receive the member tuition rate for the remainder of their tuition once their first dues payment has been submitted. Members who do not remain in good standing, as determined by Congregation Beth Jacob, are at risk for their tuition reverting to the non-member rate.
WAIVER: For themselves, their agents and their children, parents, by entering their signatures below on this form, waive any and all claims of every nature and description they, their agents or their children may have in the future against Congregation Beth Jacob Preschool, its administrators, teachers, employees or agents related to the Preschool unless such claims arise from the intentional wrongful acts or gross negligence of those parties otherwise released.
By signing above, you commit to paying the full year’s tuition as indicated by your program selection(s) on this application (except in the case of relocation away from the Atlanta metro area). Per Rabbi Ilan D. Feldman, your signature below enters you into a halachically binding contract with the synagogue. The synagogue will enforce this responsibility fully.
All previous made financial arrangements with Beth Jacob Preschool are null and void. If you need to apply for financial assistance, please fill out the Application for Scholarship located at the end of this registration form.
By signing this document, I agree to have my child up-to-date with his/her immunizations before the first day of school.
I hereby register my child as a student of Congregation Beth Jacob Preschool and agree to abide by all school rules and regulations, as outlined in the Beth Jacob Preschool Handbook.
Application for Scholarship If you are seeking a scholarship for tuition at Beth Jacob Preschool, please follow these directions carefully. You MUST
submit an application with the Registration fee BEFORE your Scholarship will be considered.
Please know that each scholarship application will be kept in complete confidence. We will be utilizing FACTS to assist us in determining eligibility for scholarship. Even if you do not choose to use FACTS as your payment for tuition, we will still need you to complete ALL the information in FACTS to help us best assess your financial aid.
Steps in applying for scholarship:
Sat, July 27 2024 21 Tammuz 5784
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