New Family Packet STEP #3 of Enrollment

CURRENT families: If you currently have a student enrolled at LRA for the 2018-2019 school year, you do NOT need to complete this packet.

NEW families (2019 - 2020 school year): (A NEW family is anyone who does not have a student CURRENTLY enrolled at LRA.)

This packet is the THIRD step in enrolling your child at Lake Ridge Academy (LRA). Step #1 (online Registration Form) and Step #2 (payment of Fees*)

must be completed before this packet will be accepted.

Print this packet (or obtain a printed copy from LRA).

Fill it out completely, including notarization on page 4.

Return completed packet to LRA.

This packet must be completed and notarized before your child can attend his/her first day of school at LRA.

For your convenience there will be a notary at our Parent Orientation meet-ing on Thursday, August 22, 2019, if you would like to turn in your packet that evening.

Questions? Contact Stephanie Billimek at sbillimek@lakeridge.org or 972-613-2222 ext. 208.

*Fees: The Registration Fee is submitted along with the online Registration Form. The Supply Fee is due by May 9, 2019. If enrolling a child after May 9, 2019, both the Registration and Supply Fees will be paid together. Registration and Supply fees are NON-REFUNDABLE. Please go to www.lakeridge.org/lake-ridge-academy for a complete list of classes and fees.

LRA New Family Packet Page 1

Lake Ridge Academy New Family Packet 2019 - 2020

Enrollment and Security Agreement

I understand and agree that Lake Ridge Academy (LRA) will provide a Christian environment in which my child can learn and play. LRA is dependent on the full cooperation of parents to operate properly.

PUNCTUALITY: I understand and agree that school hours are 9:00am to 2:00pm. I will be punctual about arrival and pick up times, and I understand that a LATE FEE will be charged if my child is picked up after 2:10 pm at a rate of $10 for each 10 minute increment (after 2:10pm = $10 late fee; after 2:20pm = $20 late fee, etc.). Late fees will be paid by the following school day.

RECORDS: I understand that a copy of this Agreement and my child ’s Registration Form will remain in the school records while my child is enrolled and for 12 months after the date of withdrawal.

CURRENT CONTACT INFORMATION: I understand that it is my responsibility to give updates to the Director regarding any changes to my phone number, address, e-mail, my child’s medical information, Secu-rity Release List, etc.

FEES: I understand that the Supply Fee is due by May 9, 2019 (the Registration Fee has already been submitted with the online Registration Form). If I enroll my child AFTER May 9, 2019, I understand that both the Registration and Supply Fees will be paid together. Registration and Supply fees are NON-REFUNDABLE. A complete list of class fees can be found at www.lakeridge.org/lake -ridge-academy.

TUITION: I understand and agree that monthly Tuition Fees are due on the SECOND THURSDAY of each month (September - May) and that a $20.00 late fee will be charged if payment is made after this date. I agree to meet my financial obligations to the school, including late fees, until I withdraw my child.

PAYMENT OBLIGATIONS: I understand that monthly tuition is due whether or not my child attends all school days. Tuition is paid for the space reserved for my child, not my child’s attendance. Monthly tui-tion is calculated on a yearly basis and divided into 9 equal monthly payments. The number of days attend-ed each month will differ.

DROP-OFF: I understand and agree that I may drop off my child only when the teacher is present in the room.

SECURITY RELEASE LIST: I understand that my child will be released only to those people listed on my Security Release List (page 3). Those on my Security Release List may be asked to show a driver’s li-cense to the Director for authorization the first time they pick up. I further understand that it is my respon-sibility to instruct the Director to add or delete individuals from my child’s Security Release List.

LRA Enrollment and Security Agreement - continued on Page 2

LRA Enrollment and Security Agreement - continued from Page 1

PASSWORDS AND IDENTIFICATION: I understand that if I ask someone to pick up my child who is NOT on my Security Release List, I will need to provide verbal authorization to the Director ahead of pick up time AND the person picking up will need to know the Family Password, which is listed on my Security Release List (page 3). If the Password is not known by the person picking up my child, then my child will not be released until one of the child’s parents/guardians can be reached by phone for authorization. This procedure will be followed regardless of the amount of time and/or inconvenience involved.

I understand that ANYONE (including parents) not recognized by the staff may be asked to give my Family Password and show a photo I.D. before my child is released to them. I agree that it is important to be abso-lutely certain of identity, and it is better to err on the side of caution.

I understand that it is my responsibility to inform the Director if there is someone who is NOT authorized to pick up my child.

LRA will exercise the utmost caution in handling the release of children at the end of their class times. The Director and staff will strictly enforce these security procedures at all times. Your full cooperation will help us keep your child and his/her friends safe.

I understand that updates and changes to this Enrollment and Security Agreement can be made during the upcoming years that my child might be in attendance LRA and I agree to abide by any future changes or up-dates made at the Director’s discretion. A current copy of this Agreement Form can always be found on the LRA website and the Director is always available to answer questions that parents have about any changes or updates to this Agreement Form.

I have read the Enrollment and Security Agreement and my questions have been answered.

SIGNATURE OF PARENT OR LEGAL GUARDIAN DATE _____/_____/_____

________________________________________________________ DATE _____/_____/_____

DIRECTOR

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Create a FAMILY PASSWORD: _________________________

Please only give your password to trusted family or friends who you authorize to pick up your child.

Name DL# Relationship Phone #

Name DL# Relationship Phone #

Name DL# Relationship Phone #

Name DL# Relationship Phone #

Name DL# Relationship Phone #

Name DL# Relationship Phone #

EMERGENCY CONTACTS

Please list IN ORDER who you want us to call if your child becomes ill or has an emergency at school (INCLUDE YOURSELF)

Name: ____________________ Phone Number: _____________________

Name: ____________________ Phone Number: _____________________

Name: ____________________ Phone Number: _____________________

Name: ____________________ Phone Number: _____________________

Name: ____________________ Phone Number: _____________________

LRA does not have clinic facilities - children must be picked up as soon as possible if they become ill while at school.

SECURITY RELEASE LIST

Child’s Last Name: ______________________

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List below who is allowed to pick up your child... Drivers License needed for first time pick up!

EMERGENCY MEDICAL TREATMENT AUTHORIZATION and

FIELD TRIP PERMISSION FORM

(A note about Field Trips: Only Pre-K and Kindergarten students take field trips at LRA, and this is always with the prior permission of parents and always in the accompaniment of LRA parents and staff.)

List all children attending LRA: _________________________________________________

In the event that I cannot be reached to make arrangements for medical treatment, I authorize any repre-sentative of Lake Ridge Academy and/or Lake Ridge Bible Church to administer first aid, or, depending on the seriousness of the emergency, call paramedics and/or transport my child to the nearest hospital or emergency treatment clinic. I authorize and hereby give my consent for any necessary medical treatment, emergency or otherwise, furnished by any licensed physician, hospital, or emergency treatment clinic (health care provider), and I agree to pay all medical fees incurred in connection with the treatment of my child under the authority granted herein. I hereby release Lake Ridge Academy and/or Lake Ridge Bible Church, any health care provider, and any of their respective agents, employees, officers, or representatives from any and all liability for any action taken on behalf of my child pursuant to the terms of this medical au-thorization.

In addition, I hereby give permission for my child to participate in any activities which constitute a part of the Lake Ridge Academy program, whether such activities take place on Lake Ridge Bible Church property or elsewhere. I hereby grant my permission for my child to ride in any vehicle for any planned field trips of the Lake Ridge Academy program. I hereby release Lake Ridge Academy, its agents, employees, officers, or representatives from any and all liability which might arise out of my child’s participation in the Lake Ridge Academy program.

This form must be signed in the presence of a notary public.

Date

Signature of Parent or Legal Guardian (MUST BE SIGNED IN PRESENCE OF NOTARY PUBLIC)

SWORN TO AND SUBSCRIBED BEFORE ME THIS DAY OF 20

STATE OF TEXAS, COUNTY OF

NOTARY PUBLIC MY COMMISSION EXPIRES

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