2011-2012 After-School & Enrichment Class Registration and Agreement

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Please fill out online 1) this registration form and 2) an Emergency/Permission Form

Prepayment is required. Please see fee schedule to choose services. Please fill out one form per child

* Beginning Date

Please check one:

Original Registration

Schedule Change Request

Cancel Previous Registration

* Child's First Name

* Child's Last Name

Sex

Age

Date of Birth

* Street Address

Address Line 2

* City

* State

* Zip Code

Mother/Guardian name

Mother/Guardian Email address

Mother/Guardian Cell Phone

Mother/Guardian Work Phone

Mother/Guardian Home Phone

Father/Guardian name

Father/Email address

Father/Cell Phone

Father/Work phone

Father/Home phone

Formatted Text

Fees (All programs)

A registration fee of $25 is due for each child’s application, “each” school year. Registration for all programs is subject to availability.

Basic After-School Program
The After School at Spence's Farm is centered around the main farmhouse and our participants have use of the extensive facilities and grounds located at the farm. Each day after arrival, the children settle in and eat the nutritious snack you have provided. We help them with their homework and give them an opportunity to play outside (weather permitting). At 4pm the children start focused activities which include gathering eggs, working in the garden, feeding the small animals, hiking, creative expression, cooking, and more.

Fees are outlined in detail in the Parent Handbook. Please review that information carefully.

Basic After-School Fees

1 day/week/month     $ 80/month (27.50/single day)
2 days/week/month   $144/month (25.50/single day)
3 days/week/month   $198/month (24.50/single day)
4 days/week/month   $245/month (23.50/single day)
5 days/week/month   $285/month (22.50/single day)

*After-school monthly payments are calculated based on the number of school days from September to May and are set at a Fixed Monthly Rate. Fees in August and June are charged per day according to the schedule above.

* Mini Camp Days (held on Teacher workdays and Holidays) are not included in monthly payments, however, we do offer free afternoon extended care to our After School kids. Go to the Mini Camp Registration page to sign up.

*Sibling Discount: Additional Siblings get a 10% discount on Basic After-School tuition only.

Enrichment Classes
The enrichment classes are only available on certain days and are held from 4:00-5:30pm. On the days when your child will be at the farm, but NOT in an enrichment program please show them as being in the After-school care program.

Pottery (Tuesdays & Thursdays) - $140/month
Woodworking (Mondays, Wednesdays and Fridays) - $140/month
Spanish For Fun (Tuesdays) - $85/month
Beginner Horsemanship $165/month, $35/class
Advanced/Intermediate Horsemanship $185/month, $40/class

*Monthly prices are based on enrollment of 1 day/week, and include pick-up, pre-enrichment care, post-enrichment care up to 6pm. Single class rates DO NOT include pick-up or any care outside of class time.

*Enrichment Classes are still held at their scheduled time on teacher workdays and holidays (when farm is not closed), even though there will be no after-school pick up. There will be no refunds or make-up classes for those that don't show.

*We hold the right to cancel any class that does not have a minimum of three students pre-registered

Transportation

We pick up at the following Elementary Schools: Carolina Friends School, Carrboro, Ephesus, Estes Hills, Forest View, Frank Porter Graham, Glenwood, Grady Brown, Hope Valley, Mary Scroggs, McDougle, Montessori Day School, Morris Grove, New Hope Elementary, Rashkis, and Seawell. The Middle Schools are: Grey Culbreth, McDougle, Phillips, and Smith.

* TRANSPORTATION:

I want my child to be picked up from school by Spence's Farm

I will drop off my child at Spence's Farm

* School Child will attend 2011-2012

If other please specify:

Grade

Enrichment Class
(ages 8+)

	Woodshop
Monday
Wednesday
Friday
No preference

Enrichment Class
(all ages)

	Pottery
Tuesday
Thursday
No Preference

Horsemanship Enrichment Program/ Lessons (ages 6+)

	Beginner	Advanced Beginner	Intermediate
Monday
Tuesday
Wednesday
Thursday
Friday
No Preference (weekdays)
Saturday (Beginner and Adv. Beginner only)
Sunday (Intermediate only)

Comments:

* I agree to comply with the following Spence's Farm policies, see Parent Handbook for more details:

I understand that I will be emailed a monthly invoice and agree to remit payment by the 25th of the month prior to when my child is enrolled in programming. I understand if I have not paid by the 1st of the month in which my child is registered for programming, my account will be charged the monthly fee plus a $25 late fee and I may risk losing my space if my payment is not accepted.

I understand Spence’s Farm will be doing focused activities each day between 4 and 5:30 pm, therefore I will call or send a note with my child to inform Spence’s Farm if my child needs an early pick-up.

I agree to call Spence’s Farm by 12pm on the days my child will NOT be picked up from school. I understand that if my child is not at the pick-up spot in a timely manner the Van Driver will make 1 telephone call to the school administrative office and 1 telephone call to the Spence’s Farm office regarding my child’s absence and then they will leave the school. I will be charged $10.00 for each time I do not call the office to inform them of my child’s absence.

I agree that this contract will remain in effect until a new Schedule Change Request (using this form) has been received by Spence’s Farm. If I want to withdraw from a program, I agree to give my withdrawal in writing. I agree to give two weeks notice before the end of a month to avoid being charged for a new month, otherwise I will be responsible to be charged for another month.

I understand pickup is no later than 6:00 pm and I agree to pay $15 for each 10 minute block past 6 pm.

I have read the Parent Handbook and I agree to Spence’s Farm policies and procedures.

I give permission to Spence's Farm to use photos of my child/ren in their promotional literature.

I understand as a current After School Parent, if I send my child to Mini-Camp, the $10 Mini-Camp PM Extended Care fee will be waived.

I understand that Spence's Farm does not give refunds. Credit will be given when appropriate.

* Signature

Date

How did you hear about Spence's Farm After-Care Program?

If referred by a friend or family member please tell us their name so we can thank them.

Spence's Farm 6407 Mill House Road Chapel Hill, NC 27516
phone: (919) 968-8581 fax: (919) 968-7618
email: spencesfarm@aol.com

* Indicates Response Required

attended camp	roadside sign
attended a festival or event	referred by a friend or family member
web search	publication
other (please specify)