City of Lakewood School Age ServicesRegistration and Financial Agreement • January 23rd, 2020
Registration and Financial AgreementRegistration and Financial Agreement • April 4th, 2019
Tuition listed is for the full school year on a 9-payment plan. The first payment is due on September 1 with remaining payments due the first day of each month through May 1. Enrollment is based on availability.
Registration and Financial Agreement between Smart Stars Academy and .Registration and Financial Agreement • August 22nd, 2013
$ per month, which is due on the first of each month (a late payment charge of $50 will be added for payments made after 5th of each month.)
REQUIRED: Please read reverse side for registration and financial agreement before signing for completion.Registration and Financial Agreement • March 6th, 2024
REGISTRATION and FINANCIAL AGREEMENT: Please note the following important expectations for all students: 1. Your handwritten signature on this form is your agreement. When registering online, use of your ID and password is the same as your legal signature. All transactions on Workday are official records recognized by Northampton Community College (NCC). 2. By registering online, you accept full academic and financial responsibility for each course, and understand all college policies relating to academic, program and course requirements; 3. Schedule changes, billing and refund deadlines published in the College Catalog, Academic Calendar and on the NCC Website. Schedule changes must be completed according to the academic calendar deadlines. 4. Students who do not attend classes in person or online are responsible for any assigned grade (s) as well as the charges billed to the student account for all tuition, fees and other student charges, regardless of whether the student attends the
Cuisine (Kids Night Out) Registration Form and Financial AgreementRegistration and Financial Agreement • January 26th, 2018
Child Name Grade Class Option (circle)Primary Elementary Child Name Grade Class Option (circle)Primary Elementary Child Name Grade Class Option (circle)Primary Elementary
Registration and Financial AgreementRegistration and Financial Agreement • July 27th, 2021
Before Care1 day per week: 2 days per week: 3 days per week: 4 days per week: 5 days per week: 7:30 am to Start of School$ 50 /month$100 /month$140 /month$177 /month$202 /month Circle days care needed M T W TH F Allergies/Notes After Care1 day per week: 2 days per week: 3 days per week: 4 days per week: 5 days per week: Dismissal to 5:30 pm$102 /month$178 /month$213 /month$274 /month$332 /month M T W TH F Before & After Care5 days per week $501/ month Other Fees to be aware of:Enrollment Fee: Schedule Change Fee:Drop Fee: Late Payment Fee: Late Pick Up Fee:Loss/Damaged Materials Fee: $35/student or $50/Family$15 per instance$50 per instance$30 per month$1 per minuteVaries Requested Start Date if after September 1:
Registration and Financial Agreement 2019-2020Registration and Financial Agreement • June 19th, 2019
Christ the King’s Extended Day program provides several attendance options to choose from. Please carefully consider your circumstances, and then select the option that best suits your needs.
Registration DEADLINE is April 23rd by 10am!Registration and Financial Agreement • April 6th, 2018
Join us for “Reduce Reuse Recycle” Kids Night Out! Help spread the word about saving our environment! We will explore ways in which to help our environment, reduce our environmental footprint, and reuse materials to create something new. The evening includes crafts, activities and a movie!
Fall 2021-2022 Full-Day Registration Form and Financial AgreementRegistration and Financial Agreement • August 18th, 2021
There is a $175.00 non- refundable registration fee for new students. No registration fee is required for returning students. Tuition is due the first of each month. A 10% late fee will be added to your balance if payments are not received by the 5th of the month. Your child will not be able to attend beyond the end of the month unless your balance is current. The tuition cost is spread evenly over 12 months regardless of the number of school days in the month. At the time of enrollment, ½ month tuition is required if your child is not beginning immediately (to hold your spot). It will be applied to your first month’s tuition payment.
REGISTRATION AND FINANCIAL AGREEMENT – PINNACLE HEALTHCARE – PINNACLE MEDICAL GROUPRegistration and Financial Agreement • February 9th, 2021
It is understood that this authorization for medical treatment and/or testing is given in advance for any specific diagnosis, treatment of emergency care or testing that may be required by the physician in the exercise of their best medical judgment. I understand that it is my responsibility to know the specific benefits of my insurance coverage. Insurance coverage is an agreement between myself and my insurance company. Therefore, it is my responsibility to make payment for non-covered services, including co-payments or co-insurance and deductibles. I hereby authorize the release of any pertinent medical information or records to the insurance carrier, ifdeemed necessary to process my medical claim. I hereby acknowledge that I have received a copy of Pinnacle HealthCare’s notice of Privacy Practices. I further acknowledge that a copy of the current Privacy Practice notice is posted in the reception area, and that I will be offered a copy of any amended notice of Privacy Practice at
Riekies Private Pre-School Registration and Financial Agreement 2021Registration and Financial Agreement • October 19th, 2020
Name and contact number of Doctor: At which pre-school or day care facility was your child? Did your child receive all the immunisations Yes or No?:
Registration and Financial AgreementRegistration and Financial Agreement • January 14th, 2020
Week 1 June 1st - June 5th M T W TH F $ $ pd. Week 2 June 8h - June 12th M T W TH F $ $ pd. Week 3 June 15th– June 19th M T W TH F $ $ pd. Week 4 June 22nd- June 26th M T W TH F $ $ pd. Total $ $ pd.
Registration and Financial AgreementRegistration and Financial Agreement • March 1st, 2021
Registration and Financial Agreement 2017-2018Registration and Financial Agreement • September 20th, 2017
Christ the King’s Extended Day program provides several attendance options to choose from. Please carefully consider your circumstances, and then select the option that best suits your needs.
