November 28, 2017Registration Posted By : admin/ 0 comments / Under : Uncategorized Your Name (required)* Your Email (required)* Phone Number* Name of Child* School* Grade Entering* 12345678 Sex* MaleFemale Date of Birth* Parent(s) or Guardian(s)?* ParentGuardian Note: If child is the subject of a court custody order (ex., foster child, or divorce custody order), you must indicate the custodial person(s) and include a copy of court order signed by a judge. Name of Parent or Guardian 1* Telephone number of Parent or Guardian 1* Name of Parent or Guardian 2 Telephone number of Parent or Guardian 2 Home Address* Custody: If parents are divorced or separated, and/or the child is the subject of a court order, a certified copy (signed by a judge) of the most current document must accompany this form. If applicable, please indicate the court ordered custodial arrangement: Joint Custody (these require court order)Sole Custody (Only with prior written/verbal authorization)Full Custody to MotherFull Custody to Father Full Custody to: Joint Custody? YesNo Does non-custodial parent have the right to visit the program site or take the child from the program site? YesNo (these require court order)Only with prior written/verbal authorization Bill to and Primary Contact Please designate one person as the billing recipient who will make all enrollment/scheduling decisions and assume all financial responsibility. We cannot bill multiple people, even in cases of joint or shared custody. This section must be completed even if same as above, and must be signed by the person designated as financially responsible. Name* Cell Number* All billing is done by email; please indicate e-mail address to which bills should be sent.* Official address to which all correspondence should be sent:* I Agree to All Financial Responsibility* PARENT/GUARDIAN EMPLOYMENT INFORMATION Parent/Guardian #1’s Employer* Occupation* Address* Phone* Parent/Guardian #2’s Employer* Occupation* Address* Phone* ENROLLMENT SCHEDULE: (Include all time periods needed for each child in the family being registered) Requested Start Date (*see below):* Before School (7:30 to 8:30 a.m.)* Mon.Tues.Wed.Thurs.Fri.Per Diem (occasional use only) After School Mon.Tues.Wed.Thurs.Fri.Per Diem (occasional use only) Pickup Time 5 p.m.6 p.m. Extended Day Kindergarten Program (EDKP) First come, first served enrollment, with limited spaces available. Please check before and after school options (above) if those additional hours are needed. Mon.Tues.Wed.Thurs.Fri. AUTHORIZATIONS HCC needs two authorized emergency contacts other than parents. Contacts must be at least 18 years of age. These individuals must be able to drive and be able to take your child in case of parent unavailability, and be within 15-20 minutes of the program. Person #1: Name Relation to child Address Mobile Number Work Number Landline Person #2: Name Relation to child Address Mobile Number Work Number Landline TUITION ASSISTANCE (TAG) GRANTS Check here if you wish to receive an application for TAG funds. A limited number of Tuition Assistance Grants for families demonstrating financial need are available each year. Applications will be accepted and considered by the review committee in July and January of each year. Please call the office for further information. TO REGISTER: GENERAL INFORMATION FOR ALL PROGRAMS: Please submit this completed registration form, along with your non-refundable yearly registration fee and a signed Enrollment Agreement. REGISTRATION FEE SCHEDULE Early Bird Registration: $50/ 1st child* Registration for Fall rec’d on or before April 30, 2019 Late Registration: $100/ 1st child* Registrations rec’d after May 1, 2019 * Add $25 for each additional child in family. Your enrollment will be considered complete once all required entrance paperwork and fees have been received by HCC. In order to begin on the first day of the 2019-20 school year, children must be fully enrolled by May 31, 2019 at 3:00 p.m. Any child registered after August 16, 2019 will start the second week of school, thereafter, children registered by any Tuesday at 3:00pm may begin the following Monday. To Register in Person: (After initial EDKP Registration) HCC Office Lutheran Church of Our Savior 204 Wayne Avenue, Haddonfield, NJ For Info: (856) 429-1603 To Register By Mail: (Not available for EDKP) PO Box 107, Haddonfield, NJ 08033 ADDITIONAL INFORMATION FOR EXTENDED DAY KINDERGARTEN PROGRAM (EDKP) REGISTRANTS ONLY: EDKP space is extremely limited and registration is on a first come, first served basis. The 2019-2020 EDKP Registration will take place on February 13, 2019 5:00pm to 7:00pm. A non-refundable registration fee of $50 will be due at the time of registration. An additional $150 deposit will be required in late spring for each EDKP registrant in order to continue to reserve a space. These fees are non-refundable if the child is withdrawn.