I wish to enroll ______in the Extended Student Services
Program at (circle one): Boulder Oaks or Creekside School site.
1. I hereby agree to pay in advance one month’s tuition on the first day of each month. If tuition payment is not received by the 15th of the month, a $25.00 late fee will be charged. ______initial
2. I understand that should the tuition fee become delinquent by one week, immediate withdrawal of my child may be required until the entire overdue balance is paid in full plus a $25.00 late fee. Tuition payment delinquent after 30 days, E.S.S. reserves the right to dismiss you from the program. ______initial
3. I understand there are no refunds for illness, holidays or partial attendance.____ initial
4. I understand that if my child is scheduled to attend E.S.S. after school, I must notify E.S.S if my child will not attend on that day. ______initial
5. I understand that a two-week written notice will be required when withdrawing from the program. If two weeks notice is not given, then two weeks tuition will be charged.______initial
6. I understand that I will be charged an annual registration fee of $25.00 per family that is non-refundable. ______initial
7. I understand that if my child remains at the Extended Student Services center past 6:00pm, I will be charged, and I agree to pay $1.00 for each minute per child, after closing. ______initial
8. If the Extended Student Services staff is unsuccessful in contacting any authorized person(s) to pick up my child 30 minutes after closing, the San Diego County Sheriff’s Department will be called to pick up my child. ____ initial
9. I understand that ESS is not responsible for personal items brought from home. Any devices with known internet capability will not be allowed, and only appropriate games, movies and music will be allowed at ESS. This will be at the Coordinator’s discretion. _____ initial
10. I understand that I must sign my child in and out of the Extended Student Services Program each day. Should I wish to have my child released to another adult, I will send my written authorization, AND call the E.S.S. center. This adult will be required to show identification. ______initial
11. I understand that any child who attends the E.S.S. program will be required to follow the school rules. If a student commits a major infraction of the E.S.S. rules, as determined by the E.S.S. Coordinator an Incident Report will be written. After two Incident Reports: a conference with the child, parents, E.S.S. Coordinator, and program Director will be held to discuss ways to prevent another incident report from occurring. A third Incident Report: the child will then be suspended from the E.S.S. program for a total of five days. Parents will not receive credit of tuition fees during this suspended time period. If a student should then receive a fourth Incident Report they will be dismissed for a total of one calendar year. These Incident Reports shall be counted against a child from the time period of July through July. ______initial
12. I understand that the E.S.S. program and staff will not be held liable for student injuries incurred or student property stolen while my child is in attendance at E.S.S. ______initial
13. I will be financially responsible for payment of the E.S.S. tuition and any damage my child causes to personal or public property. ______initial
14. If my child’s schedule needs to be changed or adjusted, I will email coordinator before it will take effect.
______
Parent/Guardian Signature Date
Financially Responsible
______
Parent/Guardian Signature Date
Financially Responsible