Navy Hale Keiki School PRESENTS Summer Creativity Camps Kindergarten through Sixth Grade *Please return this form to the Administrative Office along with the enrollment form. Session I This summer we are expanding our horizons and our offerings. Students will have two separate blocks of instruction during summer school hours (8 a.m.-12 p.m.). Don’t worry! We will have time for snack and recess on our new playground too! Please rank your child’s top four choices (1=top choice). Please feel free to include an idea for a class and feel free to include that idea when ranking your child’s top choices. We will make every effort to accommodate everyone’s first choice based on a first come, first served system and instructor availability. _____ Sign Language _____Art _____ Sewing _____Music _____ Coding _____ Mad Science _____ Cooking I’d love to see____________________________and it would be my child’s _____ choice. Childs’s Name: ___________________________Grade Level for 2018-2019 Session II This summer we are expanding our horizons and our offerings. Students will have two separate blocks of instruction during summer school hours (8 a.m.-12 p.m.). Don’t worry! We will have time for snack and recess on our new playground too! Please rank your child’s top four choices (1=top choice). Please feel free to include an idea for a class and feel free to include that idea when ranking your child’s top choices. We will make every effort to accommodate everyone’s first choice based on a first come, first served system and instructor availability. _____ Art ______Photography _____ Hawaiiana ______Etiquette _____ P.E. _____ Cooking _____ Drama I’d love to see____________________________and it would be my child’s _____ choice Childs’s Name: ___________________________Grade Level for 2018-2019
Transcript
Navy Hale Keiki School PRESENTS
Summer Creativity Camps
Kindergarten through Sixth Grade *Please return this form to the Administrative Office along with the enrollment form.
Session I
This summer we are expanding our horizons and our offerings. Students will have two separate blocks of instruction during summer school hours (8 a.m.-12 p.m.). Don’t worry! We will have time for snack and recess on our new playground too! Please rank your child’s top four choices (1=top choice). Please feel free to include an idea for a class and feel free to include that idea when ranking your child’s top choices. We will make every effort to accommodate everyone’s first choice based on a first come, first served system and instructor availability. _____ Sign Language _____Art
_____ Sewing _____Music
_____ Coding _____ Mad Science
_____ Cooking
I’d love to see____________________________and it would be my child’s _____ choice.
Childs’s Name: ___________________________Grade Level for 2018-2019
Session II
This summer we are expanding our horizons and our offerings. Students will have two separate blocks of instruction during summer school hours (8 a.m.-12 p.m.). Don’t worry! We will have time for snack and recess on our new playground too! Please rank your child’s top four choices (1=top choice). Please feel free to include an idea for a class and feel free to include that idea when ranking your child’s top choices. We will make every effort to accommodate everyone’s first choice based on a first come, first served system and instructor availability.
_____ Art ______Photography
_____ Hawaiiana ______Etiquette
_____ P.E.
_____ Cooking
_____ Drama
I’d love to see____________________________and it would be my child’s _____ choice
Childs’s Name: ___________________________Grade Level for 2018-2019
NAVY HALE KEIKI SCHOOL SUMMER 2018 STUDENT ENROLLMENT FORM
STUDENT NAME: GRADE LEVEL IN 2018-2019
q Early Bird Care (Provides care from 6:00 a.m -7:30 a.m.)
q Before School Care (Provides care from 7:00 a.m. - 7:30 a.m.)
q Full Time After School Care (Provides care Monday - Friday from dismissal - 5:30 p.m.)
q Standing Reservation After School Care
(Provides care for up to 3 days a week from dismissal - 5:30 p.m. Please indicate days that you need care.)
MON TUES WED THURS FRI
q Early Bird Care (Provides care from 6:00 a.m -7:30 a.m.)
q Before School Care (Provides care from 7:00 a.m. - 7:30 a.m.)
q Full Time After School Care (Provides care Monday - Friday from dismissal - 5:30 p.m.)
q Standing Reservation After School Care
(Provides care for up to 3 days a week from dismissal - 5:30 p.m. Please indicate days that you need care.)
MON TUES WED THURS FRI
My child receives care for the following medical conditions or allergies:
q No medical condition or allergies (Please skip to the next section.)
q Yes, my child has the following medical condition(s). (Please check all that apply.):
My child takes the following medications: (Please annotate if these medications are take at home or school):
Signature of Parent/Legal Guardian Date
HEALTH/MEDICAL INFORMATION
In the event that child becomes ill or is injured at school, and I cannot be contacted, school authorities have my permission to contact and
release my child to the custody of the emergency contacts listed above.
Unless sooner revoked or terminated by me, this Consent for Emergency Medical or Surgical Care shall become null and void from and
after July 31, 2018.
I understand my obligation to submit in writing to the school office any changes in my contact information.
Consent for Emergency Medical or Surgical Care
Verification of any allergies or medical conditions is required from your child's physician.Students with severe allergies or those that take medication at school must have a
Form SH36 on file.
If symptoms of this medical condition or allergy are exhibited during school, I would like the staff to take the following action(s):
In the event that I cannot be contacted, I hereby give my permission and authorize Navy Hale Keiki School to obtain appropriate medical
or hospital personnel to provide emergency medical or surgical care for my child. I will assume the cost of any necessary medical or
surgical care.
SUMMER ENROLLMENT
Session 1 (June 11 - June 29)
Session 2 (July 2 - July 20)
Please check requested sessions and care options.
NAVY HALE KEIKI SCHOOL PHOTOGRAPHIC AND PUBLICITY PERMISSION FORM
PRINTED PUBLICATIONS Navy Hale Keiki School on occasion may wish to include captured imagery in printed publications. Images may be captured during events organized and hosted by the school using film photography, digital photography, video, or other medium and maybe used in the following publications. Examples of printed publications: • Navy Hale Keiki School bulletin • Navy Hale Keiki School leaflets and posters • Navy Hale Keiki School course brochures • Other Navy Hale Keiki School publicity material • Articles in local media, e.g. Star Bulletin, Navy News, Honolulu Magazine • Navy Hale Keiki School yearbook Please note that any printed publications and publicity material may be replicated on the school website.
ONLINE AND ELECTRONIC PUBLICATIONS Navy Hale Keiki School on occasion may wish to include captured imagery online and in electronic publications and on the school website. Images may be captured during events organized and hosted by the school using film photography, digital photography, video, or other medium and maybe used in the following publications. Examples of electronic publications: • Navy Hale Keiki School PowerPoint presentations • Navy Hale Keiki School prospectus • Navy Hale Keiki School course brochures • Navy Hale Keiki School website Any images used for generic/illustrative purposes on the website may be replaced with more recent images/film regularly. Images of students associated with particular news stories or events may remain on the school website in perpetuity, but will be archived as new stories and events are added. Please note that websites can be viewed throughout the world and not just in the United States where U.S. law applies.
CONDITIONS OF USE 1. We will not include personal email or postal addresses, or telephone or fax numbers on video, on our website or in any school documentation. 2. We may use group or class photographs or footage with very general labels such as "science lesson" or "students at play."
PLEASE COMPLETE AND RETURN THIS FORM TO THE SCHOOL This form gives consent for the school to use pictures of the person named below for media, general publicity, including (but not limited to) the school website, leaflets, posters, display materials, prospectus, and reports. Print Name: ________________________ Signed: ____________________________________________ Relationship to Child: ______________________________________ Date: ___________________ Print Child's Full Name: __________________________________________________________________ Please Select One of the Following: YES, I give permission for my child to be included in any publicity/publication material, in school and externally, with local media such as those mentioned in this form. I also give permission for any digital photography/video to be used for this use or for press releases. NO, I do not wish my child to be included in any publications and/or publicity materials either in school or externally with local media such as those mentioned in this form. I also do not wish any digital photography/video to be used or for this use or press release.
NAVY HALE KEIKI SCHOOL TUITION AGREEMENT – Summer Enrichment 2018
Signatures and initials from both guardians are required (if applicable). For Military Families Only: If you are not the active duty military member and you are signing in their place, a copy of your Power of Attorney will be required.
1. _____ Registration Fees are due at the time of registration and are not refundable or transferable. 2. _____ Navy Hale Keiki School does not generate billing statements. Tuition fees as well as full time before or after school care fees for Summer Session I are due by May 15, 2018. Tuition fees as well as full time before or after school care fees for Summer Session II are due by June 15, 2017. Accounts not paid in full by these dates, may result in disenrollment from the program. 3. _____ For those without a FACTS account, payments must be in the form of a personal check, cashier’s check, or money order. For all others, payments will be deducted from your FACTS account. NHKS is unable to accept any cash payment over $20.00. NHKS does not accept any form of credit card payments. Checks returned to the school for any reason will incur a $30.00 charge. The returned check will not be redeposited. Payment will need to be made by money order or cashier’s check. A second returned check will require that all future payments be made by money order or cashier’s check. 4. _____ The school must be notified of disenrollment no later than May 15, 2018 for Summer Session I and June 15, 2018 for Summer Session II. A copy of official military orders or Bill of Lading from the moving company along with the school’s disenrollment notice must be submitted to receive a tuition refund. 5. _____ Tuition refunds are not given for students involuntarily withdrawn from school due to uncorrected behavior. 6. _____ Tuition refunds are not given for students voluntarily withdrawn from school for reasons including, but not limited to, moving homes on island, receiving a geographical exemption for another school, vacations, or deployments. 7. _____ Children should be picked up promptly at dismissal times. A late pick up fee of $2.00 for every 5 minutes or fraction thereof will be assessed. After the 5th late pick-up, parents will be charged $10.00 for every 5 minutes or fraction thereof. (Refer to the Parent Handbook for additional information on late pick-up fees.) 8. _____ Children in After School Care who are not picked up by 5:30 p.m. will be charged $10.00 for every 10 minutes or fraction thereof after 5:30 p.m. (Refer to the Parent Handbook for additional information on After School Care dismissal policies.) I have read, understand, and agree to the above. In the event that my account is 60 days or more in arrears, and following unsuccessful attempts by Navy Hale Keiki School to communicate with and/or collect from me, I consent to Navy Hale Keiki School communicating with my Commanding Officer, Officer-In-Charge, or other employer, however denoted, concerning my indebtedness/delinquent account. If legal action is necessitated, I agree to pay any additional legal or collection costs. If my account is sent to collections, I agree that my account will be assessed an additional 50% of the outstanding balance. All above statements, #1-8, become applicable at the time of signing. Student’s Legal Name (please print): _______________________________________________________________________________________
Parent Name (print): _____________________________________ Parent Name (print): ____________________________________
Parent Social Security Number: ____________________________ Parent Social Security Number: ____________________________
Business Manager’s Signature: _______________________________________________ Date: ____________________
DROP OFF AND PICK UP PROCEDURES Children in Early Bird Care (EBC) and children in Before School Care (BSC), arriving before 7:30 a.m. need to be signed in at room 365-1 during session 1 and 364-2 in session 2. Students in all grades who are not enrolled in EBC or BSC must be walked in to their classrooms between the hours of 7:30 a.m. and 8:00 a.m. Please do not drop your children off at the curb. Please ensure that you park in the stalls marked "visitor" or in the spaces past the dumpster. If you arrive after 8:00 a.m., you will first need to sign your child in at the office, pick up a late slip, and escort your child to the classroom. Dismissal for all grades is 12:00 p.m. Children not staying for after school care may be picked up at the green benches. To promote safety and traffic efficiency, every child who will be picked up at 12:00 will be issued a poster board card to place on the passenger side dashboard or visor. The student’s name is printed in large bold letters across the card with a class code listed on the bottom. This placard will be given to you on the first day of school. Preschool and prekindergarten children will need to be signed out at this time and staff members will have clipboards with them at the loading area. Parents will not be allowed to sit on the green benches during dismissal. All parents must be in their car for release of their child(ren) or may sign them out inside the school gate. Any child who is picked up after 12:15 p.m. will be considered late. The late pick up fee is $2.00 for every 5 minutes or fraction thereof. After the 5th late pick-up, parents will be charged $10.00 for every 5 minutes or fraction thereof. Parents may call and ask for the child to be placed in the after school care program (pending space availability) for the current daily ASC fee. CLASSROOM AND TEACHER ASSIGNMENTS Classroom and teacher assignments will be posted in front of the office during the first week of each summer enrichment session. SCHOOL SUPPLIES AND REQUIRED ITEMS All school supplies will be provided by Navy Hale Keiki School; however, we do ask that you provide a back pack (non-rolling and large enough to hold a folder) as well as complete change of clothes in a labeled Ziploc bag. Please also ensure that each piece of clothing is labeled with your child’s name. A morning snack will be served to all children and an afternoon snack is provided for those children staying for After School Care. All children staying for after school care must bring a nutritious home lunch and a toothbrush. Preschool and prekindergarten after school care students also need a crib sheet and light blanket to cover their cot at naptime. DRESS CODE/SUMMER PROGRAM T-SHIRT
Navy Hale Keiki does not have a required dress code for its students. However, it is expected that students are dressed neatly and modestly. Footwear is required. If sandals are worn, they must have a back strap. Summer school t-shirts will be provided for your child on the first day of school in the size indicated on your enrollment paperwork. These shirts will be worn for field trips and as designated by the classroom teacher. MEDICATION/ALLERGIES The school staff is not permitted to administer medication of any kind, nor may students administer their own medication. Exceptions are made on a case by case basis and must be arranged with the administrative staff before the first day of school. Exception approval requires written instructions for administering medication and authorization by the student’s parents and licensed physician. Please contact the school office to obtain the appropriate paperwork. Students with allergies or asthma must provide the school with an allergy/asthma action plan. Students with severe allergies must have a State of Hawaii, Department of Education, Form SH36, Request to Store and Administer Emergency Rescue Medications or Daily, Routine, Scheduled Medication on file prior to starting school. This form must be signed by the attending physician and parent(s) and is available in the school office. AFTER SCHOOL CARE
Summer after school care hours are from 12:00 – 5:30 p.m. Reservations for care should have been indicated on the summer enrollment paperwork. Please contact the school office with any changes, new requests or cancellations. Casual care reservations will be accommodated pending space availability. Payments for casual care must be paid in full by the end of the session. The daily after school care fee is $17.75. Cancellations for casual care must be made by 7:30 a.m. on the day of the reservation in order to not be charged. Payments for full time care and standing reservations are required prior to the start of care. All children not picked up by 5:30 p.m. will be subject to a penalty fee of $10.00 for every 10 minutes or fraction thereof. Please refer to the Summer 2018 Tuition Schedule available on our website or call the office if you have any questions. We look forward to a summer of fun and adventure! Sincerely, Mrs. Jolynn Komoda Director of the Summer Enrichment Program
IMPORTANT ENROLLMENT AND PAYMENT DATES
March 15, 2018 (ongoing thereafter): Military and Civilian Summer Applications Accepted May 15, 2018: Summer Session 1 Tuition and Full Time After School Care Fees will be processed though FACTS if applicable.
Refer to the Summer Tuition Agreement for additional payment information.
June 15, 2018: Summer Session 2 Tuition and Full Time After School Care Fees will be processed through FACTS if applicable. Refer to the Summer Tuition Agreement for additional payment information.
WE ANTICIPATE FULL CLASSES. PLEASE DO NOT DELAY SUBMITTING YOUR APPLICATION. REGISTRATION IS ACCEPTED ON A FIRST COME, FIRST SERVED BASIS.
2018 SUMMER SESSION 1 & 2 IMPORTANT ENROLLMENT INFORMATION
DUE AT TIME OF REGISTRATION (NEW AND RETURNING STUDENTS)
Completed NHKS Summer Application and Registration Forms BOTH PARENTS must sign the Tuition Agreement
Registration Fee ($50.00)
Please be advised that incomplete applications will not be processed. Students will not be eligible to attend until all applicable forms have been signed and submitted.
AGE REQUIREMENTS
New students entering Navy Hale Keiki School must meet the following age requirements.
Preschool - 3 years old by 9/30/2018 Prekindergarten - 4 years old by 9/30/2018
Kindergarten - 5 years old by 9/30/2018
DUE BY MAY 15, 2018( SESSION 1) AND JUNE 15, 2018 (SESSION 2) (NEW STUDENTS)
Copy of student’s birth certificate Student Form 14 Health Record (or equivalent). Physical examination must be performed within 12 months of student’s first day of attendance. If a physical examination cannot be completed prior to the student’s first day, please provide a statement from your health care facility indicating the date of your child’s appointment. TB skin test performed within 12 months prior to student’s first day of attendance. (A separate sheet is not necessary if your child’s tuberculosis
exam is annotated on Form 14.)
Current immunization record including recent influenza immunization. (A separate sheet is not necessary if your child’s immunizations are annotated on
Form 14.)
Copy of Power of Attorney (Only if military spouse/sponsor is deployed or unable to sign.)
Copy of Dependant Care Certificate or Family Care Plan (Only for single parent or dual military families.)
DUE BY MAY 15, 2018 (SESSION 1) AND JUNE 15, 2018( SESSION 2) (RETURNING STUDENTS)
***Returning students do not need to provide birth certificate, annually updated Form 14, TB clearance, or immunization record.*** These documents are only necessary if there are changes in information.
GRADE TUITIONEARLY BIRD CARE6:00 a.m. - 7:30 a.m.
BEFORE SCHOOL
CARE7:00 a.m. - 7:30 a.m.
AFTER SCHOOL
CARE until 5:30 p.m.
DAILY AFTER
SCHOOL CAREPreschool-6th
grade(8:00 a.m. - 12:00 p.m.)
$500.00 $125.00 $53.00 $250.00 $18.75
GRADE TUITIONEARLY BIRD CARE6:00 a.m. - 7:30 a.m.
BEFORE SCHOOL
CARE7:00 a.m. - 7:30 a.m.
AFTER SCHOOL
CARE until 5:30 p.m.
DAILY AFTER
SCHOOL CAREPreschool-6th
grade(8:00 a.m. - 12:00 p.m.)
$500.00 $125.00 $53.00 $250.00 $18.75
SESSION 2: July 2 - July 20
NAVY HALE KEIKI SCHOOL
SESSION 1: June 11 - June 29
MONTHLY BILLING STATEMENTS ARE NOT PROVIDED
Please refer to this sheet and your copy of the Tuition Agreement for any questions regarding
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