2017-2018
Policies*, Acknowledgement &
Registration Form
Hours of Operation & Program Information: Programming is open to all enrolled Southwestern Consolidated Schools students grades K-6; from 6:00 am until school starts and after school dismissal until 6:00 pm. Included in the weekly fee is breakfast (am only), snack (pm only), homework time, tutoring, themed learning, and an amazingly fun time with friends. C.A.R.E Club will follow the school schedule for all holidays and will not provide programming on days school is closed (i.e. Fall Break, Winter Break, Spring Break, etc.). On certain Teacher Work Days, we may choose to open for your convenience, we will notify you in writing of those special open days.
Drop-Off/Pick-Up: No early drop-offs or late pick-ups will be allowed. Students must be signed out by the adult picking them up in the afternoon, furthermore, the adult MUST be on the approved list provided by the parent/guardian. Person picking child up must ALWAYS check in at the front desk, and wait in the designated area for their child(ren) to arrive. In the event that a child is dropped off before 6:00 am or not picked up by 6:00 pm a $3 per minute early/late fee will be accrued. For late pick-ups, if the parent/guardian is 15 minutes late, a courtesy call will be made to the parent, if there is no answer all emergency contacts will be contacted until reaching someone about the child's situation. If no one from the approved list is able to be reached, a final attempt will be made to reach the parent/guardian. If parent/guardian has not arrived at the school by 6:30 pm, Department of Children’s Services will be notified.
School Delays and Early Dismissals: Southwestern C.A.R.E. Club program will open at 8:00 am on days where 2 hour school delay is called, if the school proceeds to cancel school after 8:00 am, you will have one hour from the time of the announcement to pick up the child(ren), we will call you to ensure receipt of the message. There will be NO after school programming when school is dismissed early for any reason (excluding our regular early release day). In this case, your student will follow the school’s protocol for early dismissal and whatever instructions you have given the school. Under these circumstances, C.A.R.E Club is in no way responsible for making sure the child gets to the correct location.
Discipline: As a school affiliated Club, all school rules must be adhered to, including conduct, dress code, and electronic user rules, as set forth in the Southwestern Handbook. If these rules are not adhered to, the child will be subject to discipline as deemed necessary by the C.A.R.E. Club Director and School Principal. If a child has multiple disciplinary actions needed the C.A.R.E Club and School may determine that the child will no longer be allowed to participate in our activities.
Medical Care: If medical care, emergency or other, happens to be needed during the child’s stay and the parent/guardian/emergency contact(s) are not able to be reached, Southwestern C.A.R.E Club may act as directed by the medical information provided to the school during registration. Furthermore, we ask that you allow C.A.R.E Club to act as a decision maker in the event of a life threatening emergency and decisions need to be made in a timely manner.
Personal Electronic Devices: Personal electronic devices, including cell phones are not permitted to be used during the child’s stay at Southwestern C.A.R.E Club. All research for homework and afterschool projects will be conducted on school provided devices. If a child is using a personal electronic device during their stay, for research or for personal use, it will be held until the end of their stay and given to the parent/guardian when pick-up occurs.
Registration: Each student must have a completed registration form on file before attending the program. A non-refundable annual fee of $25 per child is due at the time of registration. Early registration for the upcoming school year runs from April 1st to June 1st with a discounted registration fee of $20 per child, returning users registration fee is $18 regardless of registration date. Child drop-ins are not allowed. If care is needed, the family must have a completed “Registration Form” and “Policies Acknowledgement Form” on file.
Payment: You may choose for your child to attend as needed, Part-Time or Full-Time, and may choose AM only, PM only, or Both Sessions. The fee schedule is as follows, per child, regardless of length of time present each day/week. If you choose for your child to come on an as needed basis, notification of the days they will be present is needed a minimum of 48 hours before their stay. Notification can be made via email (cpappano@swshelby.k12.in.us) by phone (317-729-5320 x 405) or by sending a note in with the child. During weeks where school is closed there will be no charge. During partial weeks rates will be adjusted accordingly (if school is open only 3 days due to a holiday, a full time account will only be charged part time rates). If part time is marked on the registration form and a child stays 4 days the account would be charged the part time rate + the “as needed” daily rate for the extra day; 5 days, the account will be charged at the full time rate.
Part-Time Full-Time Thursday As Needed
(3 days/week) (5 days/week) ONLY: (Not Thurs.):
AM Only: $8/day $8/day $8/day $8/day
PM Only: $32 $50 $14 $12
Both Sessions: $50 $75 $19 $17
Payment is due in advance of stay and may be made in person at the school, mailed to the school (Attn: CARE Club Director), or sent in with the child in an envelope marked “CARE Club”. An initial payment of $50 per child is required before the child’s first stay and deductions will be made to the account based on the care needs indicated on the Registration Form. Parent(s) will be notified weekly of their balance. The user’s accounts will NOT be allowed to have insufficient funds, if the account happens to go below $0 after a single stay, the child will not be allowed to return until funds have been received. In the case above, an invoice will be sent to the user every week and an insufficient funds fee of $5 will accrue with each unpaid invoice. A $25 Overdraft Fee will be added to all checks returned for insufficient funds.
Cancellation of Services: You may choose to cancel our services by providing written notice. If your child has not stayed with us at least once per calendar month, we will cancel your service for lack of use. In either cancellation case, a $10 Reinstatement Fee will be charged if you choose to return within the same school year.
Southwestern C.A.R.E. Club does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations. These activities include, but are not limited to, hiring and firing of staff, selection of volunteers and vendors, and provision of services. We are committed to providing an inclusive and welcoming environment for all clients, members of our staff, volunteers, and vendors.
Contact Information:
Mrs. Christi Pappano, Director
Southwestern Consolidated Schools
3406 W. 600 S.
Shelbyville, IN 46176
Phone: (317) 729-5320
E-mail: cpappano@swshelby.k12.in.us
* Policies are subject to change at the will of the Director, Principal, and Superintendent. All participants will be notified before changes are implemented.
Acknowledgements:
I (we) understand that I am (we are) obligated to pay Southwestern C.A.R.E Club for these services. I (we) understand how my (our) account is to be charged and will have sufficient funds available in the account. If I (we) fail to pay for these services I (we) understand that I (we) will be obligated to pay any costs of collection incurred by Southwestern Consolidated Schools in attempt to collect any money that I (we) owe them including any late fees, collection costs, court costs, or Attorney fees. ______(initial)
I (we) understand the rules for drop-off and pick-up, delays, and early dismissals. Furthermore, I (we) understand that it is not the responsibility of C.A.R.E. Club to ensure they get to the correct location. ______(initial)
I (we) understand the discipline rules and potential outcomes. ______(initial)
I (we) give permission for my (our) child(ren) to be included in photos or videos pertaining to C.A.R.E. Club activities. ______(initial)
My (our) child(ren) are allowed to participate in all activities planned by the C.A.R.E Club (including watching G and PG Rated movies). ______(initial)
I (we) give permission for the Southwestern Administrators and Nurse to allow access to needed medical information and forms. ______(initial)
I (we) understand and agree to the policy regarding personal electronic devices. ______(initial)
I (we) understand and agree to the policy regarding cancellation of services. ______(initial)
My child(ren) will be attending Southwestern C.A.R.E Club as follows:
⃞ AM Only $8/day
⃞ Part Time- PM Only (3 days) $32/week
⃞ Part Time- AM & PM (3 days) $50/week
⃞ Full Time- PM Only (5 days) $50/week
⃞ Full Time- AM & PM (5 days) $75/week
⃞ Thursday Only- PM $14/day
⃞ Thursday Only- AM & PM $19/day
⃞ As Needed- PM Only (not Thurs.) $12/day
⃞ As Needed-AM & PM (not Thurs.) $17/day
⃞ I am a Southwestern Consolidated School Employee
I (we) have read, understand, and received a copy of the policies set forth by Southwestern C.A.R.E. Club and I hereby authorize the release of information between Southwestern C.A.R.E. Club and Southwestern Consolidated Schools.
________________________________ ____________
Parent Date
________________________________ ____________
Parent Date
Southwestern C.A.R.E. Club Registration Form
Parent/Guardian Information:
First & Last Name _____________________________________________________
Relationship to student ___________________________________________________________
Address _____________________________________________________________________
Home Phone (_____)____________ Work Phone (_____)_______________
Cell Phone (_____)____________ Email ________________________________________
First & Last Name _____________________________________________________
Relationship to student ___________________________________________________________
Address _____________________________________________________________________
Home Phone (_____)____________ Work Phone (_____)_______________
Cell Phone (_____)____________ Email ________________________________________
Please explain any separation, divorce, or custody situation of which we should be aware:
__________________________________________________________________________________
__________________________________________________________________________________
Party responsible for tuition payments (First & Last Name) :_______________________________
Allergies/Rx, other pertinent information, or special needs your child may have to safely and effectively watch over them while in our care:
Child 1:______________________________________________________________________
Child 2:______________________________________________________________________
Child 3:______________________________________________________________________
Child 1 Name _________________________ DOB _____________ Sex: ⃞ Male ⃞ Female
Grade ________ Teacher _______________ Toilet Trained ⃞ Yes ⃞ No
Child 2 Name _________________________ DOB _____________ Sex: ⃞ Male ⃞ Female
Grade ________ Teacher _______________ Toilet Trained ⃞ Yes ⃞ No
Child 3 Name _________________________ DOB _____________ Sex: ⃞ Male ⃞ Female
Grade ________ Teacher _______________ Toilet Trained ⃞ Yes ⃞ No
Persons permitted to pick up your child:
1. ____________________________________/Phone(_____)__________________________
2. ____________________________________/Phone(_____)__________________________
3. ____________________________________/Phone(_____)__________________________
Persons NOT permitted to pick up your child: ___________________________________________
Emergency Contact Information
1. ____________________________________/Phone(_____)__________________________
2. ____________________________________/Phone(_____)__________________________
3. ____________________________________/Phone(_____)__________________________
At a minimum, this form must be signed by the parent/guardian responsible for tuition payments.
Printed Name ____________________________ Printed Name ____________________________
Signature_______________________________ Signature_______________________________
Date ____________________ Date ____________________