After School International (ASI) Contract: 2019-2020

Thank you for submitting your ASI contract online. Be sure to submit a separate contract for each child you're enrolling in the program. You'll receive a PayPal invoice from the Program Coordinator when the ASI office is open again in August. This will confirm your registration. Please note, your monthly payment must be received before your child starts the program, including any past due balances owed.

If you have any contract or payment questions, or need technology assistance, contact Eddie Edwards at eedwards@ismonterey.org or Lisa Wichael-Loomis at lwloomis@ismonterey.org. For Spanish language assistance call the front office at 831-583-2165.

Gracias por enviar su contrato de ASI en línea. Asegúrese de enviar un contrato separado para cada niño que se inscriba en el programa. Recibirá una factura de PayPal del Coordinador del Programa cuando la oficina de ASI vuelva a abrir en agosto. Esto confirmará su registro. Tenga en cuenta que su pago mensual debe recibirse antes de que su hijo comience el programa, incluidos los saldos vencidos adeudados.

Si usted tiene pregunta acerca del programa o el contrato, o necesita asistencia tecnológica, comuníquese con Eddie Edwards a eedwards@ismonterey.org o con Lisa Wichael-Loomis a lwloomis@ismonterey.org. Para traducir el mensaje a español, llame a la oficina al 831-583-2165.

Email address *
Student information
First Name *
One child per form
Your answer
Last Name *
One child per form
Your answer
Birth date *
IMPORTANT: Enter the year first in drop down menu
MM
/
DD
/
YYYY
Gender *
Grade level *
Grade entering in 2019-2020
Child's primary address
Street *
Include apartment or unit number
Your answer
City *
Your answer
State *
2 letter abbreviation if in US, e.g. CA
Your answer
Zip code *
Your answer
Student lives with: *
Check all that apply
Required
Who should we contact regarding monthly PayPal payments? *
This is the person we will contact first regarding any ASI payments.
Required
What email address should we use to bill monthly payments due via PayPal? *
Email addresses entered below will be used for all contact made regarding any payments.
Your answer
Mother or legal guardian #1 info
Mother last name, Mother first name
Your answer
Cell phone
Include area code, format XXX-XXX-XXXX
Your answer
Work phone
(include area code, format XXX-XXX-XXXX
Your answer
Home phone
Include area code, format XXX-XXX-XXXX
Your answer
Mother/legal guardian email address *
Your answer
Father or legal guardian #2 info
Father last name, Father first name
Your answer
Cell phone
Include area code, format XXX-XXX-XXXX
Your answer
Work phone
Include area code, format XXX-XXX-XXXX
Your answer
Home phone
Include area code, format XXX-XXX-XXXX
Your answer
Father/legal guardian email address
Your answer
Weekly schedule - enter pick up time below for each day your child will be attending ASI:
Monday *
Choose one
Tuesday *
Choose one
Wednesday *
Choose one
Thursday *
Choose one
Friday *
Choose one
Enter the date your child will start attending the ASI/HL program. Please note, students may not attend the program sooner then one week from the day your contract is submitted. *
Your answer
Read the information below carefully and initial in the box provided
Please initial all below
Payment contract *
This contract includes all details regarding enrollment in After School International (ASI). This includes scheduling, fees, and payments. Any changes that need to be made to your child’s contract, which results in a schedule and/or fee change, including dropping from the program for any length of time, must be submitted via email at least two weeks before the next billing period. If proper notice is not given, full payment will be due in accordance with the most current payment contract.
Your answer
Family discount *
A discount of $20.00 per month is available to those families enrolling two or more students in ASI. To qualify, each student must be attending ASI three or more days a week on a regular schedule. The discount is $20.00 per month for each additional student after the first child is enrolled at full price. Those receiving financial assistance are not eligible for family discounts.
Your answer
Late payments *
ASI payments are due by the 10th of each month. All late payments will incur an additional fee of $25.00 per month for each month a payment is late. Any payment that is delinquent for more than one month may result in the student being dropped from the program until the account is current. At the beginning of a new school year any past due accounts must be paid in full in order to enroll for care in the new year.
Your answer
Late pickup policies and fees *
Late pickup is defined as being more than five minutes late for your scheduled pickup time. A fee of $1.00 per minute will be charged after a grace period of five minutes. Payment is due to the Program Coordinator upon pickup. If this problem persists (occurring three or more times per semester), revisions to the payment contract will be made by the Program Coordinator and become effective immediately. This includes a $1.00 per minute fee, which will become effective at the exact pickup time with no grace period. Additionally, you should be aware that at 6:00 pm we will immediately start calling the people listed to pick up your child if we have not heard from you. If we cannot contact anyone on your pick up list, and we have not been able to speak to you by 6:15 pm, an ASI staff member will call the Seaside Police Department for assistance.
Your answer
Financial assistance *
Financial assistance is available to ISM families based on financial need. Applications for this program may be obtained on the school website and in the front office. Contact Lisa Wichael-Loomis, Operations Manager for application details, or ASI Program Coordinator for ASI fees, discount details, or payment information.
Your answer
Return check policy *
If your check is returned to ISM for insufficient funds the school bookkeeper will contact you. Additionally, a $25.00 service charge will be added to your balance. The new balance must be paid within two working days, in cash or by money order. If the balance is not paid, your child will be disenrolled from the program until proper payment has been received.
Your answer
Primary emergency contacts and individuals authorized to take child from the ISM premises (in addition to parents)
Individuals listed here will be contacted first if we cannot reach the parents. (2 names are acceptable in each contact box, i.e. grandmother/grandfather, aunt/uncle, etc.) You must enter at least one emergency contact.
Primary emergency contact #1 (other than parents) *
Last name, First name
Your answer
Phone #1 *
Include area code, format XXX-XXX-XXXX
Your answer
Relationship to student *
Primary emergency contact #2 (other than parents)
Last name, first name
Your answer
Phone #1
Include area code, format XXX-XXX-XXXX
Your answer
Relationship to student
Additional contacts and individuals (in addition to the above) authorized to take child from the ISM premises
Include as many contacts as you require up to 4
Additional emergency contact
Last name, First name
Your answer
Phone #
Include area code, format XXX-XXX-XXXX
Your answer
Relationship to student
Additional emergency contact
Last name, First name
Your answer
Phone #
Include area code, format XXX-XXX-XXXX
Your answer
Relationship to student
Additional emergency contact
Last name, First name
Your answer
Phone #
Include area code, format XXX-XXX-XXXX
Your answer
Relationship to student
Additional emergency contact
Last name, First name
Your answer
Phone #
Include area code, format XXX-XXX-XXXX
Your answer
Relationship to student
REMINDER: At 6:00 pm we will immediately start calling the people listed to pick up your child if we have not heard from you. If we cannot contact anyone on your pick up list by 6:15 pm, and we have not been able to speak to you, an ASI staff member will call the Seaside Police Department for assistance.
Allergy/medical information
Does your child have any allergies, including food or medicine allergies? *
Parents MUST supply a daily snack for any student with allergies or food intolerance.
If yes, list here
Your answer
Does your child take any medication? *
If yes, list here
Your answer
List any other important information we should have about your child’s health, personal needs or family situation *
If there is none, enter N/A
Your answer
Doctor or medical group name
Your answer
Doctor phone
Include area code, format XXX-XXX-XXXX
Your answer
Dentist or dental group name
Your answer
Dentist phone
Include area code, format XXX-XXX-XXXX
Your answer
Movie day participation *
Students have the opportunity to participate in a movie day up to twice a month. Movies normally tie to the theme for the IB learner profile unit for the week. All movies are family movies rated G or PG. Examples of PG movies we might watch are Frozen, Brave, and How to Train Your Dragon. Students and families may opt out of this activity. If students do not participate in the group movie day they will still be able to participate in another activity with full staff supervision.
A copy of your responses will be emailed to the address you provided.
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