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WEST END CHRISTIAN SCHOOL

Financial Agreement Form

 For 20 ____-____

Parent/Guardian: __________________________________                  S.S.# _______-______-_______

Parent/Guardian: __________________________________                  S.S.# _______-______-_______

                                                STUDENT  NAME                                                              GRADE EXTENDED CARE

                #1 ______________________________________                                  ________             yes / no         mo ___  hrly ___

                #2 ______________________________________                                  ________             yes / no         mo ___  hrly ___

                #3 ______________________________________                                  ________             yes / no         mo ___  hrly ___

                #4 ______________________________________                                  ________             yes / no         mo ___  hrly ___

FEES:  Contact office to verify your fees, total and payment schedule.

PAYMENT PLAN:                                                      TOTAL MONTHLY PAYMENT: $____________________

_____  10 MONTH  (August through May)

_____  Semester or Quarterly _____________                        Verification:  _______________________________________

_____  Other __________________________

Notes: ________________________________

AGREEMENT:

                1         I understand that I will be charged $50.00 late fee for payments made after the 10th day of the month.

2         I understand that I will be charged $35.00 fee for each check returned due to insufficient funds.

3         I agree to pay the amounts listed above and agree to keep my account current.

4         I agree to make monthly payments by the first day of the month or as contracted above.

5         I understand that when my account becomes 30 days overdue, my child may be suspended from class.

6         I understand WECS Policy is that should an account be delinquent for any fee,

                        student grades and/or records will not be released to any parent, guardian or school until paid in full.

7         I understand registration fees are nonrefundable, unless the student is denied admission.

8         I understand school policies or any fee may be amended, when deemed necessary during the school year.

My signature indicates that I have read the above, and agree to abide by all the provisions.

SIGNATURE:  _______________________________          __________________________                    _________                                                Parent/Guardian                                 Parent/Guardian                                 Date

Parent/Legal Guardian Statement

In making application for my child to attend West End Christian School:

§                     I agree to support the spiritual, moral, dress, and disciplinary standards of the school as outlined in the Parent-Student and Athletic Handbook.

§                     I have read WECS’ Mission Statement and desire to have this type of education for my child.

§                     I am willing for my child to receive training in the historic doctrines of the Church, and support the school in its endeavor to encourage and guide my child in applying those doctrines to life.

If my student is accepted:

§                     I agree to assume the responsibility for my student’s education by supervising homework and keeping in regular contact with my student’s teachers.

§                     I agree to support WECS, to the best of my ability, through attendance and participation in various school activities.

§                     I agree to support, to the best of my ability, the school’s entire program through prayer, time, and financial gifts. I understand that the school depends upon gifts above and beyond the tuition and thus conducts community fundraising, and that the school expects participation by all parents.

§                     Further, in the event my child becomes ill or is injured while under school supervision, I approve the school authorities to take the following steps:

1.       Contact a parent of the student and follow his/her instructions.

2.       Contact the student’s physician and follow his/her instructions, in the event neither parent can be reached.

3.       Use their own discretion in contacting a properly licensed physician and following his/her instructions, in the event neither the parents nor the student’s physician can be reached.

If, in the opinion of a properly licensed and practicing physician, my child needs medical or surgical services which require my consent before being supplied and I cannot be reached, I hereby authorize, appoint, and empower the Superintendent or his/her designee to furnish on my behalf such written or oral authorization as may be so required. Further, I release the Superintendent, and West End Presbyterian Church from any liability that might arise from the giving of such authorization, it being my desire that my child be furnished with such medical or surgical services as soon as reasonably possible after the need arises.

§         I give permission for my child to take part in all school activities, including sports and school-sponsored trips away from the school premises and I absolve the school, and West End Presbyterian Church from liability to me or my child because of any injury to my child at or away from school or during any school activity.

§         I understand that this application cannot be considered without the application fee and that, if my student is accepted, I agree to the payment and/or refund policies as listed in the school’s fee schedule and tuition policy.

§         I understand that, if I voluntarily withdraw my student or my student is dismissed once classes have begun, I am responsible to pay the full tuition to the end of the month according to the schedule in the current tuition policy. Records cannot be forwarded to another school until all financial obligations have been satisfied.

§         WECS accepts students without discrimination in regards to race, creed, sex or national origin.  WECS reserves the right to decline admission based on both objective and subjective factors.  The school has the right to dismiss a student who is found to be out of harmony with the goals and ideals of the work and life of WECS.  An invitation to withdraw can be issued whenever the general welfare demands it, even though there may be no special or specific breach of conduct.  Respect and cooperation of the spiritual standards and academic process is expected of all students, with the encouragement and support of the parents.

§         If legal action is required to collect tuition, I, the undersigned, will be responsible to pay collection fees, attorney’s fees and court costs.

§         I agree to hold the church, school and its agents harmless for the liability to my child or any guardian or parent thereof, because of any claims on behalf of my child, against the church, school or any agent thereof because of injury or alleged injury to my child.  Should legal action, for any reason, be taken against West End Presbyterian Church of Hopewell, Va., its employees, or agents thereof on my child’s behalf and the church and/or school is found not at fault, I agree to pay any and all attorneys fees, court fees, damages, lost employee time, or other costs that are incurred to defend itself against such action.

My signature below indicates that I have read, understand, and agree with the Parent/Legal Guardian Statement.

_______________________________________________   _____________________________________________________

  Father/Guardian’s Signature                         Date             Mother/Guardian’s Signature                                  Date