Cubs Application

Part 1:

Calvary Cubs Registration Form

Applying For

Age Class:

Preschool: 3 Year Old Class (Tuesday and Thursday) Preschool: 4 Year Old Class (Monday, Wednesday, Friday) Kindergarten Class (Monday - Friday)

Child's Name:

Nick Name:

Birth Date:

Sex:

Child's Address:

Parent / Guardian:

Address (If different from Child):

Cell:

Email:

Parent / Guardian:

Address (If different from Child):

Phone:

Cell:

Email:

Is there anything you would like to make the staff aware of in regards to your child?:*

Known Allergies:*

PEOPLE AUTHORIZED TO PICK UP YOUR CHILD:

#1

Name:*

Phone Number:

Cell Number:

Relationship to Child:*

#2

Name:*

Phone Number:

Cell Number:

Relationship to Child:*

#3

Name:*

Phone Number:

Cell Number:

Relationship to Child:*

#4

Name:*

Cell Number:

Phone Number:

Relationship to Child:*

Calvary Cubs Staff will ask to see a photo ID for ANY individual that a staff member does not know. Please inform any of the authorized indivuduals to be prepared to present his/her ID. Children must be escorted to and from the building and must be signed in and out with the responsible person's name.

Calvary Cubs, a ministry of Calvary Chapel Westside, admits students of any race, color, national or ethnic origin to all the rights, privileges, programs and activities generally accorded or made available to students in the preschool programs. CCP or CCW do not discriminate on the basics of race, color, national or ethnic orgin in the administration of its eductional policies or other school administered programs.

I understand that any additional people needed to pick up my child should be submitted in writing to the Director of Calvary Cubs and put in my child's file. Unless someone is in my child's file, they will NOT be allowed to pick up my child.
I agree to accept full responsibility for fees and tution for my child to attend Calvary Cubs. Monthly preschool fees are required to be paid in order for your child to attend and remain in our programs.
I understand all preschool fees are to be paid on the first class of each month (September through May) There is a $25,00 fee for any returned checks, All returned checks are required to be settled immediately.
I understand all kindergarten fees are to be paid on the first class of each month (September through June) There is a $25,00 fee for any returned checks, All returned checks are required to be settled immediately.

I understand that Calvary Cubs rates are as follows,

Preschool 3-year old class - Tue. Thru.
$140.00/month
$1,260.00/year

Preschool 4-year old class - Mon. Wed. Fri.
$175.00/month
$1,575.00/year

Half-Day Kindergarten class - Mon. Tues. Wed. Thur. Fri.
$230.000/month
$2,300.00/year

I have read and understand the above informatin and agree to all that is stated:

Parent / Guardian:

Date:

Parent / Guardian:

Date:

Confirm Website ID (don 't touch):Website ID:

Cancel

Cubs Application

Applying For

PEOPLE AUTHORIZED TO PICK UP YOUR CHILD:

#1

#2

#3

#4

I have read and understand the above informatin and agree to all that is stated:

SERVICE TIMES

SUNDAY MORNING - 9 & 11AM (childcare provided)

WEDNESDAY SERVICE - 7:00PM (childcare provided)