�The Christian School with a Heart for the Home School Minded by LMPY8tz

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									                                Leesburg Christian School
                                    A ministry of Believers Baptist Church




               HOMESCHOOL UMBRELLA PROGRAM
              “The Christian School with a Heart for the Homeschool-minded Parent”




Leesburg Christian School, 21336 Evergreen Mills Road, Leesburg, VA 20175, Phone (703) 777.4220 Fax (703) 771.1626
                                    Leesburg Christian School
                                        A ministry of Believers Baptist Church




To Whom It May Concern:

Thank you for your interest in our Homeschool Umbrella Program.

Enclosed is the registration form and information pertaining to the program. Should you
decide to enroll, please fill the form out completely and return to LCS along with your
payment. The deadline for enrollment is October 10th.

Please note that the LCS Umbrella Program is designed for parents who want a Christian
education for their children, not who want to use it as a stepping stone to public school.

If you have any questions, please do not hesitate to call me or the secretary, Becky
Stewart. If you are only interested in the athletic program through our homeschooling
program, feel free to contact my daughter, Christa O. Schlichting, LCS assistant athletic
director.

God bless you as you endeavor to educate your children in His precepts and in His way.

In His Service,



Sharon Overstreet
Assistant Administrator
Leesburg Christian School

P.S. There is a $10 registration fee charged for each child enrolled, whether in the
academic or athletic umbrella program.




    Leesburg Christian School, 21336 Evergreen Mills Road, Leesburg, VA 20175, Phone (703) 777.4220 Fax (703) 771.1626
                                     Leesburg Christian School
                                         A ministry of Believers Baptist Church



           “The Christian School with a Heart for the Homeschool-minded Parent”

RECORD KEEPING ONLY (Deadline for enrollment is October 10th)
1ST Child - $150               Each additional child is $50 each.

($10 registration fee for each child.)                   $50 late fee per child after October 10th.
THIS ENTITLES YOU TO THE FOLLOWING:
School Records
         Parent must provide LCS with yearly attendance records, course objectives, and semester grades.

A School Administrator
         In the event parent receives a “contact” from county authorities, the school administrator is always available
         for help and advice. LCS works together with HSLDA in guiding enrolled parents, which is why it is
         required that parents join HSLDA when under the LCS homeschool umbrella program.

Field Trips
         If interested, one may hook up with the regular LCS field trips. However, parent must come along and help
         provide child’s transportation, if necessary. There may be an extra fee for the particular field trip.

Transcripts
         Students enrolled in record keeping may receive a transcript from LCS as long as minimum standards are
         met (4 yrs grammar/lit., 2/3 yrs math, 2/3 yrs. Science, ¾ yrs history, 4 yrs Bible, electives, all totaling 23+
         credits).. Transcripts will be issued at the end of the year in which the student has been enrolled upon request
         by parent(s). Graduating seniors may request a transcript at mid-term of their senior year. Transcripts will
         not be prepared for those not enrolled in LCS’s umbrella program. LCS will not make any effort toward
         preparing transcripts for students intending to go to public school. (LCS cannot assure parents that any
         public school will accept high school credits earned while under the LCS Umbrella Program.)


OPTIONAL CLASSES OR SERVICES
Stanford/PSAT Tests
         PSATs are offered in the fall and Stanford in the spring. Tests include administration and evaluation. Call the
         office to enroll your child. There is a registration deadline for each test.
          1ST Child - $25            2ND Child - $20            3RD Child - $20


School Pictures/Yearbook
         School pictures are offered in the fall. Parent may choose to put their child’s picture in the yearbook for a
         charge of $30 per child. Parents must pay for their own picture packs.

Graduation Ceremony/Diploma
         Homeschool umbrella seniors may choose to join other LCS students at graduation. If so, there is a fee of
         $175, which includes the cap and gown, diploma, ceremony and reception. Also, students must have met all
         LCS graduation requirements (see handbook).

Fine Arts Competitions through ODACS
         If interested, must contact LCS office no later than January 31st.

Academic Classes on Site
        High school English, math, history, science, or Spanish. Each academic course costs $1000.
        High school Bible, PE, choir (audition required), keyboarding, or art: $750 per year (no charge for PE if
         signed up for a JV or Varsity sport).
        Any junior high or elementary academic class is $500 per year. Non academic courses are $250.
        LCS Online- Contact Suzi Overstreet 703-777-4220 for more information



     Leesburg Christian School, 21336 Evergreen Mills Road, Leesburg, VA 20175, Phone (703) 777.4220 Fax (703) 771.1626
                                           Leesburg Christian School
                                               A ministry of Believers Baptist Church




                    Application for Homeschool Umbrella Program
                           (Academic and Record Keeping)

Date:                                                     Parent’s Name:
Address:
City:                                                     Zip:                         Phone: (H)
Email:                                                                                        (C)
      Child’s Name                         Age                    D.O.B                     Grade                               SS#




PLEASE CHECK ONE OF THE FOLLOWING:

            My family wishes to enroll in the LCS umbrella program for Record Keeping only.
 My family wishes to enroll/participate in the following classes or activities. Specify which grade level for:
 English:          Math:                 Science:            History:             Spanish:
 Choir:            Other:                                    Pictures in yearbook: Yes or No
(See accompanying sheet for costs. There is a $10 registration fee for each child.)
THE FOLLOWING CONDITIONS MUST BE MET IN ORDER FOR LCS TO PROCESS
YOUR APPLICATION: (Check if applicable.) Deadline for enrollment is October 10th. ($50 late
fee per child for applications received after that date.)

                         1. Membership in HSLDA (Homeschool Legal Defense Association). HSLDA maybe
                         reached at 540.338.5600. (Please send written confirmation of membership to LCS.)
                         2. Registration and payment for record-keeping enclosed with application(s).
                         3. Additional enrollment fees for optional classes accompanying this application ($25
                         deposit per class plus book fees and rentals.)
                         4. If student is seventh grade or higher, LCS commitment form must be signed.
                         5. Completed application signifies agreement of statement below.

                                            Statement of Faith and Practice

                                   We believe in the inspiration of the Bible;
                                  the triune God; the virgin birth, sinless life,
                                      substitutionary death, resurrection,
                                    and the second coming of Jesus Christ;
                                the sinful state of man and his need for Christ;
                                and the gift of eternal life through Jesus Christ.



           Leesburg Christian School, 21336 Evergreen Mills Road, Leesburg, VA 20175, Phone (703) 777.4220 Fax (703) 771.1626
                                             Leesburg Christian School
                                                 A ministry of Believers Baptist Church

        “The Christian School with a Heart for the Homeschool-minded Parent”

                      Application for Homeschool Umbrella Program
                                  (Athletic Participation)
Date:                                                        Parent’s Name:
Address:                                                                                    Phone: (H)
City:                                                        Zip:                           Phone: (C)
Email:                                                                                      Child’s Email:
           Child’s Name                      Age                       D.O.B                      Grade                            SS#



        PLEASE CHECK ONE OF THE FOLLOWING:

SPORTS TEAMS               SOCCER         VOLLEYBALL           BASKETBALL              BASEBALL             SOFTBALL          TRACK
Please circle one:         --Boys         --Girls              --Boys                  --Boys               --Girls           --Boys
                           --Girls                             --Girls                                                        --Girls
Please circle one:         --Middle       --Middle School      --Middle School         --Middle School      --Varsity         --Junior Varsity
                           School         --Junior Varsity     --Junior Varsity        --Varsity                              --Varsity
                           --Varsity      --Varsity            --Varsity



THE FOLLOWING CONDITIONS MUST BE MET IN ORDER FOR LCS TO PROCESS
YOUR APPLICATION:

   1. First year high school homeschool athletes must have an interview with the athletic director of LCS.
   2. Payment for athletic participation enclosed with application(s). Middle School is $75 per sport, Junior Varsity is $125 per
   sport, and Varsity is $175 per sport..
   3. Homeschool athlete abides by LCS dress code for all classes and functions, including hair cut (see school handbook on
   website, www.leesburgchristianschool.org ).
   4. All homeschoolers that participate in our athletic program are expected to attend all P.E. classes and practices, as well as the
   annual Athletic Banquet held in May. A PE grade will be given for each season of participation.
   5. Physical required from each athlete every two years for seventh-twelfth grade student athletes.
   7. If student is seventh grade or higher, LCS Student–Parent–Faculty Agreement form must be read and signed.
   8. Parents must be willing to help in fundraising efforts.
   9. Completed application signifies agreement of statement below.
   10. If student is on other athletic teams and there is a conflict, LCS must take priority.

                                         STATEMENT OF FAITH AND PRACTICE
                                           We believe in the inspiration of the Bible;
                                          the triune God; the virgin birth, sinless life,
                                              substitutionary death, resurrection,
                                            and the second coming of Jesus Christ;
                                        the sinful state of man and his need for Christ;
                                        and the gift of eternal life through Jesus Christ.




             Leesburg Christian School, 21336 Evergreen Mills Road, Leesburg, VA 20175, Phone (703) 777.4220 Fax (703) 771.1626
                                  Leesburg Christian School
                                      A ministry of Believers Baptist Church

       “The Christian School with a Heart for the Homeschool-minded Parent.”

                     Student – Parent - Faculty Agreement
I promise to uphold the standards of the school in dress and conduct. I will in honesty and
good spirit, accept correction in these areas knowing it will be given for my benefit.

I will abstain from use of tobacco (smoking or dip and other nicotine products), drugs,
profanity, vulgar language, alcoholic beverages, immorality (including sexual activity),
gossip, lying or talking critically about others, inappropriate words or pictures on any social
networking internet site, any type of bullying (physical or cyber),malicious or careless
destruction or property, stealing, ungodly music, ungodly dances, and any other activity
inconsistent with my Christian testimony.

I will work diligently on all class work, striving for the highest grade I can possibly make. I
will always do my own work and not cheat. I will not help another student cheat.

As a student at Leesburg Christian School, I will act in an orderly and respectful manner,
maintaining Christian standards in courtesy, kindness, morality and honest at all times, even
when away from the school. I will remember that how I act away from school reflects on the
Lord Jesus Christ and reflects on the testimony of Leesburg Christian School.

I will do my best to stay close to the Lord through attending a Bible-believing church, reading
my Bible regularly (hiding the Word in my heart) and praying, and telling others about the
Lord.

I will honor my parents as the Bible instructs me to do, and will honor the teachers at
Leesburg Christian School as well. I will attend all functions I am required to attend and in
proper attire.

I agree to abide by the above standards and other regulations expected of students enrolled at
LCS. I will not give the impression to students, parents or faculty that I am not in harmony
with the goals or standards of Leesburg Christian School.

This contract must be signed or initiated yearly by the student.


Student Signature                                            Date


Parent/Guardian Signature                                    Date


By signing this form, all seniors agree to participate in special activities and projects
specifically designed for their senior year (college trip, senior gift to school, Christian
Nation paper, etc.)




  Leesburg Christian School, 21336 Evergreen Mills Road, Leesburg, VA 20175, Phone (703) 777.4220 Fax (703) 771.1626
                                    Leesburg Christian School
                                        A ministry of Believers Baptist Church

          “The Christian School with a Heart for the Homeschool-minded Parent”

   Eighth Grade          Ninth Grade          Tenth Grade          Eleventh Grade         Twelfth Grade



Physician’s and Parent’s Certificate
Name of Student (Last/First):                                                                         Date:
Age:                     Height:             Weight:                         Gender:                  SS#:
Childhood diseases followed by complications:

Other illnesses or operations:
Injuries (Note abnormalities from concussions, fractures, dislocations, bad sprains, ruptures, etc.):

General Physique:
Note Abnormalities:
Bones:                    Joints:                    Arches:                 Muscles:                 Tendons:
Skin:                     Eyes:                      Ears:                   Nose:                    Throat:
Teeth:                    Abdomen:                   Genitals:               Hernia:
Lungs: Respiratory movements                                                 Rate:               Rales:
Any history of persistent coughs:                   Frequent colds:                              Pleurisy:
Pulse before exercise:                       After exercise:                 Two minutes after exercise:
Heart size:                                         Rhythm:                  Murmurs:
Blood Pressure: Systolic                                                     Diastolic:
Recommendations:

Signature of Examining Physician:                                                                     Date:
PARENTS PERMISSION
I/We give our permission for                                                    to participate in
organized high school athletics, realizing that such activity involves the potential for injury which
is inherent in all sports.
I/We acknowledge that even with the best coaching, use of the most advanced protective
equipment and strict observance of rules, injuries are still a possibility. On rare occasions these
injuries can be so severe as to result in total disability, paralysis or even death. It is agreed that
Leesburg Christian School, member schools and their representatives shall not be liable for injury
to students participating in activities under their supervision.

I/We acknowledge that I/We have read and understand this warning.

.
Signature of Student                                                             Date:


Signature of Mother (Guardian)                                         Date:


Signature of Father (Guardian)                                         Date:
   This form must be filled out and received in the LCS office before student may
                           participate on any sports team.



    Leesburg Christian School, 21336 Evergreen Mills Road, Leesburg, VA 20175, Phone (703) 777.4220 Fax (703) 771.1626
                                Leesburg Christian School
                                    A ministry of Believers Baptist Church

      “The Christian School with a Heart for the Homeschool-minded Parent”

                       Authorization to Give Medication
Student’s Name:                                                            Date:
Leesburg Christian School has my permission to administer the following drugs and medications:
Drug name and/or Prescription Number:
Dosage Amounts:
Times to be given:
Special instructions, if any:

MAY LCS ADMINISTER ROUTINE MEDICAL TREATMENTS (Tylenol, Ibuprofen, and
Bandages)?
           Yes        No (The office will attempt to contact Parent/Guardian before administering.)

LEESBURG CHRISTIAN SCHOOL AGREES TO NOTIFY THE PARENT/GUARDIAN
WHEN HIS/HER CHILD BECOMES ILL, AND THE PARENT/GUARDIAN AGREES TO
PICK UP THE CHILD AS SOON THEREAFTER AS POSSIBLE.

The parent/guardian authorizes Leesburg Christian School to obtain immediate medical care and/or
hospitalization of, the performance of necessary diagnostic tests upon, the use of surgery on, and/or the
administration of drugs to, his/her child or ward if any emergency occurs when he/she cannot be
located immediately. It is understood that this agreement covers only those situations which are true
emergencies and only when he/she cannot be reached. Otherwise he/she expects to be notified
immediately.

This authorization is effective until                    Signature of Parent/Guardian

                                         MEDICAL INFORMATION

Child’s Allergies (if any):
Child’s Doctor:                                           Telephone Number:
Family Doctor:                                            Telephone Number:
Medicine Child is taking:                                 Date of last Tetanus Shot:
Outstanding Medical History (Diabetes, Heart Disease, etc.):

                                   INSURANCE INFORMATION
                      (LCS Student accident insurance is secondary, not primary)

Insurance Company:                                 I.D. #/Policy #:                  Group #:
Insurance Company Address:
Subscriber’s Name:                                 Subscriber’s Place of Employment:
Subscriber’s Phone Number:
If your child needs to be sent home from school due to a local emergency (snow, tornado, etc.), and
you should not be home, to whom may he/she be sent? (If more than one, please state.)
Name:                            Address:                                     Phone:
If you do not have access to a radio during one of these emergencies, please note:
Destination where we can reach you:                                  or guardian

I AUTHORIZE LCS TO ALLOW MY CHILD(REN) TO PARTICIPATE IN ALL FIELD TRIPS. (THIS INCLUDES
PARTICIPATION IN JV OR VARSITY SPORTS EVENTS, IF MY CHILD IS AN LCS ATHLETE.)

Parent Signature:                                                                       Date:



Leesburg Christian School, 21336 Evergreen Mills Road, Leesburg, VA 20175, Phone (703) 777.4220 Fax (703) 771.1626
                                Leesburg Christian School
                                    A ministry of Believers Baptist Church



                              COURSE OF STUDY
To play on the LCS ball teams, students must be taking at least four credit hours for the year (Seniors are required
to take just one credit). Please fill out the form and send in with application and payment.

Date
School Year                                                                  Grade
Student Name                                                                 Birth date

For each subject listed below, list curriculum name and basic objectives.

Bible:


Language Arts (English, Spelling, Vocabulary):



Reading and Writing:



Mathematics:


Science:


History/Geography:


Foreign Language:


Fine Arts (Art, Music, Drama, etc.):


Other (Physical Education, etc.):




Leesburg Christian School, 21336 Evergreen Mills Road, Leesburg, VA 20175, Phone (703) 777.4220 Fax (703) 771.1626

								
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