Jackson-After School by csgirla

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									Jackson After School “JAS”
Student Registration Packet

PLEASE COMPLETE THIS PACKET AND RETURN IT AND THE FEES TO JACKSON’S MAIN OFFICE PRIOR TO AUGUST 10TH. SPACE IS VERY LIMITED SO REGISTER EARLY!

PROGRAM STATEMENT The program operates on a 15 to 1 staff ratio, designed with the working parent(s) in mind. To qualify, children in this program must be able to function in a group setting to ensure the safety and well being of all children.

www.Jacksonafterschool.com

Jackson After School
1325 Mt. Paran Road Atlanta, GA 30327 404-433-6126
www.Jacksonafterschool.com

Dear Parent or Guardian, This registration packet must be completed and returned before your child can attend Jackson After School.  For full-time care, the $45 registration fee and half of the first month’s tuition ($160) must be attached to the registration packet. (Total of $205.00.)  For Drop-in care, the $45 registration fee must be attached to the registration packet. Your child is NOT registered unless payments are received. Registration packets can be dropped off in the main office of W.T. Jackson Elementary Main Campus or can be mailed to the address above prior to August 10th to ensure program participation on the first day of school. If you have any questions, concerns, or comments, please feel free to call (404) 433-6126 or email at kimbishop@bellsouth.net.

Sincerely,

Kim Bishop Owner/Director

Jackson After School
An After-School Program at W.T. Jackson Elementary
The Jackson After School Program is a State Licensed After School Program directed by CERTIFIED TEACHERS. We offer your children guidance in areas of academics and creative arts. Our program is one of quality, focusing on the needs of your child(ren). Hours: 2:30pm – 6:00pm Location: W.T. Jackson Elementary School The program offers: Low ratios / 15 to 1 Certified Teachers Professional Staff Homework Hour

Art Activities Nutritious Snacks Crafts Sports

Computer Games Science Dance

With so many choices in after-school care, parents must look for quality. We offer a program staffed with Certified Teachers; one that is designed to meet the needs of your child. We provide a balance for your child. There is structured homework time as well as many opportunities for play. Homework hour is from 3:00pm – 4:00pm daily for grades 2-5, 4:00-4:45 for grades k-1. We involve all of the teachers at Smith by following up on our after-school students to make sure each child is successfully completing his/her homework on a regular basis. Playtime is essential for children in an after-school program. We provide safe, structured activities, as well as free play time. Children in the Jackson After School Program have the opportunity to socialize, run, play, and just be kids. Smith After School is a State Licensed organization owned and operated by Kim Bishop, former Smith Teacher. We serve children in Kindergarten through 5th grade. All money is directed back into the program to provide supplies and salaries. We make annual contributions to Smith Elementary School. Our location is convenient and safe. Our facility is located at the Jackson Elementary School. Children are not bused to another location. Cost: Registration Fee: $45.00 per family Tuition (1st child): Monthly $320.00 (2nd child): Monthly $220.00

Drop-in Care (attendance 3 days or less/week) $22.00 per day For more information, stop by the Jackson Elementary office or contact us at (404) 433-6126, or email kimbishop@bellsouth.net. We look forward to working with you and your child.

Jackson After School
(JAS)

Design and Operations Plan
The Jackson After School Program is a State Licensed After School Program directed by certified teachers.

JAS Mission:
The mission of JAS is to provide a healthy, safe environment in which certified teachers provide quality care to all students. Students are given the opportunity to participate in enrichment activities, study time, physical exercise and homework help sessions.

Program Description and Daily Activities:
JAS is an after school program serving Jackson Elementary School. After School Care is conducted during the school year from 2:30-6:00pm. The safety and interests of your children are our primary concern. Most staff members are current or former teachers and employees of Jackson Elementary School.  Homework Time- The JAS program features homework time as an integral part of the program. This enables children to complete their homework, allowing for family time at home in the evenings. Even though children have assistance with homework, one-on-one tutoring services are available for an additional fee. Enrichment- The JAS program offers computer time, arts and crafts, physical education, games, sports, homework help, and tutoring. Other enrichment activities are offered at Jackson by private businesses, all of which are available to JAS students. Convenient Hours- The JAS program is conducted during the school year from 2:30 until 6:00 PM, Monday through Friday. We follow the APS calendar. We are closed when the school is closed, including early release days and teacher planning days. Well-Trained Staff Members- JAS staff members are current or former Jackson teachers and employees. Staff members are CPR/First Aid trained and receive additional training throughout the year. Affordable Fees- Providing quality care at an affordable rate is one of our primary goals. The tuition is $320 per month. Drop-in care is available at $22.00 per child per day. All families must pay a registration fee of $45.00. Program Statement- The program operates on a 15 to 1 staff ratio. Children must be able to function in a group setting to ensure the safety and well being of all children. Refusal of care- Jackson After School reserves the right to discontinue child care to any student enrolled in the Jackson After School Program at any time for any reason other than the basis of race, color religion, gender, national origin, age, veteran status, disability, marital status, or sexual orientation in any of its employment practices, educational programs, services or activities.

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Jackson After School
Tuition Policy
1. Tuition for the Jackson After School Program is as follows: $45.00 non-refundable registration per family $320.00 per month ($220.00 per month for each sibling) $22.00 per day for drop-in care (3 days or less/week) Payment options: One payment of $320.00 per month or 2 payments of $160 per month for the first child. One payment of $220.00 per month or 2 payments of $110 per month for each additional sibling. Drop-in Care payment of $22.00 per day is due the day care is provided. 2. Jackson After School accepts Visa, MasterCard, Discover, Checks, Money Orders, and Cash as payment. You can also pay on line at www.Jacksonafterschool.com via Paypal. A $10.00 processing fee is charged for all Visa, MasterCard and Discover payments. 3. One half of the first month tuition is due at the time of enrollment. This is applied towards the August tuition.
4. Payments are due on the 1st (and 15th of each month if 2 payment option is selected). Tuition received after the 5th and 20th of each month is late and accounts will be charged $25.00.

5. A late pick-up fee of $1.00 per minute is charged if your child is not picked up by 6:00pm.
6. If a student is picked up late more then five times they will not be allowed to return to Jackson After School.

7. In the case of a returned check, a $35.00 penalty is charged. If JAS receives three returned checks from your account, then you will be required to pay weekly fees by money order, credit card or cash for the remainder of the year. 8. If tuition goes unpaid for two weeks, then your child will not be allowed to attend the program until this amount is paid in full. If this is not done, childcare in the JAS program will be discontinued and the student will be replaced with one from the waiting list. 9. In the case of hardship, please contact Kim Bishop to make payment arrangements.

I understand and agree to the above financial policies and obligations.

___________________________________ Parent/Guardian signature

________________ date

Jackson After School
Please complete all information below:
Your child is not registered unless all information is complete. 1. Student Name _______________________________________ Age _______ Sex _______ Grade _______ Birthday __________

2. Student Name _______________________________________ Age _______ Sex _______ Grade _______ Birthday __________ O Father O Father O Other ______________________ O Other ______________________

Home Address __________________________________________ Home Phone ______________________ Child’s Living Arrangements: O Both parents O Mother Child’s Legal Guardian(s): O Both parents O Mother
****Submit a copy of divorce decree (if applicable)

Mother’s Name ________________________________________________Home Phone _________________ Mother’s Home address (if different from child’s) _______________________________ Work Phone ____________Cell ______________email_______________________________________ Employer/Occupation and address_____________________________________________________ ____________________________________________________________________________________ Father’s Name ________________________________________________ Home Phone _________________ Father’s Home address (if different from child’s) _______________________________ Work Phone _____________Cell ______________email_______________________________________ Employer/Occupation and address______________________________________________________________ __________________________________________________________________________________________ Child’s Physician or Clinic’s Name (Child’s Primary Health Source) and Phone Number _____________________________________________________________________________________ Health Insurance: Company ________________________ Policy Number _________________ My Child(ren) may be released to the person signing this agreement or to the following: Name Address Phone Relationship

__________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Persons to contact in case of an emergency if the parents/guardian cannot be reached: Name Address Phone

Relationship

__________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________

Persons to whom your child may NOT be released to: Name Address Relationship Reason __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Other children in family (name, age and gender)____________________________________________________ __________________________________________________________________________________________ Other adults living with family (list relationship to the child) _________________________________________ Has your child had previous experiences in daycare? (after-school programs, camps, etc.) If yes, where and how long?_________________________________________________________________________________________ My Child has the following special need(s): _____________________________________________________________________________________________ _______________________________________________________________________________________ Some of your child’s experiences with school, camp, and family are factors in his/her moods and behaviors. Please describe your child’s background that you believe will help us better serve your child and your family. This information is confidential and is viewed only by the Jackson After School staff. __________________________________________________________________________________________ __________________________________________________________________________________________ The following special accommodation(s) may be required to most effectively meet my child’s needs while attending the Jackson After School Program: _____________________________________________________________________________________________ _______________________________________________________________________________________ My child is currently on medication prescribed for long-term continuous use and/or has the following pre-existing illness, allergies or health concerns: _____________________________________________________________________________________________ _______________________________________________________________________________________ Known Allergies of child(ren) (medicine, food, etc.) Write NA if none. _____________________________________________________________________________________________ _______________________________________________________________________________________ List any medications your child takes regularly? _____________________________________________________________________________________________ _______________________________________________________________________________________ Does your child have any other known medical or physical conditions, mental health disorders, mental retardation, developmental disabilities or emotional disturbances which would limit your child’s participation in the Jackson After School Program and group activities? _____________________________________________________________________________________________ Are your child’s immunizations up to date? _______

Jackson After School Policies
Appropriate Behavior Policy Please be advised that any child demonstrating inappropriate and/or dangerous behavior will be put on a one-week probation. If during this one-week probationary time, the child demonstrates these types of behaviors, he/she will be dismissed from Jackson After School. Pick-up and Escort Policy Each day, an adult MUST: 1. Report to the Media Center to sign out your child(ren) 2. Sign out your child(ren) using full name and time leaving Jackson After School. 3. Escort your child out of the building. Inclement and Severe Weather Policy On days when the school system is CLOSED FOR AN ENTIRE DAY OR CLOSES EARLY BECAUSE OF INCLEMENT OR SEVERE WEATHER such as snow, tornadoes, etc., the Jackson After School Program will NOT be offered. It will be the parent or guardian’s responsibility to be aware of early school dismissal and to make suitable arrangements. Attendance Policy An enrolled child is eligible to attend five days per week. Attendance of an ill child or children with communicable diseases will not be permitted. If your child becomes sick during the day, you will be notified to come pick up your child. Sick children cannot remain in the program and must be picked up promptly. Refusal Of Care Policy Jackson After School reserves the right to discontinue child care to any student enrolled in the Jackson After School program at any time for any reason other than the basis of race, color religion, gender, national origin, age, veteran status, disability, marital status, or sexual orientation in any of its employment practices, educational programs, services or activities. Updated Information Policy Parents are responsible for keeping JAS advised of any significant changes as they occur in the enrollment information concerning phone numbers, work locations, emergency contacts, family physicians, etc. Late Pick-up Policy Students must be picked up from JAS no later than 6:00pm, according to the Media Center clock. A late pick-up fee of $1.00 per minute is charged after 6:00pm. If a student is picked-up late more then five times they will not be allowed to return to Jackson After School. A warning will be issued after three late pick-ups. If a child is not picked up by 8:00pm, DFACS will be contacted. Transportation Policy No transportation will be provided to or from the Jackson After School Program by Jackson After School or its employees, with the exception of a medical emergency. Transportation from the Kindergarten campus is provided by Atlanta Public Schools. Informed Parent Policy It is the Jackson After School Program’s responsibility to keep parents informed of any incidents, including illnesses, injuries, adverse reactions to medications, exposure to communicable diseases that impact the child. Child Abuse Policy Jackson After School Program believes that the safety, support, and care of your child(ren) is the most important part of the after school program. The law has provisions safeguarding the well-being of child(ren). We must comply with the law as outlined below:
Child care and day care personnel having reasonable cause to believe that a child under the age of 18 has had physical injuries inflicted upon him/her by other than accidental means by a parent of guardian, or has been neglected or exploited by a parent or guardian or has been sexually assaulted or sexually exploited, MUST be reported or cause reports to be made to the Department of Human Resources, Child Protection Agency.

Unacceptable Objects Policy Any child found with knives, guns, drugs, or other dangerous objects or substances that could cause harm to others will be removed permanently from JAS and will be disciplined according to school policies.

Parental Agreement with Jackson After School, Inc.
1. Jackson After School, Inc. agrees to provide after school child care for (child) ________________ _________________ during the school year, following the APS calendar, from 2:30-6:00. 2. Jackson After School will provide snack daily. 3. My child will not be allowed to leave the facility without being escorted by the parent(s), person authorized by parent, or facility personnel. 4. I acknowledge it is my responsibility to keep my child’s records current to reflect any significant changes as they occur. (Telephone numbers, work location, emergency contacts, child’s physician, health status, etc.) 5. Jackson After School agrees to keep me informed of any incidents, including illnesses, injuries, exposure to communicable disease, which include my child. 6. I acknowledge it is my responsibility to pay tuition on time and understand that failure to do so will result in termination of childcare. I understand that outstanding balances will be charged to my credit card on file. Card # ___________________________ expiration _______ 7. I have received a copy and agree to abide by the policies and procedures for Jackson After School. 8. I acknowledge that I must have current medical insurance for my child participating in Jackson After School. 9. If the need or desire for childcare provided by Jackson After School changes and the parent wishes to discontinue services, a two week written notice is required. Failure to provide notice will result in a $160.00 fine. 10. I hereby give Jackson After School and its employees permission to provide first aid care for my child(ren), __________________________________. In the event that I cannot be reached I hereby authorize Jackson After School and its employees to authorize transportation of my child to Scottish Rite Emergency Room. I hereby grant my consent for the hospital and its medical staff to provide my child with emergency medical treatment which a physician deems necessary. I agree to accept financial responsibility for all medical expenses incurred.

Signature (parent/guardian)___________________________________ Date ________________


								
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