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					                                               Washington DCJCC Preschool
                                              Enrollment Contract 2010–2011
This contract is for the enrollment of                        , for the Washington DCJCC
Preschool for the 2010–2011 school year, which runs from August 30, 2010 through August 19, 2011.
In consideration of the acceptance of this enrollment by Washington DCJCC Preschool, the
undersigned Parent/Guardian agrees to the tuition of $                  per month for a total of twelve
months.
I understand and agree that all deposits, fees and tuition are non-refundable and must be paid from
September through August, regardless of whether or not my child attends school during that period.
I understand that according to DC Licensing regulations all enrollment and health forms must be
current and submitted to the Preschool before the first day that my child attends school.
I understand that tuition is due the first day of the month and that a $15 daily late fee will be assessed
after the 5th of the month. If tuition is not paid by the 15 th of the month, I understand that my child
can be suspended from the program
I understand that photographs taken of my child at the Washington DCJCC may be published (print
or electronic.)
Please print all information:

Child’s Name                                                              Birth Date                  Sex

Address (with ZIP)

Home Phone

Parent/Guardian 1                                                 Work or Cell Phone

Email

Parent/Guardian 2                                                 Work or Cell Phone

Email

I accept and understand the policies as stated including preschool tuition requirements and the No
Refund Policy.

Signature of Parent/Guardian                                                        Date
                                                                                                        th
We are pleased to be able to upgrade your family to a full Fitness Membership for the same required 16 Street J community
membership fee included in your monthly tuition. Your family will have access to all of the fitness facilities—pool, gymnasium,
squash and racquetball courts, locker rooms, fitness center—and a wide range of group exercise classes free to Fitness Members.
                                                        th
That’s a savings of $1,100 each year! As always, your 16 Street J membership gives you substantial discounts on camp and other
programs. Your Family Fitness Membership will start on the first day of the school year; please visit Member Services for details and
to activate your membership.


(For Office Use Only)       Date Received                                                    Amount Paid
                                     Washington DCJCC Preschool
                                     Tuition Schedule 2010–2011

                 2-Year Olds                                                             $1495
               (Two by 12/15/10)
                2 1/2 Year Olds                                                          $1495
               (Three by 3/31/11)
              Late 2’s, Early 3’s                                                      $1400
            (Turning 3 by 1/31/11)                                              (Activity Fee $175)
                3-Year Olds                                                              $1350
           (Turning 3 by 10/31/10)
       4-Year Olds (including Pre-K)                                                     $1350

               All tuitions are for a full-day schedule, 7:30 am–6:00 pm.
Sibling Discount: Subtract $28/month for membership* plus 10% for the second child.

                                                        Two-Year & 2 ½                    Three-Year Olds and
               Activity Fee
                                                          Year Olds                              Pre-K
The activity fee covers all field trips, special
 events and summer swim classes for the                          $150                                 $175
                oldest classes

                Registration Fee                                         September 2010 tuition, August
 (deposit required to reserve your child’s space)                        2011 tuition + Activity Fee
             For 2 year olds, the deposit total is $3,140
             For 2 ½ year olds, the deposit total is $3,140
             For late 2s, early 3s, the deposit total is $2,975
             For 3 and 4-year olds, the deposit total is $2,875

TOTAL DUE

Child’s Name                                                            Birth Date:                      Sex:

Parent Signature:                                                                                 Date:
                                th
   * The cost of the required 16 Street J community membership is already included in your monthly tuition, and all families have
   been upgraded upgrading it to you a full Family Fitness Membership for no extra cost. Only one membership needed per
   family, so you only need to pay this for the oldest child.
                                             Washington DCJCC Preschool
                                       Authorization for Deposit Payments
                                               For School Year 2010–2011
    *Please use this form whether paying by check or credit card and fill out a separate form for each child *


Child’s Name

Amount to Charge
                                      Total deposit is two months’ tuition plus the applicable activity fee.
                                                 Please see the Tuition Schedule for details.

Method of Payment (circle)                           Credit Card                  Check
                                                                                 (attached)
             Note: all credit card payments will incur a monthly 2% administrative fee.

Name on Card

Card Number

Card Type                                           Visa     MC       Discover        AmEx
                                                              Card
Security Code
                                                              Expiration

Please check as applicable:
□   I hereby grant the Washington DC JCC Preschool permission to charge the above amount to the above
    credit card for my child’s deposit.
□   I am paying the full amount now (check or credit card).
□   I would like to split my payments, paying for September 2010+activity fee now, and for the August 2011
    tuition on March 15, 2010.
    □ You may use my credit card to process the 2 nd payment on March 15th
    □ I have attached a post-dated check for March 15 to cover the August 2010 deposit.

Cardholder’s Signature                                                         Date

Office Use Only:
                 entered                           initials/date
        $                to deposit to 2510-O-QPS-27 (03-FY11)
        $                to deposit to 2560-O-QPS-27 (02-FY12)
        $                to deposit to 4115-O-QPS-27 (03-FY11)

				
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