RE-ENROLLMENT Registration Registration for current Sully Christian School families. Step 1 of 8 12% Family InformationParent Information Father Name Mother Name Family Last Name Primary Email(Required) Primary email used for communicationPlease indicate the number of students you are enrolling on this form(Required)1234Church You Attend Name, CityPastors Name Do you have any changes to your contact information from last year? Yes No Phone, Email, Address changes, or additional guardianship?Please list any changes here: Emergency ContactsWhen a parent or guardian cannot be reachedContact 1 First Name Last Name Phone NumberRelationship to Student(s) Contact 2 First Name Last Name Phone NumberRelationship to Student(s) Grandparent InformationWe want to keep in touch with grandparents! Please provide contact information for grandparents that would like to receive newsletters, school updates or come to Grandparents Day!Grandparent's Name First Last PhoneEmail Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Would they like to receive the monthly newsletter? By Mail By Email Not at this time Add Another Grandparent Yes No Grandparent's Name First Last PhoneEmail Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Would they like to receive the monthly newsletter? By Mail By Email Not at this time Advancement Committee | Registration ItemsStudent Name T-Shirt SizeYouth - XSY - SMY - MEDY - LGAdult - SMA - MEDA - LGA - XLStudent Name T-Shirt SizeYouth - XSY - SMY - MEDY - LGAdult - SMA - MEDA - LGA - XLStudent Name T-Shirt SizeYouth - XSY - SMY - MEDY - LGAdult - SMA - MEDA - LGA - XLStudent Name T-Shirt SizeYouth - XSY - SMY - MEDY - LGAdult - SMA - MEDA - LGA - XLWould you like to be a Room Mom? If yes, please select which classroom. Advancement will be in contact with you. Thank you! (If you select more than one, Advancement Committee will be in touch to let you know where you're needed most!) TK / Kindergarten 1st | 2nd 3rd | 4th 5th | 6th 7th | 8th Bus Board Registration ItemsIf your child/ren plans to ride the bus, please fill out the details belowPick Up Location Include name & address if different than homeDrop Off Location Include name & address if different than homePlease share any questions, concerns, or additional bussing needs with the bus board for this year.Example: on a specific day, drop-off is different than the rest. Tuition & FeesPlease email secretary@sullychristian.org if you have any questions about tuition, hot lunch or bussing. Student(s) EnrollingTK StudentProgressive Kindergarten1 Full-Time Student (includes FT Kindergarten)1 FT + 1 TK1 FT + 1 PK2 FT Students2 FT + 1 TK2 FT + 1 PK3 FT Students3 FT + 1 TK3FT + 1 PK4 FT StudentsBase tuition amount is $5,950.00 for the year. Transitional Kindergarten is $2,500 and Progressive Kindergarten is $$5,057.50, amounts are payable in 10 month increments, as represented on this form. Sibling discount will be applied for multi-child enrollment. Activity Fee Price: $25.00 Quantity: Amount per student. This fee contributes to field trip snacks, teacher gifts throughout the year, classroom parties, etc... Room moms handle these funds according to the classroom needs.Hot LunchA $50 deposit required to start the year.Family Hot Lunch Account Deposit$50$75$100$150Bus Fees | Per FamilyEnter a quantity of 1, for the applicable bus fee for your family (not per student). Please contact a member of the Bus Board with any question regarding bus fees and routes.TK Town Busing - within 1 mile of school Price: $150.00 Quantity: Full Year: $300.00, half due at registration. Per Family. (You will only need to choose one bussing option.)TK Rural Busing - 1-10 mile radius from school Price: $200.00 Quantity: Full Year: $400.00, half due at registration. Per Family. (You will only need to choose one bussing option.)Town Busing - within 1 mile of school Price: $350.00 Quantity: Full Year: $700.00, half is due at registration. Per Family. (You will only need to choose one bussing option.)Rural Busing - 1-10 mile radius from school Price: $475.00 Quantity: Full Year: $950.00, half due at registration. Per Family. (You will only need to choose one bussing option.)Rider Fee Price: $200.00 Quantity: Full Year: $400, half is due at registration. This is only for families that will not need bussing throughout the year. Per family, not per student. It is a fee to help contribute to having busses available for use of the entire school for field trips, emergency use, etc...Extended Rural Busing - 10+ miles from the school Price: $600.00 Quantity: Full Year: $1,200.00, half due at registration. Per Family. (You will only need to choose one bussing option.)Total This is an estimated total of your 1st month's tuition payment & half of the bus fee. This is not your monthly payment, as your 1/2 bus fee is included in this total and will not be included in the following statements. Our finance office will review your selections and ensure that all appropriate selections and discounts have been accounted for. We will email you with an official invoice on August 1st. TRIP & LOG-STO Discounts will be credited to tuition accounts and invoiced as they are received. Tuition Agreement(Required) I agree to the Tuition AgreementFull tuition amount is calculated according to number of children per family and the grade level in which they are attending. Discounts for multiple children are already factored into the amounts above. One tenth of the annual tuition is due at registration, as well as half year bus fees and a deposit into your family lunch account. The remaining balance of tuition is due is payable in 9 monthly payments from September 1, 2021 – May 1, 2022. Second half of the year bus fees are due at the beginning of the second semester. The tuition amount due may change with eligibility to financial assistance. Tuition amounts may be paid in full at any time and/or monthly amounts greater than the minimum may always be paid. Any alternative payments arrangements from the schedule indicated above are to be presented to and approved by the SCS Finance Committee.Hot Lunch Program Agreement/Policy(Required) I agree to the Hot Lunch PolicyStudent Lunch Cost: $2.85 The policy of Sully Christian School is to offer lunches to all students attending. When a student’s lunch account falls below zero and is at a negative amount, the following policy will apply: Families will begin to receive an email when their lunch account reaches $20.00 or less. A student may not charge lunches or ala carte items and will receive a peanut butter & jelly sandwich and milk in place of the hot lunch at the same cost as a regular school lunch. Medical History/ConditionsFill out this section according to each individual student. Please contact the school office if your student has any health concerns that need to be addressed in the school setting.Student Name | 1(Required) First Middle Last Is your child being treated for any of the following? Please check all that apply. ADD/ADHD Bone/Muscle Disease Skin Condition Heart Condition Asthma/Reactive Airway Headache/Migraine Head Injury/Concussion Seizure Disorder Diabetes Bleeding Disorder Digestive Disorder Does your student wear glasses or contact lenses? Yes No Does your student have a known hearing problem? Yes No List any recent injuries/accidents/surgeries.List any known allergies that your child has and reaction type.Does your child need an Epi-Pen at school? Yes No if yes, parents are required to supply school with an Epi-Pen.Please list all of your child's medications Add RemoveTime medication is given Add RemoveReason for medication Add RemoveNon-Routine Medication AdministrationPlease select Yes or No for each medicationAcetaminophen (Tylenol)(Required) Yes No Children's Chewable 160mg every 4 hoursIbuprofen (Advil/Motrin)(Required) Yes No Children's Chewable 100mg every 6 hoursTums/Antacid(Required) Yes No Regular strength 500mg 1-2 tabletsCough Drops(Required) Yes No 1 every 3-4 hoursStudent 2Student Name | 2(Required) First Middle Last Is your child being treated for any of the following? Please check all that apply. ADD/ADHD Bone/Muscle Disease Skin Condition Heart Condition Asthma/Reactive Airway Headache/Migraine Head Injury/Concussion Seizure Disorder Diabetes Bleeding Disorder Digestive Disorder Does your student wear glasses or contact lenses? Yes No Does your student have a known hearing problem? Yes No List any recent injuries/accidents/surgeries.List any known allergies that your child has and reaction type.Does your child need an Epi-Pen at school? Yes No if yes, parents are required to supply school with an Epi-Pen.Please list all of your child's medications Add RemoveTime medication is given Add RemoveReason for medication Add RemoveNon-Routine Medication AdministrationPlease select Yes or No for each medicationAcetaminophen (Tylenol)(Required) Yes No Children's Chewable 160mg every 4 hoursIbuprofen (Advil/Motrin)(Required) Yes No Children's Chewable 100mg every 6 hoursTums/Antacid(Required) Yes No Regular strength 500mg 1-2 tabletsCough Drops(Required) Yes No 1 every 3-4 hoursStudent 3Student Name | 3(Required) First Middle Last Is your child being treated for any of the following? Please check all that apply. ADD/ADHD Bone/Muscle Disease Skin Condition Heart Condition Asthma/Reactive Airway Headache/Migraine Head Injury/Concussion Seizure Disorder Diabetes Bleeding Disorder Digestive Disorder Does your student wear glasses or contact lenses? Yes No Does your student have a known hearing problem? Yes No List any recent injuries/accidents/surgeries.List any known allergies that your child has and reaction type.Does your child need an Epi-Pen at school? Yes No if yes, parents are required to supply school with an Epi-Pen.Please list all of your child's medications Add RemoveTime medication is given Add RemoveReason for medication Add RemoveNon-Routine Medication AdministrationPlease select Yes or No for each medicationAcetaminophen (Tylenol)(Required) Yes No Children's Chewable 160mg every 4 hoursIbuprofen (Advil/Motrin)(Required) Yes No Children's Chewable 100mg every 6 hoursTums/Antacid(Required) Yes No Regular strength 500mg 1-2 tabletsCough Drops(Required) Yes No 1 every 3-4 hoursStudent 4Student Name | 4(Required) First Middle Last Is your child being treated for any of the following? Please check all that apply. ADD/ADHD Bone/Muscle Disease Skin Condition Heart Condition Asthma/Reactive Airway Headache/Migraine Head Injury/Concussion Seizure Disorder Diabetes Bleeding Disorder Digestive Disorder Does your student wear glasses or contact lenses? Yes No Does your student have a known hearing problem? Yes No List any recent injuries/accidents/surgeries.List any known allergies that your child has and reaction type.Does your child need an Epi-Pen at school? Yes No if yes, parents are required to supply school with an Epi-Pen.Please list all of your child's medications Add RemoveTime medication is given Add RemoveReason for medication Add RemoveNon-Routine Medication AdministrationPlease select Yes or No for each medicationAcetaminophen (Tylenol)(Required) Yes No Children's Chewable 160mg every 4 hoursIbuprofen (Advil/Motrin)(Required) Yes No Children's Chewable 100mg every 6 hoursTums/Antacid(Required) Yes No Regular strength 500mg 1-2 tabletsCough Drops(Required) Yes No 1 every 3-4 hoursMedical CommunicationParents have differing preferences regarding the amount of communication they would like to receive regarding health situations at school. You will always be contacted in the case of: fever, nausea/vomiting, pink eye, broken teeth, and major accidents.List any specific medical situation below that you wish to be contacted for:How would you like to be contacted regarding the above situation(s)? Call Cell Phone Text Cell Phone Email Information, Publication and Photo ReleaseI give permission for parent/student information to be published in the school directory.(Required) Yes No I give permission for my child(ren)'s photos to be posted on the school's social media pages, website, newsletters and newspaper publications generated by the school.(Required) Yes No I give permission for my child(ren) to attend field trips/sporting events with the school.(Required) Yes No I give permission for my child(ren) to use technology, including the internet, knowing that the school is making every effort to make that technology safe to use.(Required) Yes No Verification of Information Consent(Required) I affirm that all the information contained in this registration form is accurate and completeI agree to the terms set forth regarding tuition, the statement of faith, medical history and administration, the hot lunch policy and release of information as specified on this form. I hereby affirm that I have read and agree to the terms stated herein I agree to the payment plan indicated above and accept the conditions and tuition payment requirements. Please note: This is a legal document, and your signature constitutes full agreement with the terms set forth.Signature of Consent(Required)Parent or Guardian5+2=(Required)Please enter a number from 1 to 100.Security Question | Please answer & click submit belowCAPTCHA
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