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VPK Only 2015-2016 School Year All information must be provided for this application to be considered. Please attach a copy of student’s birth certificate, current physical, & immunization forms. CIRCLE ONE: NEW STUDENT RETURNING STUDENT (PLEASE PRINT) STUDENT INFORMATION Student's Name _______________________________________________________________(__________________ ) Last First Middle Preferred Name Social Security # - - Sex _____ Age _____ Date of Birth ____/____/_____ MM / DD / Year FAMILY INFORMATION Parents are: ___ Married ___ Separated ___ Divorced ___ Mother Deceased ___ Father Deceased If parents are divorced or separated, who has legal custody? ______________________________________ Student lives with: ___ Mother and Father ___ Mother only ___ Father only ___ Mother and Stepfather ___ Father and Stepmother ___ Guardian(s) Do you have any siblings enrolled in BCS? _____ If yes, please complete information below Name:__________________________ grade: ______ Name:__________________________ grade: ______ Name:__________________________ grade: ______ Name:__________________________ grade: ______ Father/Guardian: ______________________________SS#:______________________DL#:______________________ Required Required Home Address: ____________________________________________________________________________________ Street City State Zip Phone: (_____) _______________ (_____) _______________ (_____) _______________ Home Business Cell # Email:___________________________________________@_______________________________________________ Occupation: _______________________________________________________________________________________ Company Position/Title Church Home: ____________________________________________________________ Member? Yes or No Mother/Guardian: ______________________________SS#:______________________DL#:______________________ Required Required Home Address: _____________________________________________________________________________________ Street City State Zip Phone: (_____) _______________ (_____) _______________ (_____) _______________ Home Business Cell # Email:___________________________________________@_______________________________________________ Occupation: _______________________________________________________________________________________ Company Position/Title Church Home: ________________________________________ Member? Yes or No 8350 Okeechobee Blvd. West Palm Beach, FL 33411 Phone: 561-798-9300 Fax: 561-472-1603 Director Mrs. Vicki Ingram Ext. 223 www.bcsbulldogs.org

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Page 1: VPK Only 2015-2016 School Yearbcs-fl.client.renweb.com/oa/client_files/bereanwpb/uploads/PS1516... · VPK Only 2015-2016 School Year All information must be provided for this application

VPK Only

2015-2016 School Year

All information must be provided for this application to be considered.

Please attach a copy of student’s birth certificate, current physical, & immunization forms.

CIRCLE ONE: NEW STUDENT RETURNING STUDENT

(PLEASE PRINT)

STUDENT INFORMATION

Student's Name _______________________________________________________________(__________________ )

Last First Middle Preferred Name

Social Security # - - Sex _____ Age _____ Date of Birth ____/____/_____

MM / DD / Year

FAMILY INFORMATION Parents are: ___ Married ___ Separated ___ Divorced ___ Mother Deceased ___ Father Deceased

If parents are divorced or separated, who has legal custody? ______________________________________

Student lives with: ___ Mother and Father ___ Mother only ___ Father only

___ Mother and Stepfather ___ Father and Stepmother ___ Guardian(s)

Do you have any siblings enrolled in BCS? _____ If yes, please complete information below

Name:__________________________ grade: ______ Name:__________________________ grade: ______

Name:__________________________ grade: ______ Name:__________________________ grade: ______

Father/Guardian: ______________________________SS#:______________________DL#:______________________ Required Required

Home Address: ____________________________________________________________________________________ Street City State Zip

Phone: (_____) _______________ (_____) _______________ (_____) _______________ Home Business Cell #

Email:___________________________________________@_______________________________________________

Occupation: _______________________________________________________________________________________ Company Position/Title

Church Home: ____________________________________________________________ Member? Yes or No

Mother/Guardian: ______________________________SS#:______________________DL#:______________________ Required Required

Home Address: _____________________________________________________________________________________ Street City State Zip

Phone: (_____) _______________ (_____) _______________ (_____) _______________ Home Business Cell #

Email:___________________________________________@_______________________________________________

Occupation: _______________________________________________________________________________________ Company Position/Title

Church Home: ________________________________________ Member? Yes or No

8350 Okeechobee Blvd.

West Palm Beach, FL 33411

Phone: 561-798-9300 Fax: 561-472-1603

Director – Mrs. Vicki Ingram – Ext. 223

www.bcsbulldogs.org

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MEDICAL INFORMATION

Please list Physical Limitations, Allergies, and/or Current Medications: ________________________________________

__________________________________________________________________________________________________

In Case of Emergency: In the event of illness or other emergency and we are unable to reach you, please fill in the names

of at least two (2) friends, relatives, or neighbors who would be authorized to remove your child from campus.

Name/Relationship Address Telephone #

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Physician ___________________________________ Phone _____________________ Hospital ___________________

Has the student ever been assessed through Child Find, Early Steps, or any other agency? __________________________

__________________________________________________________________________________________________

Had any type of special testing? _____ If yes, please describe and include a copy of the latest evaluation report.

__________________________________________________________________________________________________

Does your child have an IEP? Yes or No If yes, please include the latest assessment report.

SCHOOL INFORMATION

Was student previously enrolled at BCS? Yes or No If yes, what year(s): ________________

Circle grades attended at BCS: K2 K3

School other than BCS last attended: __________________________________________ (_______) ________________ School Name Telephone Number

School Address:

__________________________________________________________________________________________________ Street City State Zip Code

Reason for withdrawal from prior school: _______________________________________________________________

__________________________________________________________________________________________________

Why do you want your child to attend Berean Christian School? ______________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

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STATEMENT OF COOPERATION

1) It is the parent’s responsibility to secure the VPK Certificate from Family Central and turn it in to the Business Office. Family Central is

located at 3111 S. Dixie Hwy., West Palm Beach, FL 33405.

__________ (Parent’s initials required)

2) I understand that I must provide a copy of my child’s birth certificate, a current original immunization form as well as a current original

physical form completed on both sides. This must be turned in to the Preschool no later than Monday, August 3, 2015.

__________ (Parent’s initials required)

3) I understand the VPK hours are from 8:30AM until 11:49AM only.

__________ (Parent’s initials required)

4) Parents are responsible to obtain and read the Preschool Parent Handbook. Berean will provide access to this document via RenWeb and/or

school website.

__________ (Parent’s initials required)

5) The school reserves the right to dismiss any student who, in the discernment of BCS administration, does not cooperate with the

educational process and/or to the rules and regulations as outlined in the Preschool Parent Handbook. It is recommended that parents

attend all parent and enrollment meetings in order to obtain important information and/or policy changes.

__________ (Parent’s initials required)

6) I understand that my child must be present at least 80% of the VPK instructional hours to continue enrollment in the VPK program.

__________ (Parent’s initials required)

7) I understand that Preschool operates from August through May and is closed during Fall Break and Spring Break, however, childcare is

available. VPK instructional hours do not occur during these weeks. If you are in need of child care during these weeks, the fees are $200

for 5 days, $120 for 3 days and $80 for 2 days. I further understand that payment is due at the time of registration for the break. Payment

will be accepted in the form of cash, check or money order only.

__________ (Parent’s initials required)

8) I understand that my child is required to wear official BCS uniforms. Uniforms are purchased through the Sunshine School Uniform store.

Substitute uniforms will not be acceptable.

__________ (Parent’s initials required)

9) I understand that Berean Christian Preschool holds a K4 Graduation ceremony and my child’s participation is voluntary. I further

understand the fee is $75 and if I choose to have my child participate payment is due in full by 3/1/2016. Payment will be accepted in the

form of cash, check or money order only.

__________ (Parent’s initials required)

10) In the case of a serious accident or serious illness, the undersigned request(s) to be called immediately. If unable to make contact, Berean

Christian School or Preschool may call the physician noted on this application or take emergency-care measures as are necessary and

appropriate under the circumstances.

__________ (Parent’s initials required)

11) If, at any time, I feel it necessary as a school parent to pursue legal action against Berean Christian School in a court of law, and if a

judgment is handed down in the favor of Berean Christian School, I agree to pay, in full, all legal and attorney fees, court costs, and all

other expenses that the school may incur as a result of my action.

__________ (Parent’s initials required)

12) I give permission for Berean Christian School to use any photographs, videotapes, DVD or audio tapes of my child(ren) in the yearbook,

school promotional information, school website, social media and/or advertising.

__________ (Parent’s initials required)

Signature below signifies I have received:

a.) “Know Your Childcare Facility” brochure (CF-FSP PI #175-24).

b.) Preschool Discipline Policy.

c.) VPK Attendance Policy, which includes Preschool closing dates.

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IF STUDENTS ARE LIVING WITH BOTH PARENTS,

BOTH PARENTS MUST SIGN THIS STATEMENT BELOW.

___________________________________________ ___________________ Parent's/Guardian's Signature Date

___________________________________________ ___________________ Parent's/Guardian's Signature Date

Office Use Only

Account Current __________

A. Families ______________

S. Sheet _________________

VPK Certificate __________

Magnet _________________

Enrollment Complete ______

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Preschool Discipline Policy

Discipline is a vital component to the learning process of a child. Gentle discipline is neither

permissive nor punitive, rather a means of teaching, guiding, and training. When boundaries

and expectations are clearly defined, children feel secure. By setting rules and clearly

communicating expectations, misbehaviors can be avoided and children can develop self-

discipline and self-control. At Berean Christian Preschool, children will receive gentle, loving,

and Biblically modeled discipline. After clearly communicating expectations, the following

steps will be followed:

♦ To encourage good behavior, teachers provide praises as they “catch” children making the

right choice.

♦ A situation may be remedied by simply redirecting the child.

♦ If redirection does not cause the desired change in behavior, the child may be separated from

the group for a short period of time. This may be a “time-out” chair or a place in the room

where the child is supervised while taking a few minutes to reflect on the fact that his/her

actions did not represent good decision making.

After a brief interval, the teacher discusses the incident and appropriate behavior with the

child. When the child returns to the group, the incident is over. The period of time a child is

in “time-out” depends upon the child’s age. 2 year olds will serve a time-out no longer than

2 minutes, 3 year olds no longer than 3 minutes, and 4 year olds no longer than 4 minutes.

♦ If a child is aggressive toward another (pushing, shoving, hitting, spitting, biting), the

aggressor will be immediately removed from the group and placed in “time out”.

♦ A behavior may warrant calling a parent during the day to speak with their child over the

phone. On rare occasions, a parent may be called to come to the school to speak with their

child.

♦ Should these efforts fail to produce the desired behavior in the child, parents will be called

to meet with the Preschool Director and the child’s teacher to develop a suitable strategy for

correcting the child’s inappropriate behavior.

♦ If the above steps do not produce the desired behavior, the child will be withdrawn from the

Preschool.

♦ No spanking or any kind of corporal punishment is allowed.

Preschool Discipline Policy1 of 2

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NOTE: If a child bites another, the aggressor and victim’s parent will be called to advise them

of the incident. The aggressor will receive a bite report and the victim will receive an

incident report. These reports are to be signed and dated by the parent/guardian. The

white and yellow copies are retained by the school and the parent receives the pink

copy.

A child who bites a 3rd

time may be withdrawn from the Preschool.

If you have any questions or concerns about any of the discipline procedures, please contact the

Preschool Director.

Preschool Discipline Policy 2 of 2

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VPK Only Attendance Policy

Children are to be in class during instructional hours from 8:30am to 11:49am. Children absent more than 20% of the VPK instructional days may be withdrawn from the program. To minimize the number of absences, it is suggested that families plan vacations during Fall Break, Thanksgiving Break, Christmas break, and Spring Break. The first day of school will be August 24, 2015 and the last day of school will be May 26, 2016. Preschool will be closed the following days for the 2015-2016 school year: Labor Day - September 7, 2015 Fall Break - October 5 – 9, 2015…NOTE: Childcare offered – see note below. Thanksgiving Break - November 23-27, 2015 Christmas Break - December 21 – January 4, 2016 Martin Luther King, Jr. Day - January 18, 2016 Staff Development Day - February 12, 2016 President’s Day - February 15, 2016 Spring Break - March 7-11, 2016…NOTE: Childcare offered – see note below. Staff Development Day – March 14, 2016 Good Friday - March 25, 2016 K4 Graduation - May 6, 2016 NOTE: If you need childcare for your preschooler during Fall Break and/or Spring Break, you will to need follow the steps below: Fall Break – October 5-9, 2015 - Fill out the WebForm on RenWeb and submit payment no later than September 18, 2015. Payments after September 18, 2015, will not be accepted. Spring Break – March 7-11, 2016 - Fill out the WebForm on RenWeb and submit payment no later than February 19, 2016. Payments after February 19, 2016, will not be accepted If you choose for your child to participate in the K4 Graduation, practices will take place after VPK hours and a detailed practice schedule will be provided in February. On practice days, you will need to pack a lunch for your child or order a hot lunch from our school cafeteria. Children will eat from 12:00 – 12:30. You will need to pick up your child promptly at the end of each practice. VPK Curriculum will not take place on the following dates: Harvest Day – November 20, 2015 Christmas Party Day – December 18, 2015 Grandparent’s Day – March 4, 2016 Although VPK will not operate on these days, an invitation is extended to our VPK Only students to enjoy the party with their classmates.