2012-2013 Registration Form

Childs Name

Date of Birth School Address Apt. # Home Phone #

Age Grade/Class

Zip

Mothers Name

2012 - 2013 School Year

CALL Ruth Moore, Program Secretary: (718)944-3207 For All Programs, 8:00am3:30pm

Mothers Cell Occupation Fathers Name Work #

Fathers Cell Occupation Work #

Emergency Name & Telephone #

Starting Date

PS 7 (Escort service PS 207 and PS 37) PS 169Baychester Scholars Bronx Community Charter School

Please check the following:

Mon. Tues. Wed. Thurs. Fri. Early Wednesday/First Friday 6:00 - 6:30 p.m. coverage

We also offer After School Care, Kindergarten6th Grade at the following schools:

School Based Sites

STARTING SEPTEMBER 10, 2012

I understand that I am registering my child for the school year and will lose my deposit if I withdraw for any reason other than losing my employment or moving from the area.

Parents signature

OFFICE USE ONLY Receipt # __________________ Membership _______________ Liability ___________________ Accident __________________ Security Deposit ___________

Date _______________

An After School Day Care Program for children of Working Parents in Kindergarten to Sixth Grades (co-ed)

Introduction
The Mosholu Montefiore Community Center provides services to support the working parent and their families. Our Discovery Club After School Day Care Program serves elementary school children in kindergarten through sixth grades. The program runs from the end of the school day until 6:00p.m. or 6:30p.m. when parents arrive on their way home from work to pick their children up. We offer van or escort service from public and parochial schools in Norwood, Van Cortlandt Village, and Bedford Park. To accommodate children who attend parochial schools, we pick up on early Wednesday and first Friday. Our program, which meets Monday Friday starting September 10, 2012 June 21, 2013, offers children an enriched program of Sports & Hobby Clubs as well as Friendship Clubs, and a quiet time for homework.

Programs
An enriched curriculum of classes and clubs, including Ice Skating, Bowling, Computer, Soccer, Art Workshop, Nature Crafts, Drama, Music, Basketball, activity groups, and Homework Help. All of these classes and clubs are included in the tuition fee. Children receive a nutritious snack each day. Transportation and Pick Ups Norwood: Escort service from P.S. 94 and St. Anns; van service from P.S. 280, 56, 56 Annex, and St. Brendans. Bedford Park: Van service from P.S. 8, St. Philip Neri Van Cortlandt Village: Van service from P.S. 95 and Am Park School Williamsbridge: Van service from P.S. 41 School buses and vans from CPE, River East, Bronx New School, Kinnerert and Fieldston schools stop at our corner.

Yearly Tuition and Fees

(3:00 - 6:00p.m.)
No tuition increase this year. 5 Afternoons $2,075 (8 payments of $259.00) 4 Afternoons $1,975 (8 payments of $246.87) 3 Afternoons $1,875 (8 payments of $234.37 2 Afternoons $1,775 (8 payments of $221.87) Plus family membership, liability & accident insurances $265 per year (25% discount for siblings) NonNon-refundable Private Schools Early Wednesdays & First Fridays: $250 per year plus tuition Only Wednesday pick up for Visitation (6:00Late Coverage (6:00-6:30p.m.): $300 per year + tuition To register, a non-refundable membership must be paid in full, plus $100 security deposit. For those children who join starting in November, tuition will be prorated according to the number of weeks left in the school year. Limited scholarships are available based on income and need

Theodore Allen Program Director

Note: Note: Please be aware that the Center does NOT pick up at schools on half days. Parents can bring their child to the Center at 3:00p.m.

Does your child have an IEP? Yes

No

Special needs services may be available to your child based on certain criteria. Please call Ruth Moore at (718) 882-4000 extension 207 to set up an interview.

I give my permission for my children to participate in all activities, including trips away from the Center. I understand that the Center assumes no responsibility for personal property of child. Photos taken may be used for publicity purposes. I have read the Terms of Enrollment and agree to abide by them. Parents signature ____________________________________________ Date ______________________________________________________