Re-Enrollment Contract for Staff Children

Student's Information

Student’s Name*

First Middle Last

During the past 12 months, has your child experienced any health problems, social or emotional problems, or significant changes in the family? Please explain.

Allergies and Medications

Students with diagnosed food allergies and/or anaphylactic responses to any substance are required to have a current Emergency Care Plan on file.

Does your child have any diagnosed food allergies?

Has your child been prescribed epinephrine or an EpiPen? If so, for what substance?

Is your child currently on any medications? If so, please list medications.

Parent/Guardian 1

Relationship to Student*

Name*

First Last

Email Address*

Address*

Street Address Address Line 2 City State ZIP Code

Home Phone

(if applicable)

Mobile/Cell Phone*

Employer

Title at Place of Employment

Parent/Guardian 2

(if applicable)

Relationship to Student

Name

First Last

Email Address

Address

Street Address Address Line 2 City State ZIP Code

Home Phone

(if applicable)

Mobile/Cell Phone

Employer

Title at Place of Employment

Family Information

Siblings

Please click the + icon to add more siblings.

Name	Age	School

Student is living with:*

Father
Mother
Stepfather
Stepmother
Legal Guardian
Other

If student’s parents/guardians are divorced, which parent has legal responsibility for:

School-related decisions

School bills

Custody of Student

Financial Aid

Will you be applying for Financial Aid?*

Yes
No

Click here for the Application for Financial Aid. The due date for submission is March 8, 2019. When applying for financial aid, it is essential to follow each step and adhere to all deadlines.

Enrollment Contract

This Contract is made by and between White Rock Montessori Elementary School of the Good Samaritan, Inc. (DBA White Rock Montessori) located at 1601 Oates Drive, Dallas, Texas 75228, and the undersigned parent, guardian, or other responsible parties on behalf of the named student attending for the 2019-2020 school year.

The student is accepted for the school year under the terms, conditions, policies, and procedures of this Contract and the current year’s Parent Handbook to which the parent, guardian, or other responsible party agrees and acknowledges receipt.

Tuition and fees are calculated and are due and payable as determined in Sections “D” through “G” below.

Students are accepted only for the entire academic year, or for the remainder of the school year, if enrolled after the opening date. The fact that the School allows tuition to be paid in two or more installments in no way creates a fractional contract or in any way relieves the parent, guardian, or other responsible party of the obligation to pay the entire year's tuition.

A. Remedies

The School’s ability to operate on a sound fiscal basis depends in part on its prompt collection of tuition and other fees from parents, guardians, or other responsible parties. In addition to other remedies the School may have under this contract or under applicable law, the School may bring a judicial action for any fees not received in full in the School office by the due date. The parent, guardian, or other responsible party agrees to pay all costs for collection incurred by the School, including attorneys’ fees and other costs of litigation.

No Contract will be accepted from a parent, guardian, or responsible party whose payments of tuition, before and after school care or other fees are in arrears from a previous school year. The school will release a student's transcripts and records only when the student’s account is paid in full. All tuition and other fees must be kept current during the school year for the student to attend classes, enroll in extracurricular activities, participate in graduation, or receive a diploma.

B. Termination by the School

The School may terminate this Agreement at any time if the student’s classroom teacher and the Director determine, in their sole discretion, that the student is or will be unable to thrive in the School’s Montessori environment. A violation or non-compliance with requirements in the Parent Handbook may, without limitation, be considered in making such determination. The student is considered withdrawn after the last day of attendance. The amount of tuition payable to the School will be pro-rated from the start of the school year through the last day of attendance. The School will retain all fees.

C. Termination by the Parent, Guardian, or other Responsible Party

If the parent or guardian terminates this Contract because of unavoidable circumstances, written notice must be provided to the school. The student is considered withdrawn after the last day of attendance.

If this Contract is terminated prior to April 1, 2019 no tuition is due to the School.

If this Contract is terminated after April 1, 2019 and before school starts the tuition due and payable to the school is one-half the contracted amount.

If this Contract is terminated after school starts the tuition due and payable to the School is the sum of the pro-rated tuition from the start of the school year through the last day of attendance plus 1/2 of the pro-rated tuition from the last day of attendance through the end of the school year.

Per school policy, WRM retains all fees for student contracts terminated under any circumstances. Additionally, please keep in mind WRM will release a student's transcripts and records only when the student's account is paid in full. All tuition and other fees must be kept current during the school year for the student to attend class, enroll in extracurricular activities, participate in graduation, or receive a diploma.

Acknowledgement

The ability to fund our programs, classroom activities, and competitive teacher salaries is based on each family’s commitment to the contract you are signing.*

By clicking this box, I commit that I have read the above termination clause and am agreeing to the fulfil this obligation should I need to terminate this contract.

D. Fees

Description	Amount	Due Date
Enrollment Fee - New Students	$600.00	With Enrollment Contract
Enrollment Fee - Returning Students	$470.00	With Re-Enrollment Contract
Orientation Week Fee*	$112.50	With Re-Enrollment Contract (Price includes 50% staff discount)
Supply and Field Trip Fee	$135.00	With First Tuition Payment
Middle School Resource Fee	$135.00	With First Tuition Payment
Upper Elementary Resource Fee	$80.00	With First Tuition Payment

* Required for all transitioning and new students.

E. Program(s) Contracting For

2019-2020 Grade Applying For*

Mandatory Lower Elementary Orientation Week*

(Required for all incoming 1st Graders)
Dates: August 5-9, 2019
Fee: $112.50 (50% Faculty/Staff Discount)

My incoming 1st grader will attend the mandatory Lower Elementary Orientation Week from August 5-9, 2019.

Mandatory Upper Elementary Orientation Week*

(Required for all incoming 4th Graders)
Dates: August 5-9, 2019
Fee: $112.50 (50% Faculty/Staff Discount)

My incoming 4th grader will attend the mandatory Upper Elementary Orientation Week from August 5-9, 2019.

Mandatory Middle School Orientation Week*

(Required for all incoming 7th Graders)
Dates: August 5-9, 2019
Fee: $112.50 (50% Faculty/Staff Discount)

My incoming 7th grader will attend the mandatory Middle School Orientation Week from August 5-9, 2019.

Before & After School Care (B/ASC)

No Before or After School Care
Full Time Before School Care (BSC)
Full Time After School Care (ASC)
Full Time Before & After School Care (B/ASC)
Part Time Before & After School Care (B/ASC)

F. Tuition Pricing and Due Dates

The tuition payment amounts listed below will be prorated for all students enrolling mid-year.

Payment Option I: Annual Plan

Payable on June 1, 2019

Available only through SMART Tuition Management

SMART Tuition payment options are automatic bank draft or credit card charge, 2.65% fee for credit card charges

Annual Payments	Due June 1, 2019
Middle School	$16,186.00
Upper Elementary	$13,083.00
Lower Elementary	$12,998.00
Primary Full Day	$12,998.00
Primary Extended Day	$12,998.00
Primary Half Day	$8,141.00
Before School Care	$1,729.00
After School Care	$5,324.00
Before & After School Care	$6,455.00

Payment Option II: Semi-Annual Plan

Payable on June 1, 2019 and December 1, 2019

Available only through SMART Tuition Management

SMART Tuition payment options are automatic bank draft or credit card charge, 2.65% fee for credit card charges

Semi-annual Payments	Due June 1, 2019	Due Dec 1, 2019	Total
Middle School	$8,393.00	$8,393.00	$16,786.00
Upper Elementary	$6,784.00	$6,784.00	$13,568.00
Lower Elementary	$6,741.50	$6,741.50	$13,483.00
Primary Full Day	$6,741.50	$6,741.50	$13,483.00
Primary Extended Day	$6,741.50	$6,741.50	$13,483.00
Primary Half Day	$4,221.50	$4,221.50	$8,443.00
Before School Care	$897.00	$897.00	$1,794.00
After School Care	$2,762.50	$2,762.50	$5,525.00
Before & After School Care	$3,349.50	$3,349.50	$6,699.00

Payment Option III: 11 Month Plan

Payable on June 1, 2019 thru April 1, 2020

Available only through SMART Tuition Management

SMART Tuition payment options are automatic bank draft or credit card charge, 2.65% fee for credit card charges

Monthly Payments	June 2019 – April 2020	Total
Middle School	$1,561.45 per month	$17,176.00
Upper Elementary	$1,266.55 per month	$13,932.00
Lower Elementary	$1,258.82 per month	$13,847.00
Primary Full Day	$1,258.82 per month	$13,847.00
Primary Extended Day	$1,258.82 per month	$13,847.00
Primary Half Day	$790.82 per month	$8,699.00
Before School Care	$167.55 per month	$1,843.00
After School Care	$516.00 per month	$5,676.00
Before & After School Care	$625.55 per month	$6,881.00

G. Payment Option

Payment Option*

Please see Section F for more details about amounts and due dates for each Payment Option.

Annual Plan
Semi-Annual Plan
Monthly Plan
Bi-Monthly Plan (Taken out of every paycheck.)
Not sure, the same as in the past. (The office will reach out to Tom Lawrence to see how this was handled for your family in previous school years.)

Signature of Parent, Guardian, or other Responsible Party

I understand and agree to all terms, provisions and remedies set forth in this Contract. I understand that by signing this Contract it is my intention that the student will attend school for the entire school year and that I am not aware of any circumstance which may require me to terminate this Contract before the completion of the school year. I warrant that I have the authority to enroll the student into the school program.

White Rock Montessori does not discriminate on the basis of race, color, religion, sex, nationality or ethnic origin in its admissions, availability of programs or administration of policies and services.

I warrant the truthfulness of the information provided in this form.*

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above terms.

I have read and agree to the terms listed above.

Electronic Signature*

Please type your first and last name to serve as your electronic signature.

Re-Enrollment and Other Applicable Fees

As a member of WRM Faculty/Staff, you may pay these fees now or later.

Lower Elementary Orientation (Required for all incoming 1st Graders)

50% Faculty/Staff discount

Price: $112.50

Upper Elementary Orientation (Required for all incoming 4th Graders)

50% Faculty/Staff discount

Price: $112.50

Middle School Orientation

50% Faculty/Staff discount

Price: $112.50

Re-Enrollment Fee for Returning Students*

Price: $470.00

Re-Enrollment Fee(s)

This total includes the Re-Enrollment Fee and Orientation Week Fee (if applicable).

$0.00

How would you like to pay the Re-Enrollment Fee(s)?

Invoiced to pay all at once.
Included in the tuition and fee(s) that are deducted from my paychecks.

Re-Enrollment 2019-2020 for Staff Children (1)

Student's Information

Allergies and Medications

Parent/Guardian 1

Parent/Guardian 2

Family Information

If student’s parents/guardians are divorced, which parent has legal responsibility for:

Financial Aid

Enrollment Contract

A. Remedies

B. Termination by the School

C. Termination by the Parent, Guardian, or other Responsible Party

Acknowledgement

D. Fees

E. Program(s) Contracting For

F. Tuition Pricing and Due Dates

Payment Option I: Annual Plan

Payable on June 1, 2019

Available only through SMART Tuition Management

SMART Tuition payment options are automatic bank draft or credit card charge, 2.65% fee for credit card charges

Payment Option II: Semi-Annual Plan

Payable on June 1, 2019 and December 1, 2019

Available only through SMART Tuition Management

SMART Tuition payment options are automatic bank draft or credit card charge, 2.65% fee for credit card charges

Payment Option III: 11 Month Plan

Payable on June 1, 2019 thru April 1, 2020

Available only through SMART Tuition Management

SMART Tuition payment options are automatic bank draft or credit card charge, 2.65% fee for credit card charges

G. Payment Option

Signature of Parent, Guardian, or other Responsible Party

Re-Enrollment and Other Applicable Fees