Permission to Administer Sunscreen 2015 El Rancho School Swim

El Rancho Schools, Inc.
2015 Swim Lessons
May 18th – September 18th
Let’s swim! Group swim lessons for children, ages 3 to 14, are 30 minutes daily. All children signed up for swim
instruction will be evaluated their first week of lessons to determine the appropriate group for instruction.
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Please use a permanent marker to write your child’s name on everything brought & worn to school:
Clothing, bathing suit, towel, goggles (if needed), earplug and case (if needed) Swim bag : rubberized,
nylon, hard plastic only. Grocery bag type are not allowed at school due to the possibility of suffocation.
Bathing suits and towels must go home each day. If your child’s clothing is not marked with their name,
and we notice it, we will mark their name on any item not marked. Be sure to mark socks, shoes and
underwear.
All three-year-olds are required to wear swim diapers that the parent provides under their swimming suit.
If a child does not have them, he/she will not be able to swim that day.
Swim fees are payable in advance, when the child is signed up. It must be attached to this form.
Please do not include it in your tuition payment. Swimming lessons are $40.00 a week. Our daily rate of
$10.00 is only available for part-time students. A written one-week notice is required for a change in
swimming lesson schedule. No refunds or swim credits are given for any reason, including change of
schedule, illness, absences, inclement weather (“dry” lessons on safety, etc. will be given), field trips, etc.
Sunscreen: El Rancho School staff will apply spray sunscreen to students daily before their swim lesson,
and in the 3:00PM hour. If you would like our staff to apply spray sunscreen on your child, please bring in
the spray-only sunscreen of your choice, clearly labeled with your child’s name at the very top of the
container, complete the attached medication form for sunscreen, and leave it on the school office desk.
________/________/ 2015
Month Day
Year
Permission to Administer Sunscreen
I give permission for El Rancho School’s staff to administer one to two teaspoons of spray sunscreen now through
September 18, 2015 on _________________________________________________. ____________________________________________________
Child’s Name
Parent signature
Date
Sunscreen is only administered by staff before the child's swim lesson, and after school in the 3:00 PM hour. All
sunscreen must be walked into the school by the parent, provided in the original container, and have the child’s
name on the top of the container. The sunscreen is to be picked up by the evening of the September 18, 2015, after
which it will be discarded.
2015 El Rancho School Swim Lessons
Child: ______________________________________________________________________________
Grade level: ______________
_______ I wish my child to take swimming lessons during the following weeks.
May 18-22
May 26-29 ($35)
June 01-05
June 08-12
June 15-19
June 22-26
June 29-7/3
July 06-10
July 13-17
July 20-24
July 27-31
August 03-07
August 10-14
August 17-21
August 24-28
Parent’s Signature: __________________________________________ Date: _____________________
Page 1 of 4
August 31-9/4
Sept. 08-11 ($35)
Sept. 14-18
Attach check here for
swim lessons marked
above. This form will
not be processed
without attached fees.
EL RANCHO SCHOOL, INC.
For new or returning families who are
only interested in swim lessons.
5636 El Camino Avenue, Carmichael, CA
Mailing Address: P.O. Box 943, Carmichael, CA 95609
Phone: (916) 482-8656 Fax: (916) 482-8658
www.elranchoschool.com
SWIM LESSON APPLICATION
(for new families only)
Student’s Name:
Address:
City:
CA Zip:
Payments will be made:
Monthly
Semi-monthly
Part time: ______________________________________
Weekly
Mother’s Name:
Home Street Address:
City:
Mailing Address (if different):
City:
Occupation:
Employer’s Name:
Employer’s Street Address:
City:
Father’s Name:
Home Street Address:
City:
Mailing Address (if different):
City:
Occupation:
Employer’s Name:
Employer’s Street Address:
City:
Date of Birth:
Male , Female
Entering: 1st 2nd 3rd 4th 5th 6th 7th
Attendance: Full Time
M-F am’s
Married
CA Zip:
CA Zip:
, Divorced
, Separated
, Deceased
Home Phone No:
Cellular Phone No:
Pager No:
Work Phone No:
Social Security No:
Drivers Lic. No:
Email:
CA Zip:
Married
CA Zip:
CA Zip:
, Divorced
, Separated
, Deceased
Home Phone No:
Cellular Phone No:
Pager No:
Work Phone No:
Social Security No:
Drivers Lic. No:
Email:
CA Zip:
Custody Arrangements:
___ Copy of immunization card is attached
Page 2 of 4
El Rancho School, Inc. Fee Schedule and Fiscal Policies
Effective May 18, 2015
st
Payments: Tuition is payable in advance. We do not mail or give out monthly statements. If you need a statement, please ask for one on the 1 of the month. Please pay
tuition by cash, check, or money order and put it in the locked box located outside the office, noting on the check the child’s name. For credit card payments, your card on file
will be charged each month according to your instructions, either (1) automatically or (2) pursuant to your instructions between the 1st & 3rd and/or 15th & 17th of each month.
st
rd
st
rd
th
Payments are due on the 1 and late if received after the 3 of the month. Semi-monthly payments are due on the 1 , late after the 3 and due on the 15 , late
th
after the 17 , regardless of your child’s attendance schedule. A $25.00 late fee will be incurred if payment is not received in full by the due date(s) (no postmarks will be
accepted), you will be ineligible for the cash discount, and your credit card will be charged. If the due date falls on a day El Rancho School is closed, on a weekend, or if you
are on vacation, payment is due the prior day. If the school is unable to get a credit card authorization code for the tuition plus late fee, families have 5 school days to bring
the account current with either cash or another credit card. If this is not accomplished your child(ren) will automatically be dropped from enrollment. Your child(ren) will not
be able to return until the account is made current. The school reserves the right to cancel enrollment if NSF become excessive.
________ Initial
I, ______________________________________, authorize El Rancho School to charge my credit card in the amount of tuition plus late fee(s) on the 4th of the
month (and 18th of the month/semi-monthly payments) if tuition is not received.
Name as it appears on card: __________________________________________________________________________________
Visa
Master Card
Discover Card #: __________________________________________________ Exp. Date: _______/_______ VID Code: ________
Credit card billing address: _______________________________________________________________________________________________ Zip: __________________
Optional I, _____________________________________________, authorize El Rancho School to charge my credit card account in the amount of tuition,
swimming lessons, and or lunch ticket on the 1st-3rd of each month (and 15th-17th of each month/semi-monthly payments) to pay for school fees.
See fees on reverse; cash discount does not apply. Summer camp and swimming lessons may be included.
Authorization valid until 09/30/2015
Sign: _____________________________________________________________ Date: ________________________
Summer registration fee: There is a $50.00 fee for a new student and $75.00 for two or more new students in a family. The amount is nonrefundable after paid and is due
with the signed 2015 Summer Camp Fee Schedule and Fiscal Policy Agreement (this form). Swim lesson only registration is $25 for new families.
Discounts: (1) There is a 10% discount on monthly tuition of 2 or more children attending El Rancho School full-time (daily, including morning, afternoon, and extended day
care) and living together in the same household. The discount only applies when tuition is paid in advance, pursuant to the payment terms of this agreement. Discounts will
be forfeited on any month the payment is received late.
Returned Checks: There is a $35.00 charge for all returned checks. If your check does not clear you are ineligible for the cash discount. Your credit card will be charged
accordingly, and will include the late fee ($25) and returned check fee ($35). If we receive two returned checks within one year your tuition payments thereafter will be
automatically run on your credit card between the 1st and 3rd of each month.
Refunds: Because staff and facilities must be paid whether used or not, there are no credits or refunds for absences or illnesses, other than full-time preschool vacation with
proper notice. Part-time students may add an extra day if space is available, but may not switch a normally attended day for one that is not part of their schedule.
Drop Notice: We require 5 school days advanced written notice to the office to drop from enrollment. You will be financially responsible for this period whether or not your
child attends.
Modifications: Any changes to the Tuition Schedule and Fiscal Policies will be made by written notice to each parent at least 10 days before going into effect.
Excluded: Students may be excluded, without prior notice, from the school at the sole discretion of the principal, or her designee, for behavior deemed extremely
inappropriate. Parents of students who have been expelled will be financially responsible for tuition through their last day of attendance. Any registration, enrollment, and/or
supply fees previously paid will be forfeited.
Placement: Placement in classrooms and swim lessons at El Rancho School is determined by the school staff.
We do not discriminate on the basis of race, color, creed, sex, religion, national or ethnic origin.
Falsifying information on school forms or omitting important information which would significantly affect the school’s ability to properly and safely serve all student’s needs,
would be considered grounds for dismissal, and would be at the sole discretion of the school.
Any controversy or claim, by the parent with the school, shall be settled by arbitration in accordance with the Commercial Arbitration Rules of the American Arbitration Ass’n,
and judgment upon the award rendered by the arbitrator may be entered in any court having jurisdiction thereof.
The above policies apply equally to preschool and elementary students, both full and part-time, unless otherwise stated in this agreement.
I have read, fully understand, and agree to the above information and policies and have received a copy. I agree to pay all costs for collection of delinquent accounts, if
necessary.
BOTH PARENTS MUST SIGN: ___________________________________________
(Or guardians)
Parent’s Signature
___________________________________________
Parent’s Signature
____________
Date
_____________________________________________________________________
Please print child(ren)’s name(s)
___________________________________________
School Representative
February 13, 2015
Date
Page 3 of 4
El Rancho Schools, Inc.
2015 Swim Classes
May 18th – September 18th
Let’s swim! Group swim
lessons for children, ages
3 to 14, are 30 minutes
daily. All children signed
up for swim instruction
will be evaluated to
determine the
appropriate group for
instruction.
Swim fees are payable in
advance, when the child
is signed up. Lessons
are $40.00 a week. Our
daily rate of $10.00 is
available for part-time
students.
Sunscreen: El Rancho School staff will apply spray
sunscreen to students daily before their swim lesson.
Page 4 of 4