Pre-K Application 2015-2016
Please return this fully completed application and all requested forms, along with the
$140 registration/supply fee to: LCCA, P.O. Box 416, Haslet, TX 76052 or hand-deliver to the school
office at 12501 U.S. Hwy 287, Haslet, TX 76052 (LifePoint UMC).
INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED.
FAMILY INFORMATION
Father's Name:
Home Phone:
Mother's Name:
Mother's Cell Phone:
Address:
Mother's Work Phone:
City/Zip:
Father's Cell Phone:
Preferred Email:
Father's Work Phone:
STUDENT INFORMATION
Name:
Age:
Birthdate:
Severe Allergies:
PLEASE SUBMIT THE FOLLOWING DOCUMENTATION FOR EACH APPLICANT:
o
Copy of birth certificate
o
Immunization record or statement of voluntary exemption
o
Letter of reference from current or recent pastor (1 letter per family)
For Office Use Only:
Date Application Recv'd: ____/______/______
Application Fee Recv'd: ____________
ABOUT YOUR STUDENT
Please tell us a little bit about your student:______________________________________________________
_________________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
FATHER'S TESTIMONY
Please share how you came to know Jesus Christ as Lord and Savior and how the Lord is working in your life today:
_______________________________________________________________________________
Church Membership: _______________________________________________________________________
Are you active? YES
NO
If no, please explain: ________________________________________________
MOTHER'S TESTIMONY
Please share how you came to know Jesus Christ as Lord and Savior and how the Lord is working in your life today:
_______________________________________________________________________________
Church Membership: _______________________________________________________________________
Are you active? YES
NO
If no, please explain: ________________________________________________
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MEDIATION AND BINDING ARBITRATION AGREEMENT (one per family)
In conjunction with Tuition Policy
In signing this application, we each:
1. Profess salvation by grace through faith in Jesus Christ alone;
2. Are an active member of a Christian church in keeping with the LCCA Statement of Faith;
3. Agree with the purpose and spiritual objectives of this school;
4. Agree to uphold the parent-faculty accountability partnership that defines a UniversityModel School education to the best of my ability;
5. Agree to the following statement concerning Christian conciliation:
The parties to this agreement are Christians and believe that the Bible commands them to make every effort to
live at peace and to resolve disputes with each other in private or within the Christian community in conformity
with the Biblical injunctions of I Corinthians 6:1-8, Matthew 5:23-24, and Matthew 18:5-20. Therefore, the
parties agree that any claim or dispute arising out of, or related to, this agreement or to any aspect of the school
relationship, including any claim or statutory claims, shall be settled by Biblically-based mediation.
If resolution of the dispute and reconciliation do not result from such efforts, the matter shall then be submitted
to a panel of three arbitrators for binding arbitration. The selection of the arbitrators and the arbitration process
shall be conducted in accordance with the Rules of Procedure for Christian Conciliation of the Institute for
Christian Conciliation as printed in the Guidelines for Christian Conciliation.
The parties agree that these methods shall be the sole remedy for any controversy or claim arising out of the
school relationship or this agreement and expressly waive their right to file a lawsuit against one another in any
civil court for such disputes, except to enforce a legally binding arbitration decision.
Each party, regardless of the outcome of the matter, agrees to bear the cost of his/her/its own arbitrator and
one-half of the fees and costs of the neutral arbitrator and any other arbitration expenses.
I agree to the points above and have completed this application to the best of my knowledge and ability.
Signed _________________________________________ Date__________________
(Father or Legal Guardian)
Signed _________________________________________ Date__________________
(Mother or Legal Guardian)
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CONTINUING ENROLLMENT POLICY
Legacy Classical Christian Academy seeks out like-minded followers of Christ so that we may provide a learning
environment that is 'set apart' and different from the world. Therefore, continued enrollment status at LCCA expects
the student’s family will maintain the following biblical standards in their lifestyle and conduct:
▪
▪
▪
▪
A personal commitment to Jesus Christ
Moral purity
Regular church attendance
Ability to manage one’s household well
▪ Demonstration of a life surrendered to the Lord
Additionally, as the primary educators of children, parents need to be committed to be effective co-laborers.
This is demonstrated by parents who:
PARTICIPATE in school activities and events (i.e. conferences, programs, work days, etc.);
COMMUNICATE effectively with teachers;
ABIDE by school rules and policies;
ACTIVELY INSTRUCT and discipline their children.
For a student to be successful and to maintain enrollment status at LCCA, he/she must exhibit diligence in
his/her work. In Matthew 25:21, we read in the Parable of the Talents that the master’s response to the diligent
was, “Well done, good and faithful servant; you were faithful over a few things, I will make you ruler over many
things.”
Diligence is an attitude that pleases the heart of God. The apostle Peter wrote, “But also for this very reason,
giving all diligence, add to your faith virtue, to virtue knowledge” (2 Peter 1:5). This does not mean that every
student is expected to earn high grades, but it does mean that every student is expected to do his or her best
for the glory of God. Ultimately, only the Lord knows the heart of each student. But the campus instructor,
working closely with the parents, is able to discern whether a student is performing to his/her full potential,
and will counsel him/her accordingly.
Legacy Classical Christian Academy is blessed with resources to help meet the needs of a diverse range of
students. We are committed to expending those resources in order to minister to each student “as unto the
Lord.” All resources will be employed to ensure that each student grows spiritually, academically, and socially.
However, we recognize that fruitful ministry requires a heart that is willing to receive what is being offered.
This responsibility rests with the student and his or her family. If a student or parent demonstrates continued
behavior that is inconsistent with the philosophy and purpose of LCCA, and/or is a poor representation of
Christ-likeness, that student’s enrollment will be subject to termination.
I agree to the aforementioned Enrollment Policies.
Signed _________________________________________ Date__________________
(Father or Legal Guardian)
Signed _________________________________________ Date__________________
(Mother or Legal Guardian)
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