Registration Packet
2015-2016
REGISTRATION DAY: MAY 8, 2015
9:30-3:00
Contact Information:
[email protected]
615-424-9587
1
Priest Lake Academy Tutorial
Mission Statement: We desire to Honor God and our children by
providing educational enrichment through a learning environment
that promotes fellowship with one another and an eagerness to learn
through HIM!
The purpose of this tutorial shall be to glorify God and to work together to educate our
children.
PLA is a group of parents pooling resources to secure experienced tutors for our
students. Classes meet one day per week for 32 weeks, beginning in August and
ending in May, and are not intended to teach all that the students need to learn. PLA
classes provide a framework for academic achievement, along with hands-on
instruction, and the opportunity to participate in a group setting. Classes meet each
Friday at Smyrna Church of Christ in Smyrna, Tennessee. Tuition will vary depending
on the grade level of the participating student. Please refer to the fee schedule for
applicable fees.
PLA is a Christian tutorial and all of our classes will incorporate a Christian worldview.
Classes will not, however, provide a platform for discussion of denominational doctrine.
Tutors provide a 32 week lesson plan which is the foundation of each course. Parents
are responsible for supervising the student’s daily work. This may require parents to buy
teacher’s texts and keys for some classes. Homework must be completed. A class
that meets for one hour, once a week, cannot fully satisfy academic credit nor provide
adequate instruction unless the parent and student work together to complete what is
required outside of class.
PLA looks for students who want to be a part of an intimate academic and social group.
Since the adults and students will get to know each other very well, we expect to
develop a bond akin to that of a large family. We will not tolerate any form of social
rejection. We expect kindness, acceptance, and respect to be practiced toward our
peers and teachers. We require a year-long commitment and the payment of the full
tuition (given on a post-dated schedule) at registration in May. The tuition payments
and all fees are non- refundable. We are hiring teachers for a full year and must be
able to guarantee their salaries. Please refer to the Financial Commitment Form for
additional information.
2
Affirmation of Faith

We affirm that there is one God, infinitely perfect and eternally existent in the
person of Father, Son and Holy Spirit.

We affirm the deity of our Lord Jesus Christ, His virgin birth, His sinless life, His
miracles, His substitutionary and atoning death through His shed blood, His
bodily resurrection, His ascension to the right hand of the Father, and His
personal return in power and glory.

We affirm the Bible to be the Holy Spirit inspired, authoritative Word of God and
eternally reliable, containing the Word of God in its entirety.

We affirm the universal church, which is the Body of Christ. We affirm Christ as
its head. We affirm all who are born-again as its members. We affirm the
church's purpose as offering worship to God; fellowship, ministries of Ephesians.
We affirm the spiritual unity of believers in our Lord Jesus Christ in the essentials
of the faith and freedom in matters in which mature believers might disagree.
3
Class List, Tuition, & Fees
Class
Tutor
Yearly Tuition
Supply Fee
Chelle Greene
$256
$75
Gwen Beverly
$128
$30
Hope Bokoles
$128
$50
Kim Shepherd
$128
$30
ELEMENTARY CLASSES
Kindergarten/1st Grade (2 hour class)
2nd/3rd grade History
Trip Around the World
2nd/3rd grade Science
Apologia Swimming Creatures
4th/5th grade History
Post Civil War US History
4th/5th grade Science
Discovering God’s Design
Elementary Music
Kim Nestle
$128
$50
Gwendolyn Beverly
$128
$40
Elementary Art
Susan Gulley
$128
$50
$160
$25
$160
$25
$160
$30
$160
$30
$160
$50
$160
$30
$160
$50
MIDDLE SCHOOL CLASSES
5th & 6th Math
Melissa Davis
6/5 Saxon
Saxon Math 7/6
Melissa Davis
6th/7th History
Kim Shephard
Post Civil War US History
6th/7th IEW A
Kelli Shockey
th th
6 /7 Science Apologia Swimming
Hope Bokoles
Creatures
8th History
Kim Shephard
Post Civil War US History
8th Science Chem & Physics Apologia
Kim Nestle
8th English IEW B
Kelli Shockey
$160
$30
6th-8th Art
Larissa Reed
$160
$50
Saxon Math 8/7
Melissa Davis
$160
$25
HIGH SCHOOL CLASSES
Teaching Textbooks Algebra I
Melissa Davis
$256
$25
Teaching Textbooks Algebra II
Melissa Davis
$256
$25
Apologia Biology I
Melinda Johnson
$256
$50
Apologia Biology II
Melinda Johnson
$256
$50
Post Civil War American History
Kim Shephard
$256
$30
World History
Melinda Johnson
$256
$30
IEW C
Kelli Shockey
$256
$20
British Literature
MaryLynn Ross
$256
$25
Art
Larissa Reed
$256
$50
4
PLA Tuition and Fees
2015-2016
Maintenance Fee (includes
building fee, cleaning, & insurance
coverage)
$120 per family
Administration Fee
$25 per STUDENT
Elementary Tuition
$128 per class
+supply fee
+curriculum costs
Middle School Tuition
$160 per class
+ supply fee
+curriculum costs
High School Tuition
$256 per class
+ supply fee
+ curriculum costs
All fees and tuition monies are due on the date of registration. Maintenance and
Administration Fees can be combined into one check and should be made payable to
PLA and dated the date of registration.
Tuition monies and Supply fees are also due at the time of registration. Tuition checks
should be made payable to the TEACHER of the class. They should be dated as
follows:






You must write 8, postdated checks for each class payable to the teacher.
The checks should be dated, August 1, 2015, September 1, 2015, October
1, 2015, November 1, 2015, (DO NOT INCLUDE A DECEMBER CHECK)
January 1, 2016, February 1, 2016, March 1, 2016, April 1, 2016.
Elementary tuition check amount is $16.00 per check for each class.
Middle School tuition check amount is $20.00 per check for each class.
High School tuition check amount is $32.00 per check for each class.
Supply fees should be a separate check, also written to the teacher and
dated May 9, 2015.
Please record of your checks on the check register on the following
pages.

If you choose to pay in cash, please bring the cash (for the amounts listed
in the bullet above) in 8 individual, unsealed, envelopes per class dated
5
August through April (excluding December), with the teacher’s name,
student’s name and the class written on the outside of the envelopes.
Additionally, the supply fee for each class should be in separate
envelopes with the same information on the outside of the envelope.

There will be a charge of $32.00 per study hall. Study hall payments
should be made by the semester. A check for $16.00 per study hall should
be dated August 1, 2015 and January 1, 2016.
Example of checks for a class:
Student is taking 6th grade science class. The chart on page 4 shows that Kim
Nestle is teaching that class and it is a middle school level class. The parent
would write 8 separate checks for $20, made payable to Kim Nestle, and dated
August 1, September 1, October 1, November 1, January 1, February 1, March 1,
and April 1. An additional check for the $50 supply fee will be written to Kim
Nestle and dated for the date of registration. (May 8, 2015)
The same format should be followed for an elementary class with the amount
changed to $16.00 per check and the teacher’s name changed accordingly.
High School check amount is $32.00 per class.
*ALL FEES & TUITION ARE NON-REFUNDABLE*
6
Financial Commitment
Check Register
Please complete the register below for checks given at registration:
Check
No.
Check
Dated
Written To
Class Name
Amount
7
Check
Number
Check
Dated
Written To
Class Name
Amount
Tuition, insurance, building, administration, cleaning and any other fees are
NONREFUNDABLE in part or in whole and are NON-TRANSFERABLE. I
_______________________________, have read this policy and agree to comply
with it.
Date____________
8
PLA Student & Parent Commitment
As a student of Priest Lake Academy, I will, to the best of my ability:
 be on time to class.
 treat the church building, my teachers and my fellow students with respect and
refrain from hostile, intimidating, or offensive behavior towards other students and
adults.
 complete and turn in assignments as requested by the teacher.
 turn off and place all my electronic gadgets in my backpack during class. If I use
my phone, IPod, handheld game, or other device during class, it will be held for
the duration of the day.
 check Engrade consistently and I understand it will be an important form of
communication between teachers and students.
 dress in a manner that is respectful of myself and does not cause distractions.
(Shirts, shorts and dresses should be a reasonable length and midriffs should be
covered; this includes boxers. Tank tops are acceptable, but spaghetti straps
should be covered so that no part of the bra is visible.)
 follow the rules set forth in the Student Driver Policy and Permission Form.
 remain only in the authorized area of the building. (No one is allowed to gather in
the lobby or parking lot. Only those leaving for lunch are allowed in their cars
during the lunch period.)
 pray for my teachers, parents, and fellow students.
9
As a parent of a student of Priest Lake Academy, I will:

participate in 2 committees: 1 Friday PLA helper and 1 PLA-wide fellowship
event.

remember that I am my child’s primary teacher and accept that responsibility.

monitor homework assignments to insure my child is getting the most out of
class.

consistently check my child’s Engrade account for assignment management.

provide all textbooks and supplies necessary for my student to complete their
assignments.

not send my child to PLA if they have had symptoms of illness within the past 24
hours. (diarrhea, vomiting, fever)

maintain a positive attitude and promote a positive environment within PLA.

pray for my student, PLA teachers, Board members, and fellow tutorial families.
I have read and understand these statements and I agree to adhere to these
guidelines. In addition, I understand that any disciplinary action taken is at the
discretion of the teacher and the PLA Board and in extreme cases could result
in expulsion without refund of tuition. I also understand that re-enrollment will
be denied if this covenant is not fulfilled.
If you need to contact your student during the school day, you may call 615-424-9587.
Please do not call the church office.
10
Priest Lake Academy
Committee Commitment
PLA looks for students who want to be a part of an intimate academic and social group.
This type of academic and social environment is solely dependent on the active
involvement of our parents. PLA mandates that each family commit to serve as a PLA
Board helper for one Friday during the school year and serve on one PLA-wide
fellowship event. If a family fails to honor their commitment their student(s) will not be
allowed to return to the tutorial the following year.
Return Check Policy
A $40 fee will be charged for checks returned by the bank for any reason.
If a check is returned, Priest Lake Academy (PLA) and/or a PLA tutor will require
payment by cash, certified/cashier’s check, or money order. A personal check will not
be accepted as repayment for a returned check nor for returned check fees.
Student(s) may not return to class until the check(s) in question and all fees are paid in
full.
If there is more than one returned check incident per year, parents may be required to
make all further payments in cash, certified/cashier’s check, or money order.
11
This form is applicable to you only if your student will be driving themselves to PLA.
2015-2016 PLA Driver Permission Form
Driver's Name
Driver's Cell Phone Number
1.
2.
3.

I give the above driver(s) permission to leave school grounds during school hours

I do NOT give the above driver(s) permission to leave school grounds.
Place a check mark in the box during which the driver(s) is allowed to leave school grounds.
Hour 1
8:30-9:40
Hour 2
9:45-10:45
Hour 3
10:50-11:50
Lunch
11:55-12:20
Hour 4
12:25-1:25
Hour 5
1:30-2:30
Hour 6
2:35 -3:35
Driver 1
Driver 2
Driver 3
Please list the students that are allowed to ride with the above driver(s). Only one passenger at a
time is allowed in a vehicle. The passenger's parent's signature is also required on this form. (Note:
Student drivers are permitted to drive siblings to PLA and to leave with them after dismissal. Student
drivers are not allowed to take non-driving siblings to lunch.)
Passenger Name
Passengers Parent's Signature
Driver(s) Parent's Signature
12
Family Registration
Mother’s First & Last Name
Father’s First & Last Name
Street Address, City, Zip
Mother’s Cell Phone
Does Child(ren) live
with both parents?
Home Phone
Father’s Cell Phone
Emergency Contact Name
Email Address (contact for PLA)
Emergency Contact Phone
Emerg. Contact Relationship with
Child
Unauthorized Pick Up (Anyone NOT allowed to pick up your child.)
Pastor’s Name
Church Name
Church Phone
Umbrella School
Participating students:
Name(s)
Grade
13
PARTICIPANT/GUARDIAN
WAIVER/INDEMNITY
AGREEMENT/LIABILITY
RELEASE FORM (Release of all claims.)
Priest Lake Academy (PLA)
Participant___________________________________
Smyrna Church of Christ
Participant___________________________________112 Division Street
Participant___________________________________Smyrna, Tennessee 37167
In consideration of your accepting our child or children for participation in the above named program,
activities and Sports, I hereby, for myself, my heirs, executors, and administrators, waive and release any
and all rights and claims for damages that I may have against the above named organization, Priest Lake
Academy, and its agents, employees, representatives, successors and assigns for any and all injuries
suffered by myself or my child or children that rise out of the above-named program and activities and
sports sponsored by the above named organization.
I warrant that I have the right to authorize the foregoing and do hereby agree to hold the above-named
organization harmless of and from any and all liability of whatever nature, which may rise out of or result
from such participation.
I hereby release, forever discharge and agree to hold harmless Smyrna Church of Christ, Smyrna TN and
the directors thereof from any liability, claims or demands for personal injury, sickness or death, as well as
property damage and expenses, of any nature whatsoever which may be incurred by the undersigned
and the child participant that occur while said child is participating in Priest Lake Academy.
Furthermore, we (I) hereby assume all risk of personal injury, sickness, death, damage and expense as a
result of participation in recreation and work activities involved in the Priest Lake Academy.
The undersigned further agree to hold harmless and indemnify said church, its directors, employees and
agents, for any liability sustained by said church as the result of the negligent, willful or intentional acts of
said participant, including expenses incurred thereto.
We (I) are the legal guardians (s) of this participant, and grant our (my) permission for their participation in
Priest Lake Academy, and give our (my) permission to take said participant to a doctor or hospital and
hereby authorize medical treatment including but not limitation to emergency surgery or medical
treatment, and assume responsibility of all medical bills, if any.
For the consideration stated above, I further agree that in the event that my child or I should make any
claims against the above named organization for damages arising out of the above named program,
activities or sports, I will personally indemnify, defend, and hold harmless the organization and its agents,
employees, representatives, successors, and assigns against any and all loss and damage occasioned
thereby, including attorney’s fees.
I have read and understand the Agreement and have willingly placed my signature below as evidence of
my acceptance of all the conditions contained herein.
Signature:
Participant________________________________Date________________________
Participant________________________________Date________________________
Participant________________________________Date________________________
Guardian_________________________________Date_________________________
14
Signature Page
Please initial by each bullet statement.

_________ I have read and understand the PLA Affirmation of Faith. I understand that
all classes, activities, policies, and procedures will rest on the foundation of this
statement.

_________ I understand and agree that once registration at PLA is completed,
maintenance and administration fees, supply fees, committee buy-out fee (if applicable),
and tuition are NONREFUNDABLE in part or in whole and are NON-TRANSFERABLE.

_________ As a student of PLA I have read, understand, and agree to honor the PLA
Student Commitment. I understand that any disciplinary action taken is at the discretion
of the teacher and the PLA Board and in extreme cases could result in expulsion without
refund of tuition. I also understand that re-enrollment will be denied if this covenant is not
fulfilled.

__________ As a parent of a student of PLA I have read, understand, and agree to the
requirements listed on the Parent/Student Commitment page. I understand that any
disciplinary action taken is at the discretion of the teacher and the PLA Board and in
extreme cases could result in expulsion without refund of tuition. I also understand that
re-enrollment will be denied if this covenant is not fulfilled.

___________ I agree to fulfill the parent committee commitments required by PLA. I
understand that 2 commitments are required. If these commitments are not met, I will be
obligated to purchase the $200 buyout. If the buyout is not paid, future enrollment by my
student(s) will be in jeopardy.
o
________ I choose to opt out of the committee requirement and purchase the
buy-out. I agree to pay $200.00 on completion of my student's registration at
PLA. I understand these monies are non-refundable. ____________ Check No.
or _______________ (amount received in cash) Receipt No. ___________

___________ I have read and understand the Returned Check Policy.

___________ I have a student driver and have completed the Driver Permission Form.
Please print your full name: _________________________________________________
Date: ____________
Signature:
_____________________________________________________________________
15
PLA Calendar 2015 – 2016
August 7th– Orientation 9:00am
August 14th– First day of classes
October 2nd– End of 1st quarter
October 9th – Fall Break / NO classes
November 27th– Thanksgiving Break / NO classes
December 11th – End of 2nd quarter
December 11th – January 1st – Christmas Break / NO classes
January 8th– Return to class
February 26th – End of 3rd quarter
March 25th – Good Friday, (Aaron Academy testing week) / NO classes
April 1 – Spring Break/ NO classes
May 6th – Last day of classes
May 6th – Registration for 2016-2017 school year
*PLA will follow Rutherford County Schools for inclement weather closings.
16
What do I need for Registration?
When you come to register your student(s) for PLA, please bring the following:
1. These completed pages from your registration packet:
a. Page(s) 7 & 8. (These are the check registry pages. Record all of your
checks on these pages.)
b. Page 12 (Driver’s Form) ONLY if your student will be driving to PLA.
c. Page 13 (Registration Form).
d. Page 14 (Insurance Release Form)
e. Page 15 (Signature Page stating that you have read and agree with each
section of the packet.)
2. Checks for:
a. tuition
b. supply fees
c.
registration fees
Note: If you are hesitant to write your checks without going over the amounts and dates
with us, that is fine. We will walk you through it when you get to registration. The most
important thing is that is that you have enough checks.
When you leave registration, you will have a file folder that contains a copy of your
student(s) class schedule and a letter from each of your student’s teachers. That letter
will give you information about the teacher, the class, and will give you the information
you need to purchase the required books and materials for that class. That letter may
also have a summer reading assignment. Please read each letter carefully so your
student will be aware of the requirements for the class.
17