Application Application and Admission Contract: 2020-2021 - Leesburg Montessori I hereby make an application for my*sondaughterChild’s Full Name*Child’s Information*Dob (MM/DD/YYYY)AgeNick NameSibling:NameAge Home*Home AddressSubdivisionChild Living with*Both ParentsMotherFatherMother & Step FatherFather & Step MotherWho is financially responsible for the child*Please list any programs your child has previously attended Father’s Name*Father’s Employement Information*OccupationName of CompanyBusiness AddressEnter NA if Not ApplicableFather’s Contact Information*Home PhoneCell PhoneWork PhoneEmailEnter NA if Not ApplicableMother’s Name*Mother’s Employement Information*OccupationName of CompanyBusiness AddressEnter NA if Not ApplicableMother’s Contact Information*Home PhoneCell PhoneWork PhoneEmailEnter NA if Not ApplicableTerms and ConditionsI agree that upon enrollment of above-mentioned child at the Montessori School of Leesburg (the “School”), the undersigned, as parent(s) or guardian(s) (“I” or the “Parent”) of the above student (the “Student”) agrees to pay the Full Tuition for the 2020-2021 school year, and agrees to the following terms and conditions, the initials of one Parent representing the agreement of each Parent:I agrees to pay the Full Tuition of*FORMS: I understand that upon enrollment, I am required to provide proof of the Student’s identity and age to the School. A certificate of health for the Student, signed by a doctor is required upon admission. All required forms must be received prior to the school year.*APPLICATION: I further understand this application will make the Student eligible for an available space or placed on the waiting list. Enclosed is the application fee of $75.00, along with the $200 Registration Fee. I understand that these fees are not refundable.*DEPOSIT: Upon acceptance to the Montessori School of Leesburg, I understand that a 10% non-refundable deposit.*I agrees to pay the 10% non-refundable deposit of*TUITION: Full Tuition is prorated on a monthly basis and is due on the first of each month. The School reserves the right to raise tuition and fees after a thirty-day notice. I understand that my obligation to pay the fees for the full academic year is unconditional and that no portion of fees paid or outstanding will be refunded or canceled in the event of absence, withdrawal or dismissal from the School of the Student, in the event of changes to the School’s programs, nor upon the occurrence of a Force Majeure Event as defined herein. I understand that pupils are registered for the entire year and financial obligations must be met by May 1, 2021. All payments will be made using ACH automatic debit. I understand that a child may be denied entry on the first day of school if their financial arrangements have not been made.*LATE FEE: I understand that a $50 late fee will be added to the account after the 5th of the month for late payment. Further, the fee for a returned check is $50. After 30 days of nonpayment, Parent also agrees to pay all costs of collection, including collection agency fees, attorneys’ fees, court costs, and interest of 1.5% per month. Further, as to any account more than 90 days in arrears, the School reserves the right to accelerate the total unpaid balance of tuition and fees due under this Enrollment Agreement and refer the account to the School’s collection agent and/or counsel for satisfaction.*INCIDENTAL DAMAGE: Both Parent and School will make efforts to teach children to use materials carefully and to avoid damaging property that belongs to others; however, in the case of serious damage (over $50.00 in value), the Parent agrees to cover the cost of replacement or repair.*PARENT HANDBOOK: I have received a Parent Handbook which contains important information for all parents who enroll their children in the Montessori School of Leesburg. Please keep your Parent Handbook for future reference as it will aid in the understanding and the compliance with all policies and procedures. I understand that by signing this I also agree to abide by the rules and regulations contained in the handbook. I understand the Parent Handbook is subject to revisions.*RECORDS: I agree to the policy of the School that no student records will be released unless an account has been paid in full.*MEDIA RELEASE: Unless notified in writing, I understand that the Montessori School of Leesburg may use the Student’s picture or his or her likeness in its brochure, Facebook, and advertising materials without any monetary compensation.*MEDICAL CARE: I hereby give permission that the School may seek or administer emergency medical treatment for the Student in case we cannot be contacted by phone. All expenses for such treatment are the responsibility of the Parent. Parent hereby releases and holds the School harmless from any liability which might arise from the provision of such medical care or counseling services. I agree to give any required medication or vitamins, including over-the-counter medicine, directly to the Staff, with dosage instructions and prescription label if applicable, and not trust them to the custody of the Student. Children will not be admitted to the School when the Student displays symptoms of fever, or possible infection. A child must be free of symptoms for a 24-hour period before returning to school. If the Student becomes ill at school, I will pick up the Student from the School within two hours of notification, but in any event as soon as possible. In the event that any person in our household, even if they do not attend the School, contacts a communicable disease, I will inform the school immediately.*DISCLOSURE: I certify that I have disclosed, in writing to the School any physical, mental, or emotional disabilities of the Student or any other matter which could affect the Student’s enrollment and/or participation at the School. Except for any such separate written disclosure, Parent signifies by Parent’s signing this Enrollment Agreement that the Student is physically, mentally, and emotionally capable of participating in all aspects of the instruction and training of the School.*FORCE MAJEURE: The School’s duties and obligations under this Enrollment Agreement shall be suspended immediately without notice during all periods that the School is closed because of a Force Majeure Event. Force Majuere Event means an event outside of the reasonable control of either party which renders the completion of the full academic year impracticable or otherwise alters the form or format of the academic year. If such an event occurs, the School’s duties and obligations in the Enrollment Agreement will be postponed until such time as the School, in its sole discretion, may safely reopen.*AMENDMENT: Any amendment or modification to the Enrollment Agreement must be made in writing and must be signed and dated by the Parent and the School in order to become binding and effective.*TIME IS OF THE ESSENCE: I understand and agree that time is of the strictly essence as to all deadlines stated in this Enrollment Agreement.*CHANGE OF ADDRESS: I understand that I must inform the Montessori School of Leesburg in writing of any change of address, phone or other pertinent information pertaining to my Student.*GOVERNING LAW/WAIVER OF JURY TRIAL: The Enrollment Agreement and the rights and obligations of the parties shall be governed by and construed in accordance with the laws of the Commonwealth of Virginia without regard to principles of conflicts of law. The parties agree to waive the right to jury trial over any claims pertaining to Student’s enrollment, attendance, or separation from the School including, but not limited to, claims of breach of contract, under statute, ordinance, or common law.*PARENT ACKNOWLEDGEMENT: I acknowledge that I fully understand the terms and conditions of the Enrollment Agreement and have sought the advice of counsel to resolve any questions I have about any term or condition herein.*ENTIRE AGREEMENT: This Enrollment Agreement sets forth the entire understanding of the parties hereto with respect to the subject matter hereof and supersedes all prior and contemporaneous understandings between the parties.*ATTORNEYS’ FEES: If either party brings a claim or lawsuit against the other party to this Enrollment Agreement to interpret or enforce any of its terms, the prevailing party shall, in addition to all other damages, be entitled to reasonable attorneys’ fees and costs from the non-prevailing party.*PROGRAM SELECTION*Please check your choice:InfantPre-PrimaryPrimaryPROGRAM SCHEDULE SELECTION*Please check your choice: Half Day Morning (8:30-11:30am) Half Day Lunch (8:30am-12:30pm) Half Day Afternoon (12:00-3:00pm) Full Day (8:30am - 3:00pm) Before Care (7:30am - 8:30am) Extended Day (7:30am - 4:30pm) Extended Care (7:30am - 6:00pm) PAYMENT PLAN*Please check your choice:OPTION 1 - ANNUAL: (less $250.00 discount) due 5/1/20OPTION 2 - BI-ANNUAL: 50% due 5/1/20, 40% due 8/27/20OPTION 3 - MONTHLY: 10% deposit due 3/16/20, Monthly Installments paid 5/1/20 - 5/1/21Parent Signature*Parent SignatureDate* Date Format: MM slash DD slash YYYY Montessori School of LeesburgDate Date Format: MM slash DD slash YYYY
