PRIME TIME REGISTRATION
Prime Time Hours: Dismissal to 5:30 p.m.
Cost: $10.00 per day or $150.00 per month
Please fill out one form for each student enrolling in PRIME TIME
Registration is not complete unless form is signed below.
December 17, 2008
Student’s Full Name:
Grade/Class:
Parent/Guardian’s Name:
Work Phone:
Mother/Guardian:
Father/Guardian:
Cell Phone:
Mother/Guardian:
Father/Guardian:
Student is Enrolling for:
Full Time
Part Time
Part Time: (Please check days needed)
Monday
Tuesday
Wednesday
Thursday
Friday
PRIME TIME PROGRAM AGREEMENT
Please read the following information carefully. Your child’s registration is not complete until this program agreement is signed (on reverse) by parent / guardian.
1. Enrollment: Registration is required before a child may participate in Prime Time.
FULL TIME
$150.00 must be paid at the time of registration. This will be applied to your child’s Prime Time fee for first month of Prime Time.
PART TIME
A $50.00 deposit must be paid at the time of registration.
2. Fees: Every child registered will be charged the same rate.
FULL TIME
$150.00 per month. All accounts must be paid monthly.
PART TIME
$10.00 per day or any part of a day.
Note: To qualify for free or reduced rates, you must file with the Louisiana Child Care Assistance Program. Parents are responsible for full-rate Prime Time fees until proof of CCAP approval is provided.
Payments are due as follows:
Payment in full is due by the 5th of each month. There is no credit for school absences, sick days, or suspensions. Invoices will be sent home on the 25th day of the previous month.
Note: For students who enroll in Prime Time on a Part Time basis, a $50.00 deposit must be maintained on account throughout the school year and will be applied to the final month’s billing.
Payments may be made by check, money order, or debit/credit card. There is a $32.00 NSF fee for each
returned check.
Delinquent accounts will be charged monthly a $25 late fee or 5% of the outstanding balance, whichever is more.
I agree to pay the Prime Time program cost of:
Check one:
$10.00 per child per day (any part of the day equals the full day), billed monthly and payable on the 5th of each month; $50.00 due with registration.
$150.00 per child per month payable on the 5th of each month; $150.00 due with registration.
Please charge my VISA / MASTERCARD / DISCOVER.
Card Number:
Exp. Date:
My check, made payable to ISL, is attached.
3. Student Pick-up: There is a $1.00 per minute late fee.
Children must be picked up daily by 5:30 p.m. If you are late picking your child up more than twice, you may forfeit the right to participate in the Prime Time program.
Safety is top priority in the Prime Time program; therefore no child will be released from Prime Time without a parent/guardian signature or that of one of the three individuals listed below.
Individuals must be 16 years or older, I.D. is required.
Name:
Cell Phone:
Relationship:
Name:
Cell Phone:
Relationship:
Name:
Cell Phone:
Relationship:
4. Discipline
Prime Time is an extension of the school day. Therefore, we will follow the same discipline policy as the school.
Disruptive or disrespecful behavior towards other students or staff will not be permitted and will be cause for dismissal from the program.
Your signature below verifies that you have read the above information carefully and agree
to abide by all conditions of the Prime Time Program Agreement.
Parent Print Name
Parent Signature
Date
www.isl-edu.org
