Peake Academy

Shaping little hearts & souls for tomorrow!

Welcome to Peake Academy;

Thank you for allowing us the privilege and responsibility of serving your child in his/her great adventures in learning and exploring! We hope that your interest in Peake Academy will grow and develop into a long-term relationship with us. It is our hearts foremost desire that your child will be blessed abundantly, and appreciates his/her learning and exploring time here at Peake Academy. We aim to provide the ultimate experience a Childcare facility has to offer and with your help, we desire to instill in your child character traits that will benefit your child for the rest of his/her life, as well as to give him/her a solid foundation for relating to our immediate world. You will find within this packet everything necessary for the enrollment process. All fees must be submitted with application and will be accepted on a first come first basis. Please read over our Parent-Child Handbook carefully to ensure full understanding of our policies and procedures. Communication is vital throughout the year. Should you have any questions or concerns at the time of enrollment or at any point during the year, please don't hesitate to discuss them with us. I am confident our program will make a difference in your childs life. We are looking forward to sharing our vision with your family and enjoying a blessed year together!

Many Blessings,

Kayte Laughery Peake Academy Preschool & Childcare

Peake Academy Preschool & Childcare ~ www.peakeacademy.com ~ info@peakeacademy.com

Peake Academy
Receipt of Parent-Child Handbook 2010/2011
I have read and fully understand the policies and procedures outlined in the Peake Academy Parent-Child Handbook. I understand and agree to pay all tuition and fees in accordance with the Parent-Child Handbook, and the current Tuition & Fee Schedule. I understand that ALL families enrolled at Peake Academy are expected to adhere to such policies and procedures. I understand that the Parent-Child Handbook may be updated at any time throughout the year to reflect growth and necessary changes.

____________________________________________ ____________________
1. Signature (Parent/Guardian) Date

____________________________________________ ____________________
Print Full Name Social Security No.

____________________________________________ ____________________
2. Signature (Parent/Guardian) Date

____________________________________________ ____________________
Print Full Name Social Security No. ** Please complete and return ALL enrollment forms with your tuition and fees to the Director of Peake Academy. ** Social Security numbers for both parents must be provided on all forms.

Thank you! Peake Academy Preschool & Childcare

Peake Academy Preschool & Childcare ~ www.peakeacademy.com ~ info@peakeacademy.com

Peake Academy
Tuition & Fee Schedule 2010/2011
Tuition & Enrollment Fees: All fees must be submitted with application at the time of enrollment, unless otherwise arranged with the Director of Peake Academy. All Fees and tuition are non-refundable, non-transferable. Please see Tuition & Fee Schedule based on your childs enrollment. Annual Registration Fee: Each child is assessed a non-refundable, non-transferable annual registration fee and may be paid in full at the time of enrollment or with monthly tuition, and on/or before June 1st of each year thereafter. This fee covers only a small portion of your childs initial books, activities, orientation, administration and any other necessities needed to prepare your child for the year. ** This fee does not cover student supplies, sports fees, field trips, special art or science projects and/or music instruments, etc. Tuition: All tuition is based on a weekly schedule and is due by the 25th of each month. Payments made after the 1st at 6:00PM, will be assessed an additional fee of $50.00 per child, and $5.00 each day per child, thereafter until accounts are brought current. The first tuition payment is due at the time of enrollment. It secures your childs spot for the coming year and is non-refundable/non-transferable. Tuition & Fees 5 Days/Week 4 Days/Week 3 Days/Week 2 Days/Week 1 Days/Week Registration Fee $125.00/$180.00 $125.00/$180.00 $125.00/$180.00 $125.00/$180.00 $125.00/$180.00 Half Day $175.00 $150.00 $125.00 $100.00 $ 75.00 Full Day $350.00 $300.00 $250.00 $200.00 $150.00 Ext. Day $550.00 $450.00 $350.00 $250.00 $200.00

Sibling Discount: Receive a 5% discount on two or more sibling tuition's (all children must be an immediate family member, accounts must be current and tuition paid on/or before the 25th of each month at 6:00 PM). Discount is given ONLY on 5 full/extended paid days (does NOT apply to half days or drop-n-go days, less than 5 days). Drop-N-Go Childcare: We offer drop-in childcare Monday thru Friday between the hours of 6:00 AM and 6:00PM. This service is subject to availability and must be arranged and paid for in advance. A minimum of 2hours must be scheduled and paid. Meals/Snacks will be provided during our regular scheduled times. Punch Card [20 Hours] $60.00 $4.00 - 1st Child $3.50 - 2nd Child Individual Visits

** I have read and understand the tuition and fee schedule. I understand it is my responsibility to make sure ALL payments are paid on time, and I agree to abide by any other terms said herein and/or stated in our ParentChild Handbook.

____________________________________________________________________________________________ Parent/Legal Guardian(s) Signature

________________________________________ Date

Peake Academy Preschool & Childcare ~ www.peakeacademy.com ~ info@peakeacademy.com

Peake Academy
Parent Agreement 2011/2012

I, , enroll my child, at Peake Academy. I understand and agree to abide by all policies and procedures outlined in the ParentChild Handbook, Parent Agreement, and current Tuition & Fee Schedule.
** Please provide your initials for each category:

_________________________

____________________________

_____ I agree to pay a $ _________ annual registration fee (_____ paid in full, _____ monthly payments
arranged of $__________) with my childs enrollment papers.

_____ I agree to pay my first months tuition of $ _________ with my childs enrollment papers. _____ I understand and agree that my childs registration fee is a shared facility expense and this fee
covers only a small portion of my childs initial books, activities, orientation, administration and any other necessities needed to prepare my child for the year. I understand this fee does not cover student supplies, sports fees, field trips, special art or science projects and/or music instruments, etc. I understand and agree to pay these additional fees throughout the year, within the time requested.

_____ I understand proper enrollment is required before admittance to Peake Academy.

I understand that I have been informed about the importance of having alternative care available for my child during the scheduled and/or un-expected days our school is closed for any reason. I understand I am responsible for paying any necessary drop-in fees should my childs stay at Peake Academy extend beyond his/her original schedule for any reason. I understand and agree should Peake Academys Agenda change for the current enrollment year, notice will be given.

_____ I understand and agree that I am responsible for notifying Peake Academy as early as possible

when my child will not be attending his/her regular scheduled day due to vacation, illness and/or for any other reason. I understand I am responsible for notifying Peake Academy as soon as possible when I know my child has been exposed to a contagious illness so that a notice may be posted to alert the other parents, as required by law.

_____ I understand and agree should Peake Academy have any concerns that the school and/or

extended childcare is not a good fit for my child and/or family, the director will make every effort necessary to resolve any such concerns. In the event a solution may not be resolved, Peake Academy reserves the right to request that a child and his/her family be withdrawn from the program immediately. No credit will be given and all early termination/withdrawal policies apply.

_____ I understand and agree to abide by all policy of fees stated in the Parent-Child Handbook. _____ I understand and agree that any changes made to my childs enrollment and/or extended

childcare schedule, requires a written 30-day notice and such changes take effect the first day of the month following the last day of such notice. I understand and agree I am responsible for payment of my childs schedule whether he/she attends or not. I agree to pay the current drop-in fee for any additional hours used beyond my childs schedule, due and payable at the time of pick-up. I understand Peake Academy does not pro-rate or give credit for any reason. ** I understand Peake Academy grants no exception for any reason to the 30-day notice policy.
_________________________________________________________________________________________________ Signature (Parent/Guardian) _________________________________________________________________________________________________ Print Full Name _________________________________ Date _________________________________ Social Security No.

Peake Academy Preschool & Childcare ~ www.peakeacademy.com ~ info@peakeacademy.com

Peake Academy
Schedule Agreement 2011/2012

________________________________________ _________________________
Childs Name Anticipated Start Date

Please mark the dates and times your child will be attending Peake Academy. Once enrollment is accepted for your anticipated start date, your space is reserved for you. ** Extended hours are available upon request!
Mon __________ o Half Day o Full Day o Ext. Day Tue __________ o Half Day o Full Day o Ext. Day Wed __________ o Half Day o Full Day o Ext. Day Thu __________ o Half Day o Full Day o Ext. Day Friday __________ o Half Day o Full Day o Ext. Day

I agree to pay $ above.

____________ per month for my child to attend Peake Academy on the days listed

I have read and fully understand the Parent-Child Handbook. I accept the responsibilities listed and agree to abide by such written terms and policies. This schedule is agreed upon between the parent(s)/guardian(s) and Peake Academy. I fully understand and agree that any changes made to my childs schedule, requires a written 30-day notice minimum and such changes take effect the first day of the month following the last day of such notice. I understand Peake Academy does not pro-rate months and/or issue credit for any reason. Important Notice: Parents will be responsible for payment of their childs scheduled time. Please arrive on time to drop your child off and to pick your child up. Drop-in rates will be billed at $5.00 per 15-minutes before 6:00AM and after 6:00PM. Payment is due at the time of pickup. Please see Tuition & Fee Schedule for current rates. THANK YOU!!!

____________________________________________ ____________________
Signature (Parent/Guardian) Date

Peake Academy Preschool & Childcare ~ www.peakeacademy.com ~ info@peakeacademy.com

Peake Academy
Universal Permission Form 2011/2012

_____________________________
Childs Name

Medical Treatment Authorization:

In the event of an apparent or real emergency, in which medical treatment or hospitalization of my child may be necessary the undersigned parent(s)/guardian(s) hereby authorize and appoint Peake Academy, through its agents, to obtain any medical or hospitalization, and/or call for an ambulance or transport the above named child as they believe necessary and proper for the immediate care and welfare of said child. I do further authorize and direct any medical doctor or hospital to render any and all treatment believed necessary and proper for the immediate care and welfare of the above named child and the undersigned agrees to pay for such medical treatment and expenses incurred on behalf of such child and shall hold Peake Academy and its employees, harmless from any and all liability, claims, judgments and costs incurred in/or as a result of any such medical treatment or hospitalization.

Non-Prescribed & Prescribed Medication Authorization:

My child may be given non-prescribed medication as indicated on the container, including sunscreen, childrens pain reliever, antibacterial first aid cream and diapering ointment may be administered if deemed necessary by the poison control operator. Parent(s)/Legal Guardian(s) will be notified prior to administering non-prescription pain relievers (prescription medications must be current and require permission slips for each medication signed by a parent and the prescribing doctor).

___________________________________________________________________
Restrictions (if any)

Field Trips/Transportation:

My child may be taken on field trips or excursions by bus, private motor vehicle; and on neighborhood walking excursions, under required supervision.

___________________________________________________________________
Restrictions (if any)

Water Activities:

My child may participate in swimming or other water activities under required supervision.

___________________________________________________________________
Restrictions (if any)

Photographed:

My child may be photographed for publicity, our website, news purposes and/or for any other reason necessary for marketing Peake Academy and/or our other programs and facilities. [ ] On Site [ ] Off Site

___________________________________________________________________
Restrictions (if any)

________________________________________________ __________________
Signature (Parent/Guardian) Date

Peake Academy Preschool & Childcare ~ www.peakeacademy.com ~ info@peakeacademy.com

Peake Academy
Emergency Evacuation Form 2011/2012

_______________________________________________ ___________________
Name of child (1) Mother/Legal Guardian Work No. Home No. DOB Cell/Pager No.

____________________________ ____________ ____________ ___________ ____________________________ ____________ ____________ ___________

(2) Father/Legal Guardian Work No. Home No. Cell/Pager No.

Back up/emergency persons who are authorized to pick up your child in case of an emergency if parents/guardian(s) cant be reached. If parent/guardian(s) are reached, but unavailable to pick up their child they must arrange for their child to be picked up by an authorized person or otherwise make themselves available to do so themselves immediately:
(1) Authorized Persons Name Relationship Phone

_____________________________ _____________________ _______________ _____________________________ _____________________ _______________

(2) Authorized Persons Name (3) Authorized Persons Name Relationship Relationship Phone Phone

_____________________________ _____________________ _______________

I hereby warrant to Peake Academy that I am entitled to legal custody and possession of my child and accordingly am authorized to place my child in your care and custody, and further am authorized to sign this emergency evacuation information form.

_______________________________________________ ___________________
Parent/Guardian(s) Date

Peake Academy Preschool & Childcare ~ www.peakeacademy.com ~ info@peakeacademy.com

Peake Academy
Deschutes Public Library Program 2011/2012
In past years, our school was located downtown, one block from the Deschutes Public Library. Each Wednesday we would bundle the children up and head over for story-time, arts-n-crafts, and to check out books if time allowed. Now that we are across town we had hoped the Deschutes Public Library Book Buggy would visit us each week, as this is a service provided to in-home child day care facilities upon request. Unfortunately when I called to reserve the Book Buggy I was informed it is no longer in service at this time due to budget cuts. However, the childrens Librarian has offered to come out to our location once, maybe four times this year. Although we are honored to have her do so and we would be blessed beyond, I feel that even one to four times each year is not enough. This has been in past years the highlight and most memorable event of our preschoolers experience, not to mention the effort the Redmond Library and their staff put into your child is priceless. A solution to this would be to transport our preschoolers. Cascade East Ride Transit of Redmond would be willing to transport our preschoolers to and from the Library. The cost of this service will be approximately $3.00 per child each round-trip. I understand that this may be an expense one may not be able to bare at this time of hardship, however I would like to encourage you to think about contributing to this cause at least once each month. Please check all that apply: ____ I would be willing to commit to pay ____ $3.00 ____ $6.00 ____ $9.00 ____ $12.00 ____ each month for my child to have this opportunity. ____ I would be willing to donate ____ $3.00 ____ $6.00 ____ $9.00 ____ $12.00 ____ for another child to have this opportunity. ____ Its a great opportunity, but I am not interested at this time.

_______________________________________________ ___________________
Parent/Guardian(s) Signature Date

Peake Academy Preschool & Childcare ~ www.peakeacademy.com ~ info@peakeacademy.com

Peake Academy
Work Exchange Program 2011/2012
Peake Academy has established a program that will allow families up to $25.00 off per child's tuition per month in exchange for work around the property. It takes quite a bit of effort to maintain a facility where a number of children are constantly present. The value of this time is set at $10.00 per hour. Each family must sign in/out before and after each work period at one of our Check-in stations. Each family member (over 18 years) volunteering at our facility must be registered with the criminal history department prior to volunteer work (we must receive a copy of clearance report). Upon completion of each families hours a credit will reflect on their account for the next billing cycle (i.e. work period April 1st - 30th; credit invoice due May 25th). It is up to each family to keep track of their hours worked each month. Each family is allowed to work as much as they wish as long as they understand a minimum of 2.5 hours per child must be worked (and a maximum of $25.00) will be credited to their account per month, and hours will not be carried over from month to month. Each family must signup for specific days, hours, duties and commit themselves to following through. Although we truly appreciate each families involvement on field trips, classroom events, etc., this time will NOT be included in our work exchange program. Duties will be distributed as needed. Please do not ask for specific duties as we understand some duties may be less desirable than others. Duties may include, yet are not limited to the following: Housekeeping: sweeping/mopping floors, cleaning windows, cleaning bathrooms, washing dishes, sanitizing toys, etc. Landscaping - mowing, weeding, cleaning up animal areas, etc. Prep Work - classroom prep, running errands, etc. Fundraisers, Yearbook & MORE!

Thank you for understanding that your time and effort is more valuable than money!!

____ Yes, I am interested in Peake Academys work exchange program. exchange on _______________ (estimated date).

I am available to begin my work

____ No, I am not interested in Peake Academys work exchange program at this time.

_______________________________________________ ___________________
Parent/Guardian(s) Signature Date

Peake Academy Preschool & Childcare ~ www.peakeacademy.com ~ info@peakeacademy.com

(Please complete ALL sections of application)

Application Information

_________________________ _____________ _____________ _____________

Name of child Street Address, City, State, Zip Nickname Placement DOB Birthplace Entry Date/Age M/F

________________________________ _____________ _____________ ______

Allergy Alert Does your child have any allergies or health conditions (if yes, please explain)?

___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

Please give any information concerning your child, which will assist us in providing the best care for your child (play, eating/sleeping habits, fears, likes, dislikes, etc):

_________________________________________________________________________________________

___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

Family Information:
Child lives with (check all that apply): [ ] Father [ ] Stepfather [ ] Grandfather [ ] Mother [ ] Stepmother[ ] Grandmother [ ] Other

___________________

Check any that apply (child): [ ] Child Adopted [ ] Parents Married [ ] Parents Divorced [ ] Parents Separated [ ] Father Deceased [ ] Mother Deceased

_________________________________ __________________________ ________________________________________

Parent(s)/Guardian(s) Information: Primary email account:
(1) Mother/Legal Guardian Street Address, City, State, Zip

____________ ____________ ___________ _____________ _____________

Work No. Home No. Cell/Pager No. DOB S.S. No. (must be provided)

_________________________
Place of Employment (2) Father/Legal Guardian

_______________________________ ________
Street Address, City, State, Zip Work Hours Street Address, City, State, Zip

__________________________ ________________________________________ ____________ ____________ ___________ _____________ _____________

Work No. Place of Employment Home No. Cell/Pager No. DOB S.S. No. (must be provided) Work Hours

_________________________
Other children living in household:
(1) Childs Name

_______________________________ ________
Street Address, City, State, Zip

_________________________ _____ ___________ _____ ________________

Age DOB M/F School Attends

_________________________ _____ ___________ _____ ________________

(2) Childs Name Age DOB M/F School Attends
Peake Academy Preschool & Childcare ~ www.peakeacademy.com ~ info@peakeacademy.com

_________________________ _____ ___________ _____ ________________

(3) Childs Name (4) Childs Name Age Age DOB DOB M/F M/F School Attends School Attends

_________________________ _____ ___________ _____ ________________

Medical/Dental Information:
(1) Childs Doctor Wk Phone

_________________________ _________________________________________ __________________ __________________

On-call Phone (2) Childs Dentist Wk Phone Street Address, City, State, Zip

_________________________ _________________________________________
Street Address, City, State, Zip On-call Phone Medical Plan Policy/Group No.

__________________ ________________ _______________ _______________

Emergency Contact:

____________________________ ______________________ _______________

(1) Emergency Contacts Name (2) Emergency Contacts Name Relationship Relationship Phone Phone

____________________________ ______________________ _______________ ____________________________ ______________________ _______________

(3) Emergency Contacts Name Relationship Phone

Authorized person to pickup your child:

(1) Authorized Persons Name

_____________________________ _____________________ _______________

Relationship Phone

_____________________________ _____________________ _______________

(2) Authorized Persons Name (3) Authorized Persons Name Relationship Relationship Phone Phone

_____________________________ _____________________ _______________

Previous Childcare Experience (previous schools and/or providers will be contacted for references):
(1) School/Provider Name Street Address, City, State, Zip

_________________________ _________________________________________ _________________________ ________________ ___________ ____________

Type of Facility

___________________________________________________________________
Reason for leaving:

Contact Name

Contact No.

How long

_________________________ _________________________________________
(2) School/Provider Name Type of Facility Street Address, City, State, Zip Contact Name Contact No. How long

_________________________ ________________ ___________ ____________ ___________________________________________________________________

Reason for leaving:

Peake Academy Preschool & Childcare ~ www.peakeacademy.com ~ info@peakeacademy.com

How did you learn about Peake Academy:

[ ] Family Member [ ] Friend [ ] Internet [ ] Phone Directory [ ] Event [ ] News Paper/Magazine Ad [ ] Flyer [ ] Other

______________

Please state why you wish to enroll your child with Peake Academy:

___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________

Parent Signature:
I have read and understand the Parent-Child Handbook and Tuition/Fee Schedule. I have provided only true information on my enrollment application and I accept the responsibilities listed and agree to abide by such written terms and policies of Peake Academy. This contract may be updated at any time to project growth of our facility. Any revision/change in our policy may be given at any time to the parent(s)/guardian(s) as a written notice.

_______________________________________________ _________________
Parent/Legal Guardian Signature Date Contract Signed

Peake Academy Preschool & Childcare ~ www.peakeacademy.com ~ info@peakeacademy.com