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1 Registation Packet Gades K - 5 Extended Time Child Cae Pogam School Yea Geneal Infomation/Fees Due to state policy, all egistation packets MUST be completed in thei entiety pio to you child s fist day of attendance. All medications and medical foms must be on site and veified. If a child aives at the pogam without a completed egistation, the Paent/Guadian will be called and child will need to be picked up. Registation Fees: DISCOUNTED beginning 6/1/18-6/29/18 1 st child FREE / 2 nd child $20 / 3 d + child $10 REGISTRATION DEADLINES: Registe on o befoe August 10: Child can begin on the fist day of school, Monday, August 20. Registe between August 13-17: Child can begin SCS childcae on Monday, August 27. Registe between August 20-24: Child can begin SCS childcae on Tuesday, Septembe 4. Beginning August 27: Thee business days ae equied to pocess you child s foms. FULL RATE beginning 7/2/18 1 st child $40 / 2 nd child $30 / 3 d + child $15

2 2018/2019 Extended Time Registation Please fill out a sepaate fom fo each child being egisteed. Child s Name School Gade in Fall 2018/2019 Date of Bith / / Gende Text Messaging Communications - The cell phone numbes povided may eceive text communications egading the pogam and account infomation. This includes weathe delays and closues. Pimay Cell Phone Numbe: Cell Phone Netwok Povide: (ex. Veizon, Spint, ATT) Seconday Cell Phone Numbe: Cell Phone Netwok Povide: (ex. Veizon, Spint, ATT) I do not want to eceive text communications, I choose to opt-out of this featue. Will you child be attending ou pogam on the fist day of school? Gades 1-5 stats Monday, August 20th am pm both no Kindegaten stats Wednesday, August 22nd am pm both no Kindegaten stats Thusday, August 23d am pm both no Kindegaten stats Fiday, August 24th am pm both no PG Movie: My child has pemission to watch a suitable PG ated movie. Yes No Walking: When my child attends Maplewood Elementay (All Day Pogams and Camps) I give SCS pemission to walk my child to Bunham Pak and othe suitable locations within one mile of Maplewood Elementay, when my child is attending Maplewood. These walks may occu any time duing the 2018/2019 school yea fom August 2018 though May All walks ae supevised by child cae povides. Yes No Photogaph/Videotape: I give consent fo my child to be photogaphed o videotaped. This is fo Sylvania Community Sevices puposes (i.e.-website, Facebook page, and bochue) o any local newspape/television station coveage. Yes No Notice: Fo childen of divoced paents, the Ohio Revised Code povides that non-esidential paents ae entitled to: access to the day cae facilities duing SCS child cae hous fo the pupose of contacting thei childen; access to ecods such as child cae time and attendance; and to have a paent-teache confeence UNLESS thee is an ageement to the contay between the paents o a cout ode o divoce decee stating othewise. If this situation applies to me, I agee to povide SCS with copies of the appopiate papewok. Paent s Signatue Date Due to state policy, all egistation packets MUST be completed in thei entiety pio to you child s fist day of attendance. All medications and medical foms must be on site and veified. If a child aives at the Summe Camp pogam without a completed egistation, the Paent/ Guadian will be called and child will need to be picked up. 2

3 Pick Up List In ode to potect you child, Sylvania Community Sevices Child Cae would like you coopeation with the pick-up pocedue. Please fill out the following infomation and etun it with you egistation foms. This sheet will be kept at the site with you child s infomation so that any employee may have access to it. Anyone picking up you child will need to bing photo ID. Please emembe to include youself and spouse (if applicable) on the list below. Thank you fo helping make ou centes safe fo the childen. Desiee Thompson Lisa Ames Child Cae Diecto assistant Child Cae Diecto Child s name: School: Gade (in fall 2018/2019) The following people may pick up my child(en): Please include youself. Name Relationship Phone Numbe (Please list full name, no nicknames) (example: Mom, Dad, Gandmothe, etc.) Paent s Signatue Date Pick-Up Peson will need to show photo I.D. 3

4 N. Holland-Sylvania Road Ave. Sylvania, OH P: F: sylvaniachildcae.og

5 Paent/Guadian Signatue Date 4747 N. Holland-Sylvania Road Ave. Sylvania, OH P: F: sylvaniachildcae.og 5

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8 Sylvania Community Sevices has pemission to secue emegency tanspotation fo my child in the event of an illness o injuy which equies emegency teatment. The emegency tanspotation sevice will detemine the facility to which my child will be tanspoted. 8

9 SYLVANIA SCHOOL DISTRICT TRANSPORTATION STUDENT RELEASE 2018 / 2019 School Student is Attending: Gade: Student Name: Home Addess: Phone: Paent/Guadian: Daycae /Sitte/ Altenate Location Name: Sylvania Community Sevices- Extended day Effective Date: Pemission is given to tanspot my child named above to the daycae/babysitte/altenate addess listed above fo the school yea. Please check only one box below. BEFORE SCHOOL ONLY AFTER SCHOOL ONLY BEFORE & AFTER SCHOOL (this option includes weathe delay tanspotation) WEATHER DELAYS ONLY (Maplewood) Comments: ***NOTE: Only Consecutive Monday Fiday equests within the child s home Elementay attendance aea and to SCS Childcae will be consideed. (Please allow fo a thee (3) day notice of any tanspotation change) Any change to this elease will need to be communicated in witing by the paent/guadian to the school and to the Tanspotation Depatment as needed. Paent/Guadian (Paent / Guadian) Signatue (Date) Sylvania Public Schools ATTN: Tanspotation Dept N. Holland-Sylvania Road, Sylvania, OH Telephone (419) / FAX (419) N. Holland-Sylvania Revised: 05/2018 Road Sylvania, OH P: F: sylvaniachildcae.og 9

10 2018/2019 Extended Time Account Contact Tuition Chages: DISCOUNTED beginning 6/1/18-6/29/18 1 st child FREE / 2 nd child $20 / 3 d + child $10 FULL RATE beginning 7/2/18 1 st child $40 / 2 nd child $30 / 3 d + child $15 Secuity Deposit (Refundable) One Child All gades - $ Two o moe childen All gades - $ pe child Rates: Single / Family* Extended Time Gades K-5 AM Slot (6:30 am 9:00 am)...$9.90 / $9.40 PM Slot (3:00 pm 6:30 pm)...$13.20 / $12.55 BOTH AM & PM on same day Discounted o Daily discount when both used in same day...$21.95 / $20.85 All Day Pogams, Winte and Sping Camps Daily...$40.35 / $38.35 Late Stats Planned 2 h. delays (6:30 am 11:00 am)... $16.00 / $ % Discount when AM Late Stat and PM used in same day. Weathe Delays & Closings 2 HR DELAY (6:30 am 11:00 am)... $16.00 / $15.20 DELAY to CLOSURE When picked up no late than 11:00 am... $16.00 / $15.20 When picked up afte 11:00 am... $40.35 / $38.35 CLOSURE (6:30 am 6:30 pm)... $40.35 / $38.35 *The family ate applies to families with two o moe childen enolled with SCS-Child Cae. Othe Fees: Declined cedit cad o electonic funds - $15.00 Accounts that have a 3d declined payment within one yea will fofeit any othe payment than money ode o cetified check, fo a peiod of six months. In the event of 4th decline only money ode o cetified check will be accepted fo the emaining duation of ou sevices. Split Account Initiation Fee - $ If paents would pefe 2 accounts fo billing puposes, thee will be a one-time only, non-efundable, initiation fee, pe account. Billing Policies: Paents ae equied to use the attendance clock daily while dopping off and picking up thei child. You may use the ET pogam as needed. You child is NOT equied to have a schedule. ET billing cycle is evey 2 weeks. Accounts ae billed fo the cae aleady given in the pio two weeks. Tuition is billed bi-weekly on Wednesday. Payment is due within one week by the next Wednesday (7 calenda days). Balances geate than $20 at the end of the day Wednesday will eceive a $10.00 finance chage. Balances geate than $20 at the end of the day Fiday (10 calenda days afte billing) will be suspended fom child cae sevices on Monday. Child cae sevices will emain suspended until the past due balance is paid in full. Accounts setup fo automated payments with a cedit cad o bank account will be pocessed on the same day that tuition is billed. The pimay paye on the account will eceive an with an attached invoice and a confimation that billing has been completed and is available on MyPocae. No invoice will be mailed, unless optional mailing pefeence is checked in the box below. Paents will be equied to egiste thei account with MyPocae. MyPocae is an inteactive paent potal whee payes have access to view account balances, ledge histoy, child time cads and make payments online. Payment Options: No cash o checks will be accepted. Only electonic payments will be accepted using Tuition Expess o MyPocae. Only Visa & MasteCad accepted We offe the following electonic payment options: o Automated Cedit Cad Tansactions o Automated ACH Tansactions Checking & Savings Accounts o Point of Sale Cedit Cad Tansactions At billing office o Online Payments Pay online with Tuition Expess OR MyPocae Child(en) Name: Pimay Paye Responsible fo Payment (Pint Name): Pimay Paye Responsible fo Payment (Signatue): Pimay Paye s Addess: Date: Paent s Social Secuity Numbe: (* A social secuity numbe is equied fo egistation to be complete.) Billing Pefeences: qoptional - I would also like a pape statement mailed to my home addess. 10

11 2018/2019 Extended Time How did you lean about ou pogam? I have used SCS child cae pogam peviously with one of my childen, who attends (please select one): Cental Tail Highland Hill View Maplewood Sylvan Stanahan Whitefod Woodow Pe-K Nothview Pe-K Refeal Who efeed you? Postcad eceived in mail Bochue eceived in mail Phone Book AT&T Toledo Phone Book Veizon Sylvania Phone Book Sylvania Advantage Newspape Intenet Ou company web site: Ou Child Cae web site: Ou Facebook Page (Sylvania Community Sevices Child Cae) Othe Sylvania Schools Office Othe: 11

12 Dea Child Cae Families, At Sylvania Community Sevices Child Cae, we ae constantly looking at ways to impove the sevice we povide you and you childen. With this in mind, we have changed ou payment system to electonic payments only. We have eliminated cash and check payments in an effot to steamline ou tansactions. Tuition Expess pat of the Pocae Softwae system we use to manage ou centes allows us to pocess payments safely, quickly and efficiently. Tuition Expess is a Payment Cad Industy (PCI) Level 1 Sevice Povide. You pesonal account infomation could not be safe. Automated payments ae poven safe than paying by check the potential fo check faud and identity theft ae eliminated. Please look ove the Tuition Expess Fequently Asked Questions. Thee, you will find answes to questions you may have egading Tuition Expess o automated payments in geneal. If you have futhe questions, please call us at Moe infomation is available at TuitionExpess.com. Tuition Expess is The way we pocess payments at Sylvania Child Cae. We offe the following Tuition Expess payment options (You will only choose one): MyPocae Pay using you online account. Payments post automatically to you account ledge. Tuition Expess Online You may schedule a payment fo a futue date using a cedit cad. Complete the Tuition Expess enollment fom, Section C. Automatic Payment w/ Cedit Cad SCS will pocess you payment automatically using the cedit cad infomation completed on Tuition Expess enollment fom, Section A. Automatic Payment w/ Bank Account SCS will pocess you payment automatically using the bank account infomation completed on Tuition Expess enollment fom, Section B. Visa & MasteCad ae accepted. By completing the Tuition Expess Paent Enollment Fom, you will help us make temendous stides in simplifying ou tuition and fee payment pocessing stides that allow us to spend even moe time with you childen in ou cae, and less time pocessing payments. Tuition Expess is a win-win-win convenient fo you, efficient fo us and best fo the childen. Sinceely, Sylvania Child Cae 12

13 Convenient and Safe On-time Payments Fequently Asked Questions by Paents We ae excited to offe automatic payments though Tuition Expess. With this sevice it is no longe necessay fo you to wite a check fo tuition and fees. Payments will be automatically debited fom you bank account o chaged to you cedit cad. All payments ae secue and you can even choose to have a eceipt ed to you afte each tansaction. It s easy to sign up just ask you child cae povide. When I pay my tuition automatically, how secue is my account infomation? Vey secue moe secue than when you wite checks. The checks you wite evey day have you name, addess, phone numbe, and sometimes you dive s license numbe on them. With this infomation, ciminals have all they need to access you account, o wose, steal you identity. Automatic payments geatly educe this potential by limiting the amount of infomation available and the numbe of people who have access to it. Tuition Expess also incopoates additional secuity pocedues, utilizing 128-bit encyption. What if the child cae povide makes a mistake and takes out too much money? Repot the eo immediately it was likely an honest mistake. The child cae povide will adjust you account accodingly. What if my child cae cente and I disagee about a payment? If you feel that the payment should not have been made, you have the ight to dispute the chage. Contact you bank o cedit cad company. Tuition Expess and you child cae povide will wok closely to esolve the issue in a timely manne. Does this fom of payment give the child cae cente access to my account? Nobody at the child cae cente has access to you account. When you sign up fo Tuition Expess, you only authoize you bank o cedit cad company to elease the exact amount owed to you povide, when it is due and payable. How will I know when a payment is taken out of my account? You child cae expenses will be taken out of you account on a schedule that you and the child cae cente agee upon. You child cae cente has the ability to pint statements fo you ecods, pio to the withdawal of any money. Payments made electonically will post to this statement with the Tuition Expess label. Statements issued though you bank o cedit cad povide will display the name of you child cae cente fo debited tansactions When I sign up fo Tuition Expess, how will this help my child cae povide? You child cae povide has chosen to offe automatic payments fo seveal easons. Fist, it will give you the convenience of not having to wite a check evey time tuition and fees ae due. Second, it allows egula scheduling of you payments. Thid and most impotantly, automatic payments educe the amount of time you child cae povide spends on administative tasks, giving staff moe time to spend with the childen. How do I get stated? Simply complete the Payment Authoization fom and etun it to you child cae povide. They will do the est! Whee can I lean moe? Fo moe infomation on the benefits of Tuition Expess, please visit us at tuitionexpess.com. Copyight Pocae Softwae, 11/2/

14 Please choose only 1 option: A, B o C Automated Payment Pocessing Safe Convenient Easy We ae excited to offe the safety, convenience and ease of Tuition Expess a payment pocessing system that allows secue, on-time tuition and fee payments to be made fom eithe you bank account o cedit cad. ELECTRONIC FUNDS TRANSFER AUTHORIZATION FOR BANK ACCOUNT and CREDIT CARD I (we) heeby authoize (business name) Sylvania Community Sevices to initiate cedit cad chages to the below-efeenced cedit cad account (Section A) OR, initiate debit enties to my (ou) checking o savings account, indicated below (Section B). To popely affect the cancellation of this ageement, I (we) ae equied to give 10 days witten notice. Cedit union membes: please contact you cedit union to veify account and outing numbes fo automatic payments. Check with the cente fo accepted cedit cad types. *Visa and Mastecad* COMPLETE ONE SECTION ONLY SECTION A (Cedit Cad) Cadholde Name Phone # Cadholde Addess City State Zip Account Numbe Expiation Date Cadholde Signatue Date SECTION B (Bank Account) You Name Phone # Addess City State Zip Bank o Cedit Union Name Bank o Cedit Union Addess City State Zip Routing Tansit Numbe (see sample below) Account Numbe (see sample below) Checking Savings Authoized Signatue Date Fo Official Use Only A sevice of Date Received Employee Signatue 14 Copyight Pocae Softwae 1/16/2015

15 TM Please choose only 1 option: A, B o C Automated Payment Pocessing Safe Convenient Easy Section C (online pay) We ae excited to offe the safety, convenience and ease of Tuition Expess Online Payments. You can pocess on-time tuition and fee payments with you cedit cad at TUITIONEXPRESS.COM REGISTRATION Sylvania Community Sevices As a custome of (business name), I (we) wish to egiste at fo the pupose of making Online Payments using a cedit cad. PLEASE CONTACT CENTER REPRESENTATIVES FOR CREDIT CARD TYPES ACCEPTED BY CENTER. SCS ACCEPTS VISA AND MASTERCARD Cadholde Name Phone # Cadholde Addess City State Zip Cadholde Signatue Date Website Registation Code: (Please select a 4 digit PIN that will be used when you egiste at TuitionExpess.com) 4 digits A sevice of Fo Official Use Only Date Received Employee 4747 Signatue N. Holland-Sylvania Road Sylvania, OH P: F: sylvaniachildcae.og 15