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Admission Application Form

Fill out the below application to begin the enrollment process for your child at Beacon Country Day School.

= required
 

Enrollment Information
 
Grade child will be entering:
Term Child will be Starting:
 
Child's Information
     
Child's First Name:
Child's Middle Name:
Child's Last Name:
     
Child Nickname:
Child's Age
 
     
Street Address:
     
City:
State:
Zip:
     
Date of Birth:
     
Parents' Information    
     
Father's First Name:
Father's Last Name:
 
     
Street Address (if different from child's):
     
City:
State:
Zip:
     
Occupation:
Employer:
Email Address:
     
Home Phone:
Work Phone:
Cell Phone:
     
Mother's First Name:
Mother's Last Name:
 
     
Street Address (if different from child's):
     
City:
State:
Zip:
     
Occupation:
Employer:
Email Address:
     
Home Phone:
Work Phone:
Cell Phone:
     
Please check if: Divorced Seperated
     
Step Parent's Information (if applicable)  
     
Step Parent's First Name:
Step Parent's Last Name:
 
     
Street Address (if different from child's):
     
City:
State:
Zip:
     
Occupation:
Employer:
Email Address:
     
Home Phone:
Work Phone:
Cell Phone:
     
Other Children in the family  
     
Name(s):
Age(s):
     

I (We) understand the obligation to pay the tuition and fees for the academic year is unconditional, so that no portion of such tuition and fees so paid or outstanding will be refunded or cancelled notwithstanding the subsequent absence, withdrawal, or dismissal of the student from Beacon Country Day School. It is understood that the selection and admission of the student reserves that place for the Full Academic Year. In the event of non-payment of any installment of tuition or fees, the entire balance may be accelerated, and the undersigned agrees to pay costs of collection, including court costs and reasonable attorney’s fees. In the event of deliberate destruction of materials or property by the student, the parents will be responsible for payment of replacement. Beacon reserves the right to dismiss, suspend, or cancel the student for any reason it deems to be in the best interest of the school, other students, or faculty.

In the event of accident or sudden illness that this agency’s authorities feels requires emergency treatment and I, other persons specific to this application, or the requested physician cannot be reached, do hereby authorize this agency to obtain the necessary medical or hospital care. I further agree to assume the financial obligation incurred for such care. I hereby give blanket permission for my child(ren) to leave the school for planned activities, including picnics, swimming, visits to the zoo, etc. I give permission for staff to apply sunscreen to my child’s exposed skin prior to outside play if necessary, and give specific directions for application in the additional information area herein.

Please type your name to signify your acceptance of the above terms:

 
Comments / Questions
 
Please use this space for comments or questions: