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Child Care
Contract for Enrollment
St. Paul’s
Lutheran child Center 582-9745
695 Grant
Street, P. O. Box 70, Winneconne, WI 54986
Child’s
name:_____________________________________________________________________
(last)
(first) (middle)
Home Phone:________________________
Child’s Birth date______________ Sex: M F Cell Phone:
_________________________
Cell Phone: __________________________
Parents’ names:
________________________________________________________________
(mother) (father)
Address: ______________________________________________________________________
(street,
include P O Box)
(city) (zip code)
Name
of home congregation:_______________________________________________________
E-Mail where parent can be
reached_________________________________________________
Home
e-mail where we can send you
information________________________________________
All
fractions of an hour are rounded up to the next whole hour, for example 2.5 hrs.
of care will become 3 hours.
Discount
Costs:
Below are the
charges for each age group served. There will be a 5% discount for the second
child and a 10% discount for the third child.
My
child needs care as follows (specify arrival/departure times):
Infant,
Toddlers, & Two’s:
____Full
week of childcare, at least 8 hours a day, 5 days a week is $185.00
____Full day childcare, up to 10 hours a day is $45.00 a day
____7
hours a day are $38.00 a day.
____5
hours a day are $28.00 a day.
____3
hours a day are $17.00 a day.
Times: Please list below the days and times you will need care of your child.
Monday: ______________ to ____________ Tuesday: __________ to
__________
Wednesday: ____________to ____________ Thursday: __________ to
__________
Friday: ________________ to _____________
Preschool Age:
____Half-day pre-school—3
hrs, 8:00 AM to 10:45 AM – cost for first child $10.50 (wk $52.50)
____Half-day childcare—5
hrs, (Example 6:30 AM to 11:30 PM or 7:00 am to noon)—cost for first child
$17.50 (wk $87.50)
____Full-day Pre-school—7
hrs, 8:00 AM to 2:45 PM – cost for first child $24.50
(wk
$122.50)
____Full-day childcare—10
hrs a day- (Example 6:30 AM to 4:30PM or 7:30 AM to 5:30 PM) cost for first
child $35.00 (wk $175.50)
____Full
Day/Full week childcare
for 3 to 5
year olds will be discounted to $165.00 per week.
Monday: ______________ to ____________ Tuesday: __________ to
__________
Wednesday: ____________to ____________ Thursday:__________ to
__________
Friday: ________________ to _____________
(a.m.
preschool classes 8:00-10:45 p.m. preschool classes 12:00-2:45 p.m.)
School Age:
____Before
school care, 6:30 am to 7:45 am is $3.50 per day ($17.50 wk)
____Before and
after school care 6:30 am to 7:45 am and 3:10 pm to 5:30 pm is $11.50 per day.
($57.50 wk)
____After
school care is $8.00 per day. ($40.00 wk)
____Summer
Care or no-school days are $31.50 per day.
Drop In Care: For children not scheduled on a weekly basis.
____Drop
in care is $6.00 an hour. Dates: __________, __________, __________, __________
Times:
__________ to ___________
Any additional hours will be at a $3.50 an hour rate
This
schedule of childcare to start on: ____________________ and end on:
___________________
Total due at
beginning of each week = $______________
Registration Fees:
Registration fee (one time, non-refundable registration due with initial
application only)
St.
Paul’s Lutheran Church members $50/ nonmembers $100
$______________
Late
fee: If child is not picked up by 5:30 p.m., there is a $1.00/minute per child
charge to be paid by the first day of attendance in the next week.
Up
to six vacation days and six sick days with no charge are allowed from July 1-
June 30 of the next year. For vacation days, the director must be notified in
writing at least one week in advance. If your child is sick, you can notify the
director in writing of your intent to use a no-charge sick day or when you call
to inform the center that your student is ill indicate that you would like to
use a sick day. If you chose to use sick days as vacation days, you will be
responsible for paying for any absences that occur.
I
agree to abide by State of Wisconsin HFS 46 licensing rules and St. Paul’s
Lutheran Child Center policies and procedures.
Parent’s signature: __________________________________________ Date _______
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