Family Registration Form Page 2
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1
2AUTHORIZATION
Medical Emergency. In case of medical emergency, we authorize school officials to make the best
decision on behalf of our child(ren) if we cannot be reached in a timely manner.
Agree
Disagree
Medication. My child(ren) has my permission to receive acetaminophen, ibuprofen, antacids,
cough drops and minor first aid treatment upon request.
Agree
Disagree
Riding the VCS School Bus/Van. My child has permission to ride the school bus/van to and from
school events.
Agree
Disagree
Media Agreement. I grant permission for my child and family to be included in any film, video,
print, yearbook and/or website for the sole purpose of marketing Valley Christian School, without
any form of compensation or notification.
Agree
Disagree
School Directory. I grant permission for my family’s name, address and phone number to be
included in the VCS Telephone Directory that will be distributed to all VCS school families, faculty
and staff.
Agree
Disagree
TUITION PAYMENT SCHEDULE
Single Payment (2% discount applied if paid before 8/1 or in the case of late enrollment, before the student begins school).
12 Month Plan (July – June) *
10 Month Plan (Sept. – June) *
th
th
* FACTS Automated Bank Withdrawal Schedule
5
of the month
20
of the month
Same as last year
PARENT AGREEMENT
We have studied the Admissions Handbook and agree with and support all the policies of Valley Christian School. We are aware
that the Board Policy handbook and the Student Handbooks are available in the north office. We agree to the Board of Directors
policy on tuition and payment of the same, along with any late fees. We agree to submit to and support the rules, guidelines and
expectations of any program at Valley Christian School in which our child(ren) participate. We will process any grievances
according to Matthew 18:15-20 and will abide by any final decisions the Board of Directors may make in that matter.
PARENT/GUARDIAN SIGNATURE
MOTHER
FATHER
Print Name:
____________________________________
Print Name:
_____________________________________
Signature:
____________________________________
Signature:
_____________________________________
Date:
____________
Date:
____________
Church family attends:
___________________________________________________________________________________
Any family members VCS alumni?
Year Graduated:
______
Name at graduation:
________________
No
Yes
OFFICE USE ONLY
Received current immunization records or signed Religious Exemption form. Date received: ______________
Received Self Administer Medication form (if applicable). Date received: _______________
Registration fees received by accounting office. Amount received: _____________ Date received: ________________
Notes: ________________________________________________________________________________________________
______________________________________________________________________________________________________
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