RVUSD EXTENDED CARE REGISTRATION FORM 2017-2018 Child #1 Name School Grade Child #2 Name School Grade Start Date of Care: A one-time annual program registration fee is required upon registration. This fee is $50 per child, $75 per family. Tuition rates are based on 180 school days. Holidays and School In-Service days are not included.. Rates below are the cost per month and have been divided into 9 payments, September-May. Payments are due by the 1st of each month. Morning Only Care begins at 7 a.m. Afternoon Care until 6 p.m. and includes Morning Care on the same day. 1 day a.m. M T W TH F..$28 1 day a.m./p.m. M T W TH F $64 y. 2 days a.m. M T W TH F..$56 2 days a.m./p.m. M T W TH F $128 3 days a.m. M T W TH F..$84 3 days a.m. /p.m. M T W TH F $192 4 days a.m. M T W TH F..$112 4 days a.m./p.m. M T W TH F..$256 5 days a.m. M T W TH F..$140 5 days a.m./p.m. M T W TH F..$320 *If your days vary due to custody or your work schedule, please contact your site coordinator. Please check the applicable boxes below if apply: Drop-In Policy: We offer a pre-paid voucher for using our drop in care. Morning Only Drop-In is $10 per morning; Afternoon Drop In is $20 per day. Preapproval for drop in days is required 24 hours in advance and must be approved by the Site Coordinator. Minimum purchase price is $100. (Complete a Drop-In Voucher form)... Applying for Reduced Rate: Submit form with registration. Split Pay: Each responsible adult must submit their own contract Agency: (Outside agency responsible for payments) Parents/ Guardians using the Extended Care Program services agree to the following: I understand that I am responsible for payment for my scheduled contracted days whether my child is in attendance or not. I further understand that extended care has the right to immediately drop any child whose behavior endangers themselves or others. I understand that my payment is due on the 1st of every month and no balances can carry over. I understand that extended care closes promptly at 6:00pm, and I understand that a rate of $5.00 per min/ per child is assessed for late pickups. I agree to the rates, terms and conditions of this contract. (Please print name and date on line) ADMIN USE ONLY Registration Fee: $ Check#: Initials: Date: Waitlist: Staff
RVUSD Day Care Student Information/Medical Form Child #1 Name Birthdate / / Sex M F Age Allergies Child #2 Name Birthdate / / Sex M F Age Allergies Home Address City Zip Responsible Adult Information: Name Phone (W) Cell Relationship Email Name Phone (W) Cell Relationship Email Primary Language The following people (in addition to the adults above) are authorized to pick-up my child: Pick-up #1 Name/Relationship Phone # Pick-up #2 Name/Relationship Phone # Pick-up #3 Name/Relationship Phone # Pick-up #4 Name/Relationship Phone # Any other information we should know? Parent Comments:
Welcome to the 2017-2018 School Year for RVUSD Extended Care! Our priority is to ensure your child is provided daily with a safe, nurturing and fun environment. Registration packets can be picked up at each extended care site and the district office. Forms may also be accessed on the website at rvusd.org. For any questions contact Joy Lindeman, Extended Care Director: 542-7375 ext.4113 / jlindeman@rvusd.org. Please read and become familiar with our policies and procedures! WHAT WE OFFER: Each day your child will be given the option to participate in Homework Club and an Outdoor or Creative activity. A snack is provided once a day in the afternoon to all participants. HOURS: We provide before school care at 7 A.M and after school care until 6 P.M. RATIOS: We strive to keep a 1 staff per 15 student ratio. Therefore space is limited and sites may become full. REGISTRATION FEE: A annual program registration fee of $50 per child/ $75 per family will be required upon registration. TUITION: Tuition rates are based on 180 school days. Holidays and School In-Service days are not included. Rates below are the cost per month and divided into 9 payments, September- May. Payments are due the 1st of each month. EXAMPLE: If you need morning care on Monday and afternoon care on Tuesday, Wednesday and Fridays, your total tuition cost for the month will be 1 day morning $28 + 2 day afternoon $128 = $156 Morning Only Care begins at 7 a.m. Afternoon Care until 6 p.m. and includes Morning Care on the same day. 1 day a.m. M T W TH F..$28 1 day a.m./p.m. M T W TH F $64 2 days a.m. M T W TH F..$56 2 days a.m./p.m. M T W TH F $128 3 days a.m. M T W TH F..$84 3 days a.m. /p.m. M T W TH F $192 4 days a.m. M T W TH F..$112 4 days a.m./p.m. M T W TH F..$256 5 days a.m. M T W TH F..$140 5 days a.m./p.m. M T W TH F..$320
DROP IN ONLY: There is a pre-paid voucher for drop-in care to assist families who may need periodic care throughout the year. Participants will be required to pre-purchase a minimum of $100 towards their voucher. All drop-ins need to be pre-approved by your site coordinator 24 hours in advance of care needed. Our drop-in rates are $10 per day for morning care and $20 for afternoon care. A registration packet must be submitted with the drop-in voucher form. PAYMENTS: All payments are due by the 1 st of the month. We Do Not Send Invoices or Reminders. You may submit payments to your extended care site coordinator, by mail or to the district office. Cash only payments will only be taken at the district office. Payments must be paid in full, we do not carry over any outstanding balances from previous months. (Example; May extended care fees will be due by May 1 st ) You are responsible for payment for all days you contract for whether your child is in attendance or not. We Do Not Give Credit for Any Missed Days. This includes vacations, sickness, family in town, sports etc. RETURN CHECKS: A $20 bank fee will be applied to all returned checks. COLLECTIONS: Payments that are not received are subject to be sent to collections. We make every attempt to avoid this step. Please contact the programs director if necessary, we are committed to working with families. CHANGES: A change form submission is needed for all scheduling changes and cancellations. A Two Week notice is required for any reduction of days or cancellations. You are able to change your schedule a total of 3 times, throughout the 180 days of school at no cost. A $20 book keeping fee will be applied to any schedule changes made after your 3 rd change. SPLIT PAY: If payments are split between two responsible parties, each party must have their own registration forms on file and submit their own payments. REDUCED RATE: We offer a reduced rate for those families who qualify. A reduced rate day care form is available on our website or at our day care sites. For more information please contact Joy Lindeman 542-7375 ext. 4113. INTERSESSIONS: A separate registration is required for all intersession programs. We provide care for, some days during the Thanksgiving, Winter, Spring and Summer breaks. CURRENT CONTACT INFORMATION: It is the responsibility of the child s guardian to inform the extended care coordinator of any changes to their child s contact information. Ex: phone number, address, authorized pick-up list etc. RECEIPTS/TAX INFORMATION: Upon your request we will provide you with a receipt and your yearly tax information. Our TAX ID is #68-0262005 CHILD S ATTENDANCE: Because your child s safety is important to us, it is the responsibility of the guardian to inform the day care site of any absences. The extended care program reserves the right to terminate enrollment in the extended care program after the fifth (5) unannounced absence. Please call and leave a message for your site coordinator any time of the day.
SIGN IN/SIGN OUT: The extended care program requires that children be signed in and out by their parents or guardian, daily. All sign-in sheets are legal documents and are a permanent part of a student s record. Please inform your site coordinator if someone different is picking up your child and please keep your authorized pickup list current! We will ask to see a photo ID if the staff does not know the person. LATE PICK-UP POLICY: If children are not picked up by closing time (6 pm all sites), a late fee of $5 will be charged for every minute beyond closing time. If your child is not picked up after 30 minutes we will call people on your emergency contact list. If we cannot contact anyone, we will call the police and CPS. If your child/children are picked up late more than 5 times, we reserve the right to terminate enrollment in the program. MEDICATION/SICK CHILDREN: Medication will be administered only after the Permission to Administer Medication Form has been completed or is on file. Your school extended care coordinator per doctor s orders will administer the medication. If your child becomes ill or hurt we will contact the parent immediately. We reserve the right to send a child home if we see that he/she has a fever or is vomiting. SNACKS: Extended care provides a light snack each afternoon. Parents/guardians may provide extra or supplemental snack for their child, if desired. Please do not send snacks high in sugar. A healthy snack is preferred. HOMEWORK POLICY: Each site provides a supervised homework time during the afternoon Monday thru Thursday. A staff person supervises and helps children during homework time, however is not able to provide 1:1 tutoring. Children are encouraged to do their homework but they are not required to. TOYS FROM HOME/CELL PHONE: No toys or electronics from home are allowed in the extended care program. All cell phones must be kept in the child s back pack. Children are welcome to use the day care phone to contact their parents if necessary, and parents are encouraged to call the extended care if they need to speak with their children. YOU MUST RE-ENROLL EVERY YEAR: We do not assume you will be returning to our program. To secure your spot in extended care please re-register every year.
IMPORTANT EXTENDED CARE CONTACTS Joy Lindeman: After School Programs Director 542-7375 ext.4113 / jlindeman@rvusd.org 1000 Yulupa Ava Santa Rosa 95405 Kathy Poznanovich: Assistant to Director 542-7375 ext.4113 / kpoznanovich@rvusd.org 1000 Yulupa Ava Santa Rosa 95405 Sequoia Elementary School Austin Creek Elementary (Mornings Only) 5305 Dupont Ave. Santa Rosa 95409 1480 Snowy Egret Dr. Santa Rosa 95409 539-3410 ext.4691/p3, P4 & P5 539-3410 ext. 4691 /Multi-Purpose Rm. Coordinator: Kathryn MacDonald Coordinator: Kathryn MacDonald sequoiadaycare@rvusd.org sequoiadaycare@rvusd.org *Afternoon bused to Sequoia Madrone Elementary School Binkley Elementary School 4550 Rinconada Dr. Santa Rosa 95409 4965 Canyon Dr. Santa Rosa 95409 539-9665 ext.4494/rm. P5 & P6 539-6060 ext. TBA Coordinator: Tracie Pulliam Coordinator: TBA madronedaycare@rvusd.org binkleydaycare@rvusd.org jlindeman@rvusd.org Spring Creek Elementary School Matanzas Charter 4 th -6 th (Mornings Only) 4675 Mayette Ave. Santa Rosa 95404 1687 Yulupa Ave. Santa Rosa 95405 545-1771 ext.4750/ Rm.18 545-1771 ext. 4750/ Rm. 11 Coordinator: Julie Galante Coordinator: Julie Galante springcreekdaycare@rvusd.org springcreekdaycare@rvusd.org *Afternoon bused to Spring Creek Village Elementary School Whited Elementary School 900 Yulupa Ave. Santa Rosa 95405 4995 Sonoma Hwy. Santa Rosa 95409 545-5754 ext.4890/rm.18 & Computer Lab 539-2400 ext. 4919/ Rm. 17 &19 Coordinator: Debbie DeVore Coordinator: Loretta Mederios villagedaycare@rvusd.org whiteddaycare@rvusd.org