2021-2022 Kids With a Smile Preschool

Griffin Foundation School District

1830 S. Alvernon Way, Tucson, AZ 85711
Office: 520-790-8400 Fax: 520-620-6570

Enrolling in Summer Camp 2022
Enrolling in KWAS Preschool 2021/2022

Student Information

Student Name*

First Middle Last

Age*

Date of Birth*

Place of Birth*

Gender*

Male
Female

Parent Information

Parent Name*

Contact Number*

Mother's Email

Father's Email

Home Address

Street Address Address Line 2 City State ZIP Code

Is at least one parent/guardian a member of the Armed Forces on active duty?

Yes
No

Home Phone

Work Phone

Cell Phone

Last Preschool/Childcare Attended

Last preschool/childcare attended:*

Address of last preschool/childcare attended:

City State

KWAS/Summer Camp Contract 2021-2022

I agree to enroll my child, name in the field below, in the Kids with a Smile Preschool Program and/or Summer Camp beginning on the below selected date. These programs are designed to serve students ages 3 and 4 or 5-12. Children must be potty-trained. A student that has behavior issues such as not following classroom procedures, endangering the safety of other students, or not potty-trained will be placed on a 2 weeks probation period. I understand the school will provide my child with a quality preschool program lead by caring staff in a safe and positive learning environment. Hours of operation: Monday through Friday, 8:00 am – 5:00 pm with a modified Summer Camp schedule.
Half day morning is 8:00 am to 12:30 pm and half day afternoon is 12:30 pm to 5:00 pm. A late pick-up charge of $1.00 per minute will be assessed by the agency if a child is not picked-up at the close of business.

Child Name*

First Last

Date*

I agree

Tuition and Fees

I understand:

I enroll my child in the KWAS Preschool or Summer Camp for ______days per week*

on a ______ (half/full) day basis, and that any days my child comes to the KWAS Preschool/Summer Camp outside of the days agreed upon in this contract, a drop-in fee will be charged to the parents.*

Half Day
Full Day

My weekly tuition is $________, If extended child care is required after Pre-school classroom hours, $7.50 per day will be add to your bill.

If applicable DES co-pay per week is $_______.

Parent(s) are required to pay for their child’s preschool services by the week before services are rendered, or at the latest, the first day of the week services are provided. If payment is not received by the due date, a $15 late fee will be charged each week on the past due balance. After two weeks of nonpayment or payment due is greater than $200, the child will be removed from the program until balance is paid in full (no exceptions). A child that is not picked-up one hour from the close of business, the school representative will contact CPS and/or the Police Department for child pick-up. A $1 per minute charge will be billed to your account.
Co-pays will be based off the Parent/Guardian’s Responsible Daily Charges off the Provider/Parent/Guardian’s Agreement for Child Care Charges.

2. One week’s tuition, to be submitted with your application, is held as a deposit. The first week’s tuition is required as payment for the first week of class.

3. A non-refundable $45.00 registration and processing fee is due at enrollment.

4. Payment is due for the contracted time, including statutory holidays, whether the child attends or not. Tuition will be waived for Spring Break (1 week) and Winter Break (1 week).

5. The school district will provide a thirty-day notice prior to a rate increase.

6. I have the option to enroll my child in extra-curricular activities for an extra charge.

7. Mandatory withdrawal will be requested if a child does not abide by the standards of conduct, demonstrates extreme behaviors that hurt others or failure of the school to meet the needs of the child or parents.

8. Drop-in care rate is $30.00 per day.

9. Any checks not honored by the bank will be subject to a $30.00 service charge.

10. Parents will complete all registration forms including health records, emergency and permission authorizations for pick-up, and any other required records or forms before student entry into the program.

11. To bring my child to the program on time and pick him/her up on time after class ends.

12. To call the KWAS Preschool teacher/Summer Camp Team Leader at 790-8400 to inform her of my child’s absence or notify her of any illness that may keep my child home, such as: diarrhea, vomiting, fever, infected skin or eyes, undiagnosed rash or a contagious disease.

13. To provide a change of clothes or come and get my child at Preschool in the case of a toileting accident.

14. The KWAS Preschool/Summer Camp program will be closed for Labor Day, Veteran’s Day, Thanksgiving Day, Christmas Day, New Year’s Day, Martin Luther King Day, Rodeo Break, Memorial Day, and 4 th of July; as well as one week for Spring Break and one week for Winter Break. We may include other closures; parents/guardians will be notified in advance.

15. The district will be closed in the case of extreme weather conditions (i.e. heavy snow or storm causing power outages).

16. Written notice must be given one full week prior to a child leaving the preschool program. If one full week’s notice is not given to the school, the deposit will be used to pay for failure to provide the school with one full week’s notice.

17. By signing this document you agree and understand the policies and procedures of the Kids with a Smile Preschool and Summer Camp program:

I consent, acknowledge, and approve of the procedures, rules, and regulations of Kids with a Smile Preschool/Summer Camp.

Arizona Department of Health Services: The licensing agency shall have the authority to interview children or staff and to inspect child and facility records without prior consent. The licensing agency shall also have the authority to observe the physical condition of children, which could indicate possible abuse or neglect.

I authorize the school district to call an emergency ambulance in case of accident or acute illness and to arrange for possible emergency medical and surgical care in case I am not immediately available. Before such action is taken, it is understood that a conscientious effort must be made to notify me or the below contact at the following number:

Contact Name

Contact Phone

Preschool Schedule

Preschool schedule:

Monday
Tuesday
Wednesday
Thursday
Friday

Length

Full Days
Half Days

Parent Name*

Home Phone*

Work/ Cell Phone*

Signature

Emergency Information

Student Lives With:*

Name of person (persons) who have Legal Custody:

Mother/Guardian Name:*

First Middle Last

Mother/Guardian Home Phone*

Mother/Guardian Work Phone*

Mother/Guardian Employer

Father/Guardian Name:*

First Middle Last

Father/Guardian Home Phone*

Father/Guardian Work Phone*

Father/Guardian Employer

In case of an emergency, our procedure is to contact the parent/guardian that is listed first on the Student Data form at work or home. If we are unable to contact you, the second person listed on this form will become the next person to contact. The seriousness of the issue will determine whether or not the persons listed below will be asked to care for your child. A rescue unit will be called in a serious situation.

Person(s) who will care for and transport the student if the parent(s) cannot be contacted:

Person 1 Name

Person 1 Relationship

Parson 1 Daytime Phone

Parson 1 Cell Phone

Person 2 Name

Person 2 Relationship

Parson 2 Daytime Phone

Parson 2 Cell Phone

The following person(s) may NOT remove my child from the school:

If so, comment?

Student Background Information

Student's Name

First Middle Last

Disclaimer: The questions below are only asked for continuation of services and are not a condition of enrollment.

To promptly serve the student, do you have the most current IEP?*

Yes
No

Has the student ever had behavior or attendance issues?*

Yes
No

What are your goals and expectations of the school and your child?

How did you learn about the Griffin Foundation School District?

Brochure, Flyers, and Handout
Government Advertisement
Internet/Media Online Sites
Griffin Foundation’s Website
Walk-in
Relative
Friend
Newspapers/Television/Radio: Station/Name

Name of Reference:

* Optional to answer for enrollment.

Race/Ethnicity Two-Part Question: Complete both questions:

Part 1: Ethnicity (Choose one only)

Yes, Hispanic or Latino American Indian or Alaska Native A person of Mexican, Puerto Rico, Cuban, South or Central Asian American or other Spanish culture or origin, regardless of race
No, not Hispanic or Latino

Part 2: Race (Choose one or more)

American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White

McKinney-Vento Act Eligibility:

Is your current address a temporary living arrangement?

Yes
No

How long have you been at current address?

Is this temporary living arrangement due to loss of housing or economic hardship?

Yes
No

Where is the student currently living? (If applicable, check one box)

In a Shelter
In a Motel
With more than one family in a house or apartment
In a place not designed for ordinary sleeping accommodations (ex. car, park, campsite)

Transportation

List the Daycare authorized to provide transportation for your child:

Daycare Name

Daycare Address

Street Address City State ZIP Code

Daycare Phone

Daycare Contact Person

Days daycare is scheduled to transport your child from GFSD:

Monday
Tuesday
Wednesday
Thursday
Friday

I verify that the information provided above is accurate and true:

GRIFFIN FOUNDATION SCHOOL DISTRICT

2021-2022 New School Uniform Policy

Parents: All students enrolled for the 2021/2022 school year are required to wear the Griffin Foundation School District uniform for their specified school. Parents can purchase uniforms from vendors or department stores. Uniforms must follow our style and material requirements. Clothes not allowed to be worn to schools: Denim, Blue Jeans, Sweats, Baggy pants, Spandex, Skinny Jeans, or Cargo pants (pants with 4 pockets in front). Leggings are acceptable in Solid White, Solid Navy, or Solid Black. No Stretch pants are allowed. Uniform bottoms must be Cotton or Polyester and no more than 3% of other material. Clothes that are too revealing is not acceptable, short pants must be of regular length and uniform should not be skin tight. Mohawks and shaved heads are not allowed, but a fade hairline is acceptable. Unnatural hair colors are not allowed. Tattoos are not allowed and piercings must be kept to a minimum. Modest make-up is allowed for middle school students only. A sweatshirt/jacket with a zipper is allowed in the buildings, but no hat or gloves can be worn inside. A non-school sweatshirt with a hood cannot be worn in school buildings. Uniformity dress codes: All students are required to tuck in their shirt tails except on Free Dress Friday.
If you are interested in purchasing uniforms from the Griffin Foundation School District, please stop by the front office.
As preparatory schools, it is important that students wear the required uniform attire. Parents will be called to bring in a change of clothes and/or called to pick-up their child, if the child is identified as wearing an unapproved uniform to school. Students may receive a uniform warning violation and/or suspension.

Thank you and we look forward to another great school year with increased student achievements.

Every Friday! – Free Dress Day

This school year the Griffin Foundation School District will be allowing students a Free Dress Day every Friday. We are happy to announce this new event for students to celebrate the end of each week.
It is impossible for school administrators to identify all items that might be inappropriate attire, but if any outfit is deemed to be inappropriate for school, the student may be given a warning not to wear the item again or the parent could be called to bring a change of clothes.
Blue Jeans or non-uniform bottoms will be allowed to be worn. Please make sure bottoms are clean, non- baggy. Pants must be on the waist and not showing the student’s underwear. Please make sure shirts, shorts, and dresses have a modest hem length. No sleeveless shirts or spaghetti straps will be allowed. No inappropriate writing or language on clothes. Students are required to follow policies and directives of the uniform dress codes as stated by GFSD. Failure to do so could result in suspension.
We believe this will be a wonderful school year for our students.
Sincerely, Administration

2021-2022 Kids With a Smile Preschool

Griffin Foundation School District 1830 S. Alvernon Way, Tucson, AZ 85711 Office: 520-790-8400 Fax: 520-620-6570

Student Information

Parent Information

Last Preschool/Childcare Attended

KWAS/Summer Camp Contract 2021-2022

Tuition and Fees

Preschool Schedule

Emergency Information

Student Background Information

Transportation

GRIFFIN FOUNDATION SCHOOL DISTRICT

2021-2022 New School Uniform Policy

Every Friday! – Free Dress Day

Griffin Foundation School District

1830 S. Alvernon Way, Tucson, AZ 85711
Office: 520-790-8400 Fax: 520-620-6570