2017-18 REGISTRATION PACKET INFORMATION Dear Parents, Thank you for enrolling your child in Rose Hill Christian School. Please note the following information regarding registration fees, tuition, and information needed to enroll. All information is necessary and vital for the completion of your child s registration. Please complete each page. ENROLLMENT FEES Re-enrollment Fees o Prior to June 1 st $45.00 o June 1 st June 30 $55.00 o July 1 st July 31 $65.00 o August 1 st - $75.00 New Student Enrollment $75.00 All new enrollees must present a certified birth certificate and social security card. All other health forms must be turned into the office by August 14 th for your child to be officially enrolled in a class. Every student must have an up-to-date Immunization Certificate on file in the office with a student medical exam. These must be on Kentucky forms. All new students must have proof of a vision exam by an optometrist or ophthalmologist on a Kentucky Eye Exam Form. All K4 and K5 students must have a dental screening from their dentist or doctor s office. TUITION Tuition is payable in 10 monthly payments beginning August 1 st. Tuition for the year may be paid in full by August 31 st in order to receive a 3% discount. Students will not be allowed to start the first day of school unless the first month s tuition is paid. All previous year s tuition payments must be current before students may re-enroll for the new year. Please keep in mind that the school board is continuously working to assist parents with tuition costs. Scholarship forms can be picked up in the office on March 15 th and due back on April 21 st. The Tuition Assistance Applications are only available online this year. The deadline to apply is June 15 th. Grade 1 st Child 2 nd Child 3 rd Child 4 Year Olds (K-4) 2,540.00 2,160.00 1,270.00 K5 (All Day) - 6 th 4,460.00 3,790.00 2,230.00 7 th - 8 th Grade 4,530.00 3,850.00 2,270.00 9 th - 12 th Grade 4,660.00 3,960.00 2,330.00
1001 Winslow Road Ashland, KY 41102 606-329-1957 606-324-6105 APPLICATION FOR ADMISSION Grade To Enter: ( ) New Enrollment ( ) Re-Enrollment Date: Last Name First Middle Street City State Zip Code Age Birth Date Place of Birth (City, County, State) Race Home Phone Parent(s) Cell Student Cell Father s Name Employer Phone Mother s Name Employer Phone Parent E-Mail Address(es) (for school communication): Marital Status: ( ) Married ( ) Single ( ) Separated ( ) Divorced ( ) Widowed Public School District Living In Last School Attended & Address Circle Grades Attended at Rose Hill: K4 K5 1 2 3 4 5 6 7 8 9 10 11 With Whom Child Lives: Student goes by what name Student s Grades Have Been: ( ) Above Average ( ) Average ( ) Below Average Has Student Failed Any Grade? ( ) No ( ) Yes If yes, what grade? Has Student Ever Been: ( ) Suspended ( ) Expelled ( ) Retained ( ) Received Professional Counseling/Testing If any are checked please explain Does Student have any Learning Disabilities that might limit him such as: ( ) Dyslexia ( ) ADD ( ) ADHD ( ) Perception ( ) Attention Span Deficit ( ) Hand-Eye Coordination ( ) Others Describe any physical disabilities (heart, hearing, speech impediment, nervous condition, etc.) NEW ENROLLMENT: Why do you desire to enroll your student at Rose Hill Christian School? Church Now Attending: Family Members That Attend: ( ) Father ( ) Mother ( ) Student ( ) Other Family Members) Father: Christian ( ) Yes ( ) No Church Member ( ) Yes ( ) No Active: ( ) Yes ( ) No Mother: Christian ( ) Yes ( ) No Church Member ( ) Yes ( ) No Active: ( ) Yes ( ) No 2017-18 EMERGENCY INFORMATION (If parents cannot be reached) Name Name Address Address Home Telephone Home Telephone Cell Phone Cell Phone Relationship to Student Relationship to Child Student s Physician Phone Student s Dentist Phone Rev. 3/9/2017
**** MEDICAL FORMS **** REQUIRED BY THE STATE OF KENTUCKY AND All K4, all new K5, and all new enrollees must have the following to enroll: 1. A certified Birth Certificate must be presented at the time of enrollment. (Hospital certificate and wallet size cannot be accepted.) 2. A Social Security card must be presented at the time of enrollment. All K4, all new K5, and all new enrollees must have the following before enrollment: 1. A Student Medical Exam on the Kentucky form must be presented before August 1. (No other forms can be accepted.) 2. A vision exam by an optometrist or ophthalmologist must be presented before August 1. This must be on the Kentucky Eye Exam form. (No other forms can be accepted.) 3. A dental exam on the Kentucky form. 4. An up-to-date Immunization Certificate on the Kentucky form must be presented before August 1. (No other forms can be accepted.) The dates of the following shots must be on the form: DPT - must have 5 (with the 5 th dose after the 4 th birthday) Polio - must have 4 (with the 4 th dose after the 4 th birthday) MMR - must have 2 Hepatitis B - must have 3 Hib - must have 3 or 4 Varicella - must have 2 or must have had the chicken pox disease Prevnar (Pneumonia) - must have a series of 4 If your child s fourth birthday is after August 1, you must present a Provisional Immunization Certificate by August 1. After your child turns four year old, they will need their shots and a new Immunization Certificate completed and turned in to the office. All 6 th Grade Students must have the following before August 1: 1. A new Student Medical Exam on the Kentucky form. (This is not the sports physical) 2. Tdap Booster 3. Meningococcal Vaccine 4. A new Immunization Certificate on the Kentucky form listing all immunizations.
*** Parent s Pledge of Acceptance *** Student s Name: We, the parents, realize and accept the challenge to follow God s Word as it reads in Proverbs 22:6 to Train up a child in the way he should go. We realize that this training must first take place in the home and that the Christian school is merely an extension of the home which continues to lead the child in the Christian teaching of God s Word. We pledge that if for any reason our child does not respond favorably to the school curriculum or policies, we will withdraw quietly and without delay. (Most students should be able to adjust to the school life properly within a nine week period). We understand that the school reserves the right to dismiss any student for inappropriate conduct (examples: drugs, alcohol, sex, misbehavior) during school hours and those spent away from school. We as parents understand the school s testimony in this area is of utmost importance and every student is given the responsibility by God to uphold it. We hereby invest authority in the school to discipline our child as necessary. Reasonable disciplinary action may include detention, corporal discipline, suspension, or expulsion from the school. We understand that the teacher and administration must have our utmost support in this area to properly correct the child. We understand that the school believes and follows Proverbs 22:6, Colossians 3:20, and Hebrews 12:6. We further agree that we will cooperate and discipline our child in the home as needed. We pledge our loyal support to the school through prayer and personal involvement in the activities of our child. We also pledge to pay tuition payments on time. We understand that should payments become as much as two months delinquent, we may be asked to withdraw the student. Should a problem arise concerning payment of tuition, we MUST notify the school office and work out a suitable arrangement. We understand that tuition payments must be up to date at the end of each grading period before the student may receive their report card, progress report and access to my STI online account. Also, in the event of graduation or withdrawal from the school, the student s account must be paid in full in order for the student s records to be released to any school or college. Any and all refunds will be subject to board approval/policy. We as parents of the student applicant do sincerely give our pledge to all items as stated above. Father s Signature: Date: Mother s Signature: Date:
*** Standard of Conduct Agreement *** Junior High and Senior High School Students Rose Hill Christian School welcomes those students wishing to enroll who have the desire to gain a quality education conducive to Christian training and academic excellence. In this atmosphere of definite and positive Christian standard of conduct, good scholastic planning and intimate personal interest between faculty and student, there is a fine opportunity for development of strong Christian character. Students of Rose Hill Christian Jr. & Sr. High School are expected to obey the rules and policies of the school while enrolled. Even though some rules may seem arbitrary or against personal philosophy, it is required that all students adhere to the rules and obey them without question or complaint. The student handbook is written to list and explain most of the rules and philosophies in which Rose Hill Christian School believes and teaches. Even though all rules are not listed, it is to be understood that the student is to behave in a manner consistent with the standards set forth by the school. Rose Hill Christian School believes in the standard of living as set forth in the Bible, which we believe to be the infallible, divine Word of God. Rose Hill Christian School will discipline students who do not adhere to the rules and standards as set by the school. Since Rose Hill Christian School believes in and teaches the Word of God, it is expected that each student will bring their Bible to school and study diligently in Bible classes. Students are also required to bring their Bible to chapel, which is held once each week. Church attendance should be regular and students should be faithful in serving in activities provided by their church. Students are not to swear or use indecent language. Smoking, sex, use of drugs and use of alcoholic beverages are forbidden on or off school property. These, as well as gambling, dancing and involvement in rock and roll are forbidden on school property or school-sponsored trips. We expect our students to present a Christ-like example. Students are to maintain Christian standards in courtesy, kindness, morality and honesty. Students found to be out of harmony with Rose Hill Christian School s ideals of work and life may be invited to withdraw whenever the general welfare of the school or student demands it, even though there may be no special breach of conduct. I have read this Standard of Conduct and while enrolled in Rose Hill Christian School agree to cooperate with these standards to the fullest extent. Student s Signature: Date: As a parent, I have read this Standard of Conduct. I will cooperate with the school in its endeavor to maintain these standards. Father s Signature: Date: Mother s Signature: Date:
EMERGENCY MEDICAL/MEDICATION PERMISSION FORM Student s Name: Grade: Date: Parent s Name: Home Phone #: Allergies: List potential medical condition that might require medical intervention while at school: Routine Medications (asthma, seizures, etc. Who to call in case of emergency: Name Phone # Relationship Cell Phone # Child s Doctor (Name & Phone #) Child s Dentist (Name & Phone #) Hospital Preference: I give permission for my child to receive the following over the counter medications at school: Tylenol Ibuprofen Tums Chloraseptic Spray Other I understand that if my child needs to receive prescription medications during the school day, I will need to send the medication in its original container, with written permission and instructions. I understand that if my child repeatedly requests medications for headaches, sore throat, etc. I will be notified by the school. I understand that all medications must be kept in the office. Students are not allowed to have any medications kept with them during the day. I understand in case of an emergency R.H.C.S. has my permission to seek medical treatment. Parent s Signature: Date:
*** Student Cell Phone Usage *** Use of cell phones by students on the Rose Hill Christian School property during school days will be regulated by the following rules. Cell Phones may be used before 8:00 a.m., after 3:15 p.m. and at lunch only. No one will be given an excused tardy from lunch due to use of cell phones. Students are expected to use their time wisely and eat their lunch before checking cell phone. No one is to use their phone to text or call a parent without permission from the office (this includes coming to pick them up, bring lunch, etc.) for any reason. A detention will be assigned if they text without permission and during undesignated times. Violation of Cell Phone rules will result in the confiscation of the phone and will only be returned to the parent. Upon the 1 st offense the student will receive a detention. Upon the 2 nd offense the student will receive two detentions and phone privileges will be denied for 1 week. The 3 rd violation will result in loss of cell phone privileges for the rest of the year. These rules apply to the use of another student s phone as well as their own. This violation will not void the penalty of confiscation or detention. By signing the above, you hereby give permission for your phone to have its contents reviewed. Parent Signature Date Student Signature Date Student s Cell Phone Number
FIELD TRIP CONSENT FORM Dear Parent (s), Occasionally your child s class may be going on field trips within the local area. Your signature is needed on this form in order for your child to attend such educational outings. This form is a vital part of your child s school folder if they will be participating in off-campus experiences. Before each trip, you should receive a note, e-mail, or text giving all pertinent details. I hereby give permission for my son/daughter to accompany the class on various local field trips during the school year. All trips will be under the direction of a teacher. I hereby relieve Rose Hill Christian School of all responsibility beyond that of normal supervision. Student Name: Grade Parent/Guardian Signature Date ****************************************************************** In Case of Emergency Contact: Emergency Phone #: Doctor s Name & Phone #: Dentist s Name & Phone #
Media Consent Form (Yearbook,Web Page,Etc.) I hereby consent to the use of any photographs/digital recording taken of my child by the Rose Hill Christian School or the media for the purpose of advertising, yearbook, or publicizing events, activities, facilities and programs of the Rose Hill Christian School in newspapers, newsletters, website, television, radio and other communications and advertising media. By law, Rose Hill Christian School protects the privacy of the students and is prohibited from releasing students personal information. From time to time representatives of the news media are invited to campus to cover events at our schools. When this happens there is a possibility your child/children may be photographed, digitally recorded, or interviewed for a news story. Please mark one of the choices below and return to school. Yes, I allow my child/children to be identified in any of the above mentioned categories. No, I do not want my child/children identified in any of the above mentioned categories. Parent/Guardian Signature: Date: PLEASE PRINT Parent/Guardian s Name: Student: Address: City: State/Zip: