BISHOP AMAT MEMORIAL HIGH SCHOOL

Please print this form, initial and bring with you to registration. Signature Acknowledgement & Accountability Please go to www.bishopamat.org to access the documents listed below. My student(s) and I have read and understand the following documents provided to us by the Bishop Amat Memorial High School Administrative Office. Both STUDENT AND PARENT must initial the following: Student(s) Parent Parent/Student Policies Agreement Form Computer Use and Internet Access Agreement Personal Technology Device(s) on Campus Agreement Acknowledgement of Receipt of Guidelines for Adults Interacting with Minors Guidelines for Adults Interacting with Minors Parent s Authorization to Use Child s Image, Voice and/or Work Christian Service Requirement Acknowledgement Form Consent to Treatment of Psychological Services Letter From Principal Regarding Military Recruitment Consent Letter From Assistant Principal, Academics (Pertains to Seniors Only) I will verify the Communication Information Sheet which will be provided to me when I come to campus to pick up the class schedule for my student(s). I will make any necessary changes to the Communication Information Sheet at that time. I understand my signature acknowledges receipt of an Internet copy of the documents listed above. I will print and complete this document, the Parent Code of Conduct Agreement, the Health Information/Disaster Release Form, and the 2018-2019 Tuition Contract and bring with me when picking up my student s class schedule. SENIOR PARENTS ONLY: In addition to the above forms, I will also print and complete the Cal Grant Verification Form and the Diploma Name Form and bring to campus as well. Student Signature Parent/Guardian Signature Date Student Signature Parent/Guardian Signature Date Student Signature

2018-2019 Parent Code of Conduct Agreement For over sixty years, Bishop Amat High School has been blessed by a supportive parent community with whom the school partners to educate our young men and women in the Catholic faith tradition. While parents hold the primary responsibility for the education of their children, the school, Church, and community work together to support and complement parents in this role. To maintain a successful partnership, it is essential that every parent recognize the school s stated philosophy and specific expectations for all families and students enrolled at Bishop Amat High School. It shall be an express condition of enrollment that students and parents/guardians shall conform themselves to standards of conduct that are consistent with the Christian principles of the school, as determined by the school in its discretion and described in detail in Lancer Life, the Bishop Amat High School Student/Parent Handbook. Such standards of conduct include, but are not limited to, the following: Parents/guardians are expected to interact courteously and cooperatively with the school to assist students in meeting the academic, moral, and behavioral expectations of the school. Parent/guardians may not display disruptive behavior which interferes or threatens to interfere with the operation of a classroom, office, office area, athletic event, campus facility or any other school-sponsored program or activity. Any threat to do actual bodily harm to an administrator, teacher, coach, staff member, security officer, fellow parent or student regardless of whether the behavior constitutes a criminal offense warrants immediate withdrawal of the family from the school. Parents/guardians may respectfully express their concerns about school operations or personnel by following the protocol described on page 34 of Lancer Life. They may not do so in a manner that is discourteous, scandalous, rumor-driven, disruptive, threatening, hostile or divisive. This includes the use of loud or offensive language, swearing/cursing, using profanities or displaying temper outside of Christian character in addition to sending abusive or threatening emails, phone messages or other written communications to any Bishop Amat Memorial High School employee, security personnel, or volunteer. Parents/guardians are expected to model appropriate behavior by not utilizing social media platforms to post defamatory, offensive or derogatory comments regarding the school, administrators, teachers, coaches, staff members, security personnel, fellow parents, or students. Concerns expressed by a parent/guardian regarding school operations should be made via the appropriate channels described on page 34 of Lancer Life. In the event any parent/guardian is found to be posting libelous or defamatory comments on Facebook, Twitter, Instagram or other social media outlets, the school will expect that the parent/guardian remove such comments immediately as a condition of their student s continued enrollment. Additionally, the use by parents/guardians or students to publicly humiliate another by inappropriate social media postings, group texts, or online chat platforms will not be tolerated as per the school s discipline code. Parents/guardians are to refrain from smoking (cigarettes, vape/juuling devices, legalized cannabis) and from consuming and/or being under the influence of alcohol or drugs while on campus. This includes while in attendance at extracurricular activities (ie: athletic events, performances, etc.). I/We, the parent(s) of the students named below, acknowledge the standards of conduct and agree to abide by the expectations described herein and in Lancer Life, the student/parent handbook of Bishop Amat Memorial High School. I/We understand that the school reserves the right to determine, in its discretion, when conduct is of such a severe nature as to warrant immediate action without warning and/or without an intermediate step short of withdrawal from Bishop Amat Memorial High School. Parent Name (print) Parent Signature Date Parent Name (print) Parent Signature Date Student Name (print) Student Name (print) Student Name (print)

Health Information / Disaster Release Form 2018-2019 Student Last Name First Middle Date of Birth Student ID Address Home Phone Number Emergency Information Father Mother Parent Name Parent Occupation Name of Employer City of Employment Work Hours Business Phone Cell Phone Email Address In case of medical emergency, indicate the Parent and Phone Number to be called first: Which of the parents listed above live with the student? (Circle) Both Mother Father List the name and contact information for two (2) local persons, other than parents, who will care for your child in an emergency. These persons must be able to take the student home if necessary. ( ) Name Relationship Daytime Phone Number ( ) Name Relationship Daytime Phone Number Medical Information Name Location/City Phone Physician Insurance Company Allergies/Other Medical Conditions: Medication student takes regularly:

NOTE: All medicines, including Tylenol, must be kept in the Infirmary, in the original bottle, and must be clearly labeled with the student s name and instructions. A note must be kept on file. My Signature below gives my approval to send my son/daughter to the hospital for emergency treatment should this be necessary. I hereby release the school from financial obligations incurred because of emergency procedures. DISASTER RELEASE - Complete this section carefully. Your child will be released from school according to the permission level you choose below. (Be sure to discuss your choice with your child). In a disaster emergency, I give my permission to release my child to: (please check one or more) his/her parents only his/her own responsibility I do not give permission to release my child his/her carpool driver any person on this form Other (please specify) Father s Signature Date Mother s Signature Date NOTE: These signatures will also be used to authenticate parent signatures on absent and early dismissal notes. FOR SCHOOL USE ONLY Student Released to Time Date School Official Initials Notes:

TUITION AND FEES CONTRACT 2018-2019 Student s Full Legal Name Student ID Number One Student Tuition Two Students (same family) Three Students (same family) $ 8,525.00 per year $ 14,300.00 per year $ 16,500.00 per year Tuition is due and payable in full by July 1, 2018. Fort he convenience of parents, it may be paid in eleven installments due by the 1st of each month, July through May. The monthly amounts are: One Student Two Students (same family) Three Students (same family) $ 775.00 per month $ 1,300.00 per month $ 1,500.00 per month REGISTRATION FEE (Non-refundable) The Registration Fee for 2018-2019 is $800.00 per student ($600 is non-refundable and non-transferable). Current families pay this fee in two parts; incoming freshmen pay the fee in full at time of registration. This fee offsets the cost of various student services offered throughout the school year (student activities, campus ministry, athletic activities, yearbook, Lancer Life, the student planner and summer reading program). The mandatory raffle ($200) is also included in this fee. PARENT PARTICIPATION PROGRAM Each family is obligated to render 36 hours of service per year to the school. Six of the thirty-six hours must be completed through the Bingo Program and ten hours completed through the Development Office. If this obligation is not fulfilled by May 10, 2019 the family will be charged $20.00 per hour for uncompleted regular hours and $30.00 per hour for uncompleted bingo/development hours. FAMILY PLEDGE PROGRAM All families are expected to participate in the Family Pledge Program by donating $420 annually to the Development Program for each year a family has a student attending the school. Parents fulfill this obligation by making payments of $35.00 per month. The donations made through this program provide the school with funds to make capital improvements to the campus. These donations (non-refundable) are tax deductible. SPECIAL NOTES (1) The Registration Fee and the July and August tuition must be paid before a student s schedule of classes is released. (2) Parents are expected to make regular monthly tuition payments. When a tuition account becomes seriously past due, the parent will be notified. Satisfactory payment arrangements must be made or the student will be placed on financial suspensión, which means the student will not be allowed to attend school or participate in any athletic or extracurricular activity, practice, or competition. If the problem cannot be resolved, the student may be asked to withdraw from the school. (3) Student s tuition accounts must be current in order to take semester exams. Tuition that is delinquent at the time of exams must be paid in cash, cashier s check, money order, or by credit card. (4) A late fee of $30 per month will be charged to accounts with outstanding account balances after the 10th of each month. Payments delayed in the mail will incur this charge. (5) There will be a $35 charge for checks returned by the bank. Families who continue to write bad checks may be required to pay by cash or money order only. I understand and agree to abide by the povisions of this financial schedule. Parent/Guardian Signature Date Revised July 2018