8350 Okeechobee Blvd.

West Palm Beach, FL 33411

Phone: 561-798-9300 Fax: 561-472-1603
Director Mrs. Vicki Ingram Ext. 223
www.bcsbulldogs.org

VPK Only
2016-2017 School Year
All information must be provided for this application to be considered.
Please attach a copy of students birth certificate, current physical, & immunization forms.
CIRCLE ONE:

NEW STUDENT

RETURNING STUDENT

(PLEASE PRINT LEGIBLY)

STUDENT INFORMATION
Student's Name _______________________________________________________________(__________________ )
Last
First
Middle
Preferred Name
Social Security #

Sex _____ Age _____ Date of Birth ____/____/_____

MM / DD / Year

FAMILY INFORMATION
Parents are:

___ Married ___ Separated ___ Divorced ___ Mother Deceased ___ Father Deceased

If parents are divorced or separated, who has legal custody? ______________________________________

Student lives with:

___ Mother and Father

___ Mother and Stepfather

___ Mother only

___ Father and Stepmother

___ Father only

___ Guardian(s)

Do you have any siblings enrolled in BCS? _____ If yes, please complete information below
Name:__________________________ grade: ______ Name:__________________________ grade: ______
Name:__________________________ grade: ______ Name:__________________________ grade: ______
Father/Guardian: ______________________________SS#:______________________DL#:______________________
Required

Required

Home Address: ____________________________________________________________________________________

Street

City

State

Zip

Phone: (_____) _______________ (_____) _______________ (_____) _______________

Home

Business

Cell #

Email:___________________________________________@_______________________________________________
Occupation: _______________________________________________________________________________________
Company

Position/Title

Church Home: ____________________________________________________________ Member?

Yes

or

No

Mother/Guardian: ______________________________SS#:______________________DL#:______________________
Required

Required

Home Address: _____________________________________________________________________________________

Street

City

State

Zip

Phone: (_____) _______________ (_____) _______________ (_____) _______________

Home

Business

Cell #

Email:___________________________________________@_______________________________________________
Occupation: _______________________________________________________________________________________
Company

Position/Title

Church Home: ________________________________________ Member?

Yes

or

No

MEDICAL INFORMATION
Please list Physical Limitations, Allergies, and/or Current Medications: ________________________________________
__________________________________________________________________________________________________
In Case of Emergency: In the event of illness or other emergency and we are unable to reach you, please fill in the names
of at least two (2) friends, relatives, or neighbors who would be authorized to remove your child from campus.
Name/Relationship

Telephone # (Please indicate whether home, cell or work)

__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Physician ___________________________________ Phone _____________________ Hospital ___________________
Has the student ever been assessed through Child Find, Early Steps, or any other agency? __________________________
__________________________________________________________________________________________________
Had any type of special testing? _____ If yes, please describe and include a copy of the latest evaluation report.
__________________________________________________________________________________________________
Does your child have an IEP? Yes or No

If yes, please include the latest assessment report.

SCHOOL INFORMATION
Was student previously enrolled at BCS?

Yes or No

Circle grades attended at BCS:

K3

K2

If yes, what year(s): ________________

School other than BCS last attended: __________________________________________ (_______) ________________

School Name

Telephone Number

School Address:
__________________________________________________________________________________________________
Street

City

State

Zip Code

Reason for withdrawal from prior school: _______________________________________________________________

__________________________________________________________________________________________________
Why do you want your child to attend Berean Christian School? ______________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________

STATEMENT OF COOPERATION
1)

It is the parents responsibility to secure the VPK Certificate of Eligibility from Early Learning Coalition and turn it in to the Business
Office. Early Learning Coalition is located at 3111 S. Dixie Hwy., Suite 142, West Palm Beach, FL 33405.
__________ (Parents initials required)

2)

I understand that I must provide a copy of my childs birth certificate, a current original immunization form as well as a current original
physical form completed on both sides. This must be turned in to the Preschool no later than Friday, July 29, 2016.
__________ (Parents initials required)

3)

I understand the VPK hours are from 8:30AM until 11:49AM only.
__________ (Parents initials required)

4)

Parents are responsible to obtain and read the Preschool Parent Handbook. Berean will provide access to this document via RenWeb and/or
school website.
__________ (Parents initials required)

5)

The school reserves the right to dismiss any student who, in the discernment of BCS administration, does not cooperate with the
educational process and/or to the rules and regulations as outlined in the Preschool Parent Handbook. It is recommended that parents
attend all parent and enrollment meetings in order to obtain important information and/or policy changes.
__________ (Parents initials required)

6)

I understand that my child must be present at least 80% of the VPK instructional hours to continue enrollment in the VPK program.
__________ (Parents initials required)

7)

I understand that Preschool operates from August through May and is closed during Fall Break and Spring Break, however, childcare is
available. VPK instructional hours do not occur during these weeks. If you are in need of child care during these weeks, the fees are $200
for 5 days, $120 for 3 days and $80 for 2 days. I further understand that payment is due at the time of registration for the break. Payment
will be accepted in the form of cash, check or money order only.
__________ (Parents initials required)

8)

I understand that my child is required to wear official BCS uniforms. Uniforms are purchased through the Risse Brothers Uniforms store.
Substitute uniforms will not be acceptable.
__________ (Parents initials required)

9)

I understand that Berean Christian Preschool holds a K4 Graduation ceremony and my childs participation is voluntary. I further
understand the fee is $80 and if I choose to have my child participate payment is due in full by 3/1/2017. Payment will be accepted in the
form of cash, check or money order only.
__________ (Parents initials required)

10) In the case of a serious accident or serious illness, the undersigned request(s) to be called immediately. If unable to make contact, Berean
Christian School or Preschool may call the physician noted on this application or take emergency-care measures as are necessary and
appropriate under the circumstances.
__________ (Parents initials required)
11) If, at any time, I feel it necessary as a school parent to pursue legal action against Berean Christian School in a court of law, and if a
judgment is handed down in the favor of Berean Christian School, I agree to pay, in full, all legal and attorney fees, court costs, and all
other expenses that the school may incur as a result of my action.
__________ (Parents initials required)
12) I give permission for Berean Christian School to use any photographs, videotapes, DVD or audio tapes of my child(ren) in the yearbook,
school promotional information, school website, social media and/or advertising.
__________ (Parents initials required)
Signature below signifies I have received:
a.) Know Your Childcare Facility brochure (CF-FSP PI #175-24).
b.) Preschool Discipline Policy.
c.) VPK Attendance Policy, which includes Preschool closing dates.

IF STUDENT IS LIVING WITH BOTH PARENTS,

BOTH PARENTS MUST SIGN THIS STATEMENT BELOW.
___________________________________________
Parent's/Guardian's Signature

___________________________________________
Parent's/Guardian's Signature

___________________
Date

___________________
Date

Office Use Only

Account Current __________
A. Families ______________
S. Sheet _________________
VPK Certificate __________
MP ____________________
Magnet _________________
Enrollment Complete ______
APPLICATION #

Preschool Discipline Policy

Discipline is a vital component to the learning process of a child. Gentle discipline is neither
permissive nor punitive, rather a means of teaching, guiding, and training. When boundaries
and expectations are clearly defined, children feel secure. By setting rules and clearly
communicating expectations, misbehaviors can be avoided and children can develop selfdiscipline and self-control. At Berean Christian Preschool, children will receive gentle, loving,
and Biblically modeled discipline. After clearly communicating expectations, the following
steps will be followed:
To encourage good behavior, teachers provide praises as they catch children making the
right choice.
A situation may be remedied by simply redirecting the child.
If redirection does not cause the desired change in behavior, the child may be separated from
the group for a short period of time. This may be a time-out chair or a place in the room
where the child is supervised while taking a few minutes to reflect on the fact that his/her
actions did not represent good decision making.
After a brief interval, the teacher discusses the incident and appropriate behavior with the
child. When the child returns to the group, the incident is over. The period of time a child is
in time-out depends upon the childs age. 2 year olds will serve a time-out no longer than
2 minutes, 3 year olds no longer than 3 minutes, and 4 year olds no longer than 4 minutes.
If a child is aggressive toward another (pushing, shoving, hitting, spitting, biting), the
aggressor will be immediately removed from the group and placed in time out.
A behavior may warrant calling a parent during the day to speak with their child over the
phone. On rare occasions, a parent may be called to come to the school to speak with their
child.
Should these efforts fail to produce the desired behavior in the child, parents will be called
to meet with the Preschool Director and the childs teacher to develop a suitable strategy for
correcting the childs inappropriate behavior.
If the above steps do not produce the desired behavior, the child will be withdrawn from the
Preschool.
No spanking or any kind of corporal punishment is allowed.

Preschool Discipline Policy1 of 2

NOTE: If a child bites another, the aggressor and victims parent will be called to advise them
of the incident. The aggressor will receive a bite report and the victim will receive an
incident report. These reports are to be signed and dated by the parent/guardian. The
white and yellow copies are retained by the school and the parent receives the pink
copy.
A child who bites a 3rd time may be withdrawn from the Preschool.
If you have any questions or concerns about any of the discipline procedures, please contact the
Preschool Director.

Preschool Discipline Policy 2 of 2

VPK Only Attendance Policy

Children are to be in class during instructional hours from 8:30am to 11:49am. Children absent more than 20% of the
VPK instructional days may be withdrawn from the program. To minimize the number of absences, it is suggested that
families plan vacations during Fall Break, Thanksgiving Break, Christmas break, and Spring Break. The first day of school
will be August 15, 2016 and the last day of school will be May 19, 2017. NOTE: The first and last day of school are
subject to change according to the Public School Calendar.
On the last VPK day of each month, parents sign a form that states: I swear (or affirm) that my child attended the
Voluntary Prekindergarten Education Program during the months listed below. I certify that my childs daily attendance in
the program was recorded by the private provider or public school and that I or my representative signed the attendance
record each day that my child attended the program. I further certify that I continue to choose the private provider or
public school to deliver the program for my child and direct that program funds be paid to the provider or school for my
child. This form will be maintained along with your childs sign in/out sheet.
Preschool will be closed the following days for the 2016-2017 school year:
Labor Day - September 5, 2016
Fall Break - October 37, 2016NOTE: Childcare offered see note below.
Thanksgiving Break - November 21-25, 2016
Christmas Break - December 19 January 3, 2017
Martin Luther King, Jr. Day - January 16, 2017
Staff Development Day - February 17, 2017
Presidents Day - February 20, 2017
Spring Break - March 6-10, 2017NOTE: Childcare offered see note below.
Staff Development Day March 13, 2017
Good Friday - April 14, 2017
K4 Graduation - May 5, 2017 see note below.
The following dates are NON-VPK Days:
Harvest Day November 18, 2016
Christmas Party Day December 16, 2016
Grandparents Day March 3, 2017
Although VPK will not operate on these days, an invitation is extended to our VPK Only students to enjoy the activities
with their classmates.
NOTE: If you need childcare for your preschooler during Fall Break and/or Spring Break, you will to need follow the
steps below:
Fall Break October 3-7, 2016 - Fill out the WebForm on RenWeb no later than September 23, 2016. I understand that
my account will be billed.
Spring Break March 6-10, 2017 - Fill out the WebForm on RenWeb no later than February 17, 2017. I understand that
my account will be billed.
If you choose for your child to participate in the K4 Graduation, practices will take place after VPK hours and a detailed
practice schedule will be provided in February. On practice days, you will need to pack a lunch for your child or order a
hot lunch from our school cafeteria. Children will eat from 12:00 12:30. You will need to pick up your child promptly
at the end of each practice.