Application - Bald Eagle Valley Community

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Building Bridges After-School Program
Bald Eagle Valley Community United Methodist Church
111 Runville Road, Bellefonte, PA 16823
This program was established at the Bald Eagle Valley Community United
Methodist Church by Gay Kline, a retired elementary school teacher and church
member. She became aware that families within the congregation were in need
of affordable after-school care and recognized that the church’s convenient
location next to Wingate Elementary School made it a logical space for afterschool care not only for church members, but for others.
Quality, loving, and affordable childcare remains the mission of Building Bridges
after School. The program is outlined below:
 The program serves Kindergarten through 5th grades students from
Wingate, Howard, Mt. Top and Port Matilda Elementary Schools.
 Hours are 3:00 pm to 6:00 pm.
 Children are escorted from Wingate Elementary to Bald Eagle Valley
Community United Methodist Church by Building Bridges staff.
 Positive, ethical attitudes are encourages and each child’s worth as a
unique creation of God is recognized.
 A homework area is provided.
 A snack is provided every day.
 Indoor and outdoor play areas are available.
 A variety of fun and educational activities are planned each week and
include crafts, projects, guest readers, etc. These are based on seasonal
themes or other interests.
 Christian holidays are celebrated.
 All Building Bridges caregivers have clearances on file and have received
Safe Sanctuaries training.
 Full-time or part-time options are available.
Please call 814-355-8870 or email us at bevbuildingbridges@outlook.com for
additional information.
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Building Bridges After-School Program
Bald Eagle Valley Community United Methodist Church
111 Runville Road, Bellefonte, PA 16823
Rates and Payment Guidelines
Attendance
Tuition
Additional child
Full Time (4 to 5 days/week)
$50/week for 1 child
$15/week per child
Part Time (1 to 3 days/week)
$36/week for 1 child
$9/week per child
 One week’s tuition is due at registration.
 Payment for each school week is expected during or before that week.
 A weekly payment schedule for the year will be provided based on the
school calendar. Full tuition for each week is required regardless of
absences or school cancellations. Cancellation days will be added at the
end of the year at no charge.
 In the case of an early dismissal, Building Bridges will be cancelled for that
day.
 Statements will be issued monthly. Any past due accounts persisting after
1 month will notified in writing. In that case, payment arrangements* must
be made or attendance will be suspended. Checks returned for NSF must
be paid with cash.
 Hours are 3:00 pm to 6:00 pm. We forgive occasional, unavoidable delays.
Habitual lateness (10 or more minutes, 3 or times in a month) may incur an
additional fee of $5/quarter hour.
 Caregivers are not responsible for financial matters. Any financial
questions or concerns should be addressed to the director or financial
secretary. Confidentiality will be maintained.
 If a leave of absence (and suspension of payment) is necessary, please
notify the director in writing prior to the absence. Your space may be filled
by someone on the waiting list in the event of a prolonged absence.
 Early registration is encouraged. A coupon good for 1 week’s tuition to be
used at any time during the school year will be issued if registration is made
(and paid) by the 1st week of August.
*The mission of the Building Bridges program is to provide quality, low-cost child care. The
guidelines above were developed to be clear, consistent, and fair to all participants in the BBAS
program. We understand the difficulties families with school age children face and do not want
to deny child care to anyone willing to make a reasonable arrangement that is fair to other
participants and the program itself.
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Building Bridges After-School Program
Bald Eagle Valley Community United Methodist Church
111 Runville Road, Bellefonte, PA 16823
Payment Agreement
Student Names:
___________________________________________________________________
___________________________________________________________________
Attendance
Options
Full-Time
Part-Time
Number of
Children
Total Tuition
Date Paid
I have read and understood the Rates and Payments Guidelines and agree to:
Item
Pay the 1 week’s tuition at the time of registration
Pay each week’s tuition before or during that week
Pay full tuition regardless of absences and school cancellations.
(Cancellations will be made up at the end of the year with no
charge.)
Initial
st
Signature of Parent(s) responsible for payment:
_________________________________________
Date: ______________
_________________________________________
Date: ______________
Please Print Clearly
Parent Name(s): _____________________________________________________
Phone: Evenings: _________________________ Mobile: ___________________
Email: _____________________________________________________________
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Building Bridges After-School Program
Bald Eagle Valley Community United Methodist Church
111 Runville Road, Bellefonte, PA 16823
Pick-Up Release Agreement
Permission is granted for my child ______________________________________
to be picked up by the following persons:
Name
Phone Number
Your child will not be released to anyone without direct or written permission
from the parent signed below.
For the safety of your child, even persons named will be asked for identification if
they are unknown to the Building Bridges Staff.
Signature of Parent/Guardian _________________________
Date ___________
Photograph Release Agreement
Permission is granted for my child, ______________________________________
to be photographed as part of the Building Bridges Program. Photographs may be
displayed in the building, used in newspaper articles, on the church web site or in
other media.
Signature of Parent/Guardian _________________________
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Date ___________
Building Bridges After-School Program
Bald Eagle Valley Community United Methodist Church
111 Runville Road, Bellefonte, PA 16823
Emergency Information
Student Name: ___________________________________________ Sex: M F
(First
Middle
Last)
Student Address (Mailing and Physical if different)
Mother/Guardian Name and
Address
Home Phone
Date of Birth
Grade
Home Phone
Parent Email
Work Name and
Address
Work Phone
Work Name and
Address
Work Phone
Mobile Phone
Father/Guardian Name and
Address
Home Phone
Mobile Phone
In case of accident or serious illness 911 will be called and parent/guardian
contacted. Payment of any fees will be the responsibility of the parent/guardian.
Names and Phone Numbers of Persons who will assume responsibility if Parents cannot be reached.
1.
2.
Physician Name and Phone
Dentist Name and Phone
Medical Insurance Company
Insurance Phone Number
Allergies/Other Health Issues
Date Last Tetanus Shot
List of medications your child takes or might be taking.
Insurance ID and Group
I have reviewed and understand the conditions of this emergency information.
Signature of Parent/Guardian _________________________
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Date ___________
Building Bridges After-School Program
Bald Eagle Valley Community United Methodist Church
111 Runville Road, Bellefonte, PA 16823
Behavior Guidelines
Rules






Follow directions the first time they are given
No offensive language, teasing, or name calling
Keep hands, feet, and objects to yourself
Do not interrupt
Use good manners
Be honest
Rewards
 Children are rewarded for making good choices
Consequences
 There are consequences for disregarding the rules.
 A warning is given.
 Continued disregard results in time from the group activity for 1 minute per
year of child’s age.
Parents
Your child will be encouraged to show respect to each other, those in charge,
themselves, and their surroundings. It is expected that the adults in charge will
show the same respect in a caring manner.
FYI
 Use of personal electronic devices is not allowed during BBAS hours. These
items must remain in the child’s backpack. (Note: Some exceptions may be
made at the discretion of caregivers. For example, something necessary to
complete homework or the use of cell phone in case of an emergency.)
 In fairness to others, we also required personal toys, trading cards and food
to remain in your child’s backpack.
 Building Bridges will provide all food and activities.
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