Student Re-enrollment
“Developing Excellence In Tomorrow’s Leaders”
____________________________
A Ministry of Living Word On The Move
185 Tunis Rd., McDonough, GA 30253
Phone: 770-954-0797
Fax: 770-914-9222
www.livingwordchristianacademy.net
OFFICE USE ONLY
____Completed Application
____Enrollment Fee
____Matriculation Fee
____Activity Fee
____Ren Web Fee
____August’s Tuition
____Tuition Agreement
____FACTS Information
____Health Records Updated
STUDENT INFORMATION
Student’s Name: _______________________________________________________________________
Address: ___________________________________________ Home Phone #: _____________________
City: __________________________ State: _______ County: ______________ Zip: _______________
FAMILY INFORMATION
Father’s Name: ________________________________________________________________________
Cell #:____________________ Home Phone if different from student’s:_________________________
Email Address:_______________________________ Occupation: ______________________________
Employer: ________________________________ Work Phone #: ______________________________
Address if different from Student’s: _______________________________________________________
Mother’s Name: _______________________________________________________________________
Cell #:_____________________ Home Phone if different from student’s:_________________________
Email Address:_______________________________ Occupation: ______________________________
Employer: ________________________________ Work Phone #: ______________________________
Address if different from Student’s: _______________________________________________________
CHURCH INFORMATION
Name of church: ________________________________________ Pastor: ________________________
Address: _____________________________________________ Are you an active member? ________
MEDICAL INFORMATION
Name of Doctor: __________________________________ Phone #: _____________________________
Insurance Carrier: ________________________________ Policy #: _____________________________
Restrictions/Allergies:___________________________________________________________________
Medications now being taken: ____________________________________________________________
Emergency contacts other than parent:
#1 Name: __________________________ Phone: ______________ Relationship to student:_________
#2 Name: __________________________ Phone: ______________ Relationship to student:_________
In case of emergency, I hereby give permission to the licensed physician and or hospital selected by Living
Word Christian Academy to hospitalize, secure treatment for, and order injection, anesthesia, or surgery.
Yes______ No_______
I am responsible for any medical care needed for myself or my child in case of emergency and or incur any
cost upon which my child must return home due to medical or disciplinary reasons. I release Living Word
Christian Academy and its respective agents from any liability for injury or damage and assume all risks
relating to my child’s participation in activities at or in transit from all off campus field trips.
Adult/Parent/Guardian Signature:_______________________________ Date:_______________
TRANSPORTATION / AUTHORIZED PICK UPS
Please list those who have permission to pick up your child from the academy.
Name
Address
Phone
1.____________________________________________________________________________________
2.____________________________________________________________________________________
3.____________________________________________________________________________________
4.____________________________________________________________________________________
SPECIAL INFORMATION
In case of divorce, separation, etc., please provide the following information:
Person(s) who has legal custody of child: _____Both Parents _____Father _____Mother _____Other
Student lives with: _____Both Parents _____Father _____Mother _____Other
Will the student be using After Care on a regular basis? ______Yes ______No
Please check one of the following:
_____My child may charge lunches, snacks, and drinks (other than milk) at their will to my school
account.
_____My child may only receive lunches, snacks, or drinks (other than milk) if I have preordered it
on RenWeb.
Are you interested in being a room mother or classroom volunteer? ______Yes _____No
STUDENT BEHAVIOR AND CONDUCT AGREEMENT
My student and I have read from the LWCA Handbook and fully understand the actions that are
considered offenses. We have full understanding that the decisions for such actions will result in the
consequences listed in the handbook. We understand that any inappropriate action listed or not
listed will result in a consequence so deemed necessary by the administration. I the parent am in
complete agreement with the consequences thereof and I will in all aspect of discipline be supportive
of LWCA, its teachers and its administration.
Parent’s Name:____________________________ Parent’s Signature: ___________________________
(please print)
Student’s Name:__________________________ Student’s Signature: ___________________________
(please print)
PARENTAL AGREEMENT
In making this application for the registration of my child, I understand and agree that:
1.
The Registration Fee of $230.00 is non-refundable.
2.
The following factors are considered in approval for each application of registration to Living
Word Christian Academy:
A. Academic achievement levels as indicated by the entrance exams.
B. Conduct and attitude of student.
C. Family’s commitment to support the academy program through compliance with school
policies, requirements set forth by the school as now and hereafter in effect.
D. Student’s willingness to comply with LWCA entrance requirement forbidding student’s
use of tobacco, marijuana, alcoholic beverages, or the consumption of any illegal drugs at
home, school or off campus.
3.
I will be responsible for and punctual in making regular payments for each month that the
child is enrolled for one day or more.
4.
The academy administration has full responsibility in placing my child in the proper grade
level.
5.
The academy has full discretion in the classroom discipline of my child.
6.
I understand that the school reserves the right to expel any student whose parents or guardians
fail to cooperate with the school administration.
7.
I understand that as part of enrollment, I am giving permission for my child to attend all
school sponsored field trips.
8.
I will be responsible for my child being in full compliance with the Uniform Code of LWCA.
9.
I will provide punctual transportation for my child’s arrival and departure from the academy.
I have read the Parent Agreement and am supportive of LWCA by requiring my child to obey all school
policies, requirements and rules as now and hereafter in effect.
Date
Signature of Parent or Guardian
STUDENT AGREEMENT: (Required only for students in grades 6 through 12)
I understand that my attendance at LWCA signifies that I am committed to abide by all policies,
requirements, and rules set forth by the school as now and hereafter in effect.
________________________________________________________________________
Date
Signature of Student
NOTE: A complete listing of the school’s policies, rules and requirements are found in the student
handbook.
Living Word Christian Academy accepts students regardless of race, nationality or ethnic origin.
FINANCIAL INFORMATION/AGREEMENT
All families shall be expected to make tuition payments according to one of the following payment plans.
Please select which payment option you choose
1.
_____Payment-in-full Under this plan the entire amount of tuition is paid on or before August 1 st.
If you choose to pay yearly tuition in full, you will receive a discount rate of one month’s tuition
off of your payment.
2.
_____*Deferred Monthly Payments – ACH Option Under this plan, the year’s tuition is paid
monthly over a period of 10 months. All families that choose a monthly payment plan must enroll
in the FACTS automatic deduction plan made through your checking or savings account. Monthly
tuition payments will be deducted on the 5th of every month beginning September 5th. Manual
payments will not be accepted. The first month’s tuition must be paid in cash or money order on
or before August 1st. If August’s tuition payment is not made, a $65.00 late fee will be
assessed. All tuition payments for the remaining 9 months will be made through FACTS. Please
read the attached information on how to sign up with FACTS if you choose this option
instead of payment in full.
NSF/Late Payments All payments missed due to insufficient funds will incur a NSF fee of $35.00 as well
as a late fee of $25.00. You may also incur additional NSF fees from your financial institution. Tuition for
that month must then be brought in to the school office immediately upon notification of insufficient funds
in the form of cash or money order along with the $35.00 NSF and $25.00 late fee. Any fees 10 days past
due will result in the student not returning to class until past due balance is paid in full.
Additional Charges – All other charges such as lunch and before/after care will be due the 1st of
every month in the form of cash, money order, or through PayPal. There will be a 5 day “grace”
period before a $25.00 late fee will be added to the late balance and attendance to class will be denied
after the 15th until the late balance is brought current. It is suggested that these fees are paid weekly.
If you would like to make payments through PayPal, please send payments to lwca.payments@yahoo.com.
For those of you who are not familiar with PayPal, PayPal deducts a small fee if a credit or debit card is
used to send money. This fee is 2.9% of the amount sent + an additional $ .30 per transaction. (Example:
fee on $100.00 will be $3.30) This fee will be charged to your school account. PayPal is only to be used
for all charges other than tuition.
Delinquent Accounts When any account becomes greater than fifteen (15) days in arrears, LWCA may, in
its sole discretion, deny class attendance, before or after care attendance, withhold academic reports and
transcripts, and revoke the enrollment contract for past due accounts. Any students that are denied
attendance due to delinquent accounts will receive zeros for missed work. Class work missed must be made
up with no opportunity for credit. No records or transcripts will be transferred to another school until all
accounts are paid. An account must be current before a student will be allowed to re-enroll for the
following school year.
Elective Fees that may be added to your account include Piano, Voice, or Guitar Lessons (Grades K5 –
12th) $30.00 per month, Home Economics (Grades 9th – 11th) $50.00 (if applicable), Competition Cheer
Squad $100.00 (if applicable), Boys Basketball $100.00 (if applicable), Biology Lab (10th grade) $50.00,
K5 & 8th Grade Graduation $50.00, 12th Grade Graduation $75.00. Biology fees will be applied in
October. Graduation fees will be applied in March.
The tuition schedule is as follows:
Due May 1st
Due June 1st
Due August 1st
Grades
*Enrollment
*Matriculation
Tuition
K5-5th
$230.00
$260.00
$3200.00
6th-8th
$230.00
$300.00
$3300.00
9th-12th
$230.00
$340.00
$3600.00
Due July 1st
Due July 1st
*Activity
*RenWeb Fee
$50.00
$35.00
$50.00
$35.00
$50.00
$35.00
*Enrollment Fees after May 1st are $300.00
*Matriculation Fees after June 1st are as follows:
K5-5th
$300.00
6th-8th
$340.00
9th-12th
$380.00
*Activity Fee is non-refundable fee that covers field trips. *RenWeb Fee is a mandatory nonrefundable fee per family to ensure parental updates, parental supervision of grades, student conduct
and financial obligations, as well as constant communication with teachers, staff, and administration.
All fees must be paid in order for your child to begin school on August 3rd.
Multiple Family Tuition Schedule
1st child
2nd child
Regular Tuition
$20 Discount
3rd child
$30 Discount
4th child
Free
5th child
*See Note
*Families with more than 4 children will pay half the cost of tuition for each child after the fourth.
The cost of the tuition will revert back to the first child column and, depending the child’s grade
level, would be half the amount listed for that grade.
Referrals – Any parent referring another family to LWCA will receive a $300.00 credit. The guidelines are
as follows:
1.
2.
3.
4.
Your name must be written on the “Student Application” on the “referred by” line.
The referred family must pay the entire Enrollment fee, Matriculation fee, RenWeb fee, Activity
fee and first month’s tuition. All checks must clear the bank.
The $300 credit is then applied to your account.
Referral credits are only given during the same academic year that the referral was submitted.
I HAVE READ ALL OF THE FINANCIAL POLICIES INCLUDED IN THIS DOCUMENT AND AGREE TO
ABIDE BY THE POLICIES AND PAY ALL TUITION AND FEES ON TIME BASED ON THE PAYMENT
OPTION WE HAVE SELECTED ABOVE.
Father’s Name:____________________________ Father’s Signature: ___________________________
(please print)
Mother’s Name:__________________________ Mother’s Signature: ___________________________
(please print)
Enrolling With FACTS: Visit the school’s website www.livingwordchristianacademy.net and click on
the FACTS logo on the Enrollment tab to get started, or visit the following site
https://online.factsmgt.com/signin/4JXNL.
Please have the following information available when enrolling:

Account information for the person responsible for payment: bank name, account number, and the
bank routing number. Most of this information is located on your check.

To protect your privacy, you will be asked to create your own unique FACTS username and
password. Please be sure it is something you can easily remember.

Before clicking the Submit button, please carefully read through the Final Review and the Terms
and Conditions. Once Living Word Christian Academy has finalized your agreement, you will
receive a confirmation notice from FACTS. All tuition payments beginning September 5th
will then be handled through FACTS.
Should you have any questions regarding this plan, please contact the school office at 770-954-0797 or
FACTS at 866-441-4637.
Please enroll with FACTS as soon as possible. All families must be enrolled by August 3rd to begin
school. Please remember August’s tuition is due by August 1 st in the form of cash or money order. We
are looking forward to a great year.