MAS-UC QI 2023-2024 Registration Form

MAS-UC QI 2023-2024 Registration Form
Asalamu Alaikum Dear MAS-UC QI Parents,

Welcome to MAS-UC QI 2023-2024 school year, please make sure to take your time to read the attached documents below and to correctly fill out the following form. Online registration will only be accepted if completely filled out. By submitting this form, you are agreeing to the bylaws of the MAS-UC QI AND the attached documents below.

*Note: Registration will not be considered complete unless registration payment is received (please see below).*

*Note: Preschool 3 years old and 4 years old must be fully toilet trained before entering the class (no pull ups or diapers allowed)*
Students' Information
123456
Student #1
In personVirtual
Full Name*

First NameLast Name
Pre-K (2yrs)Pre-K (3 yrs)Pre-K (4 yrs)Kindergarten1st2nd3rd4th5th6th7th8th9th10th11th12thOther
Date of Birth*

MonthDayYear
Student's E-mail
Student's Phone Number

Area CodePhone Number
MaleFemale
Allergies/Medical Information?*
Student #2
In personVirtual
Full Name*

First NameLast Name
Pre-K (2yrs)Pre-K (3 yrs)Pre-K (4 yrs)Kindergarten1st2nd3rd4th5th6th7th8th9th10th11th12thOther
Date of Birth*

MonthDayYear
Student's E-mail
Student's Phone Number

Area CodePhone Number
MaleFemale
Allergies/Medical Information?*
Student #3
In personVirtual
Full Name*

First NameLast Name
Pre-K (2yrs)Pre-K (3 yrs)Pre-K (4 yrs)Kindergarten1st2nd3rd4th5th6th7th8th9th10th11th12thOther
Date of Birth*

MonthDayYear
Student's E-mail
Student's Phone Number

Area CodePhone Number
MaleFemale
Allergies/Medical Information?*
Student #4
In personVirtual
Full Name*

First NameLast Name
Pre-K (2yrs)Pre-K (3 yrs)Pre-K (4 yrs)Kindergarten1st2nd3rd4th5th6th7th8th9th10th11th12thOther
Date of Birth*

MonthDayYear
Student's E-mail
Student's Phone Number

Area CodePhone Number
MaleFemale
Allergies/Medical Information?*
Student #5
In personVirtual
Full Name*

First NameLast Name
Pre-K (2yrs)Pre-K (3 yrs)Pre-K (4 yrs)Kindergarten1st2nd3rd4th5th6th7th8th9th10th11th12thOther
Date of Birth*

MonthDayYear
Student's E-mail
Student's Phone Number

Area CodePhone Number
MaleFemale
Allergies/Medical Information?*
Student #6
In personVirtual
Full Name*

First NameLast Name
Pre-K (2yrs)Pre-K (3 yrs)Pre-K (4 yrs)Kindergarten1st2nd3rd4th5th6th7th8th9th10th11th12thOther
Date of Birth*

MonthDayYear
Student's E-mail
Student's Phone Number

Area CodePhone Number
MaleFemale
Allergies/Medical Information?*
Family Information
Home Phone*

Area CodePhone Number
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
YesNo
Father's Name*

First NameLast Name
Father's Phone Number*

Area CodePhone Number
Father's E-mail*
Father's Occupation*
What is the best method of communication to reach you?
YesNo
Mother's Name*

First NameLast Name
Mother's Phone Number*

Area CodePhone Number
Mother's E-mail*
Mother's Occupation*
What is the best method of communication to reach you?
YesNo
YesNo
YesNo
Guardian's Name*

First NameLast Name
FemaleMale
Guardian's Phone Number*

Area CodePhone Number
Guardian's E-mail*
Guardian's Occupation*
What is the best method of communication to reach you?
Emergency Contacts
Please list names and phone numbers of three people other than the parents to be contacted in case of an emergency. The emergency contacts will be contacted in a case where the parents cannot be reached or when the parents do not show up to take the child home on time. The emergency contacts are allowed to take the students with them in case the parents cannot be reached.
Emergency Contact #1
Name*

First NameLast Name
Relationship to Student*
Phone Number*

Area CodePhone Number
Emergency Contact #2
Name

First NameLast Name
Relationship to Student
Phone Number

Area CodePhone Number
Please keep this information up-to- date with the teachers and the office staff. If any day for any reason you or your emergency contacts are unable to pick up your child, please let the teachers and the office staff know in writing the date and the name of the person who is taking the child home that day. The school staff has the right to ask the emergency person for a personal ID and to make a copy of it.

Health information is a very important. Please be sure to inform MAS-UC QI in writing about any medical problem your child has. Enclose any relevant medical papers with this form to keep in the child’s folder.
Please list any extra allergies or medical information (not listed above) necessary for the school to know.
To complete the form, acknowledge that you agree to the following rules by checking "Agree" below. You cannot submit the form without checking all of the boxes.
I agree to be responsible for the conduct and actions of my child/children and to release MAS-UC QI from any claims, demands, incidents, accidents or sicknesses including those related to COVID-19 that may occur during participation in classes or activities.

Furthermore, I agree to release MAS-UC QI and its employees and will hold them responsible from any liability which may arise from incidents, accidents or sicknesses including those related to COVID-19 that may occur involving myself and my children while on MAS-UC QI premises, to the extent allowed under the law.
I agree to follow the guidlines provided by the CDC and CUPHD regarding safeguards to prevent COVID-19. I will always bring my children to school masked and encourage my children to:

a. maintain a 3-6 foot distance whenever possible.

b. wash hands fequently.

c. pursue testing when necessary.

I will keep my children home if they uncharacteristically show any of the following:

- fever, chills, cough or sore throat.

- shortness of breath, difficulty breathing, fatigue, muscle or body aches.

- headache, new loss of taste or smell.

- congestion or runny nose.

- nausea, vomiting or diarrhea.
Agree
Agree
Agree
Agree
Agree
Yearly Tuition Pre-K&KG: $700/ Elementary & Middle school: $570/ High School: $450. Failing to pay tuition on time, without arrangement with the school financial officer and the approval of the principal, will give MAS-UC QI the right to stop the child from attending the program, exclude the child from graduation ceremonies, hold the report card, and not re-register the child or siblings for the following school year.*

Agree
Agree
Agree
Agree
Agree
Agree
Registration Payment

*Note: Registration will not be considered complete unless registration payment is received.*
***Please make sure that the payment quantity selected below agrees to the number of students registered above.***
Registration Fee*
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Registration Fee$15.00

Quantity
Item subtotal:$0.00

1st Quarterly Tuition Fee (Pre-K/KG)$195.00

Quantity
Item subtotal:$0.00

1st Semester Tuition Fee (Pre-K/KG) $390.00

Quantity
Item subtotal:$0.00

Yearly Tuition Fee (Pre-K/KG) $780.00

Quantity
Item subtotal:$0.00

1st Quarterly Tuition Fee (Elementary/Middle) $165.00

Quantity
Item subtotal:$0.00

1st Semester Tuition Fee (Elementary/Middle)$330.00

Quantity
Item subtotal:$0.00

Yearly Tuition Fee (Elementary/Middle) $660.00

Quantity
Item subtotal:$0.00

1st Quarterly Tuition Fee (High School) $165.00

Quantity
Item subtotal:$0.00

Yearly Tuition Fee (High School) $660.00

Quantity
Item subtotal:$0.00

Total $0.00
By submitting this form, you are providing your virtual signature that all the information on this form is correct AND that you agreeing to the bylaws of the MAS-UC QI and to the documents below.

MAS UC QI 2023-2024 Registration Form (same as 2022-2023)

MAS UC QI 2023-2024 Handbook (same as 2022-2023)
Should be Empty:

MAS-UC QI 2023-2024 Registration Form

Students' Information

Family Information

Emergency Contacts

Registration Payment