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Fervent Beginnings Private Before & After Care Enrollment Form

Fervent Beginnings Private Before & After Care Enrollment Form

Please complete and submit this form to enroll your child for our childcare program!
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    Please Select
    • Please Select
    • Afghanistan
    • Albania
    • Algeria
    • American Samoa
    • Andorra
    • Angola
    • Anguilla
    • Antigua and Barbuda
    • Argentina
    • Armenia
    • Aruba
    • Australia
    • Austria
    • Azerbaijan
    • The Bahamas
    • Bahrain
    • Bangladesh
    • Barbados
    • Belarus
    • Belgium
    • Belize
    • Benin
    • Bermuda
    • Bhutan
    • Bolivia
    • Bosnia and Herzegovina
    • Botswana
    • Brazil
    • Brunei
    • Bulgaria
    • Burkina Faso
    • Burundi
    • Cambodia
    • Cameroon
    • Canada
    • Cape Verde
    • Cayman Islands
    • Central African Republic
    • Chad
    • Chile
    • China
    • Christmas Island
    • Cocos (Keeling) Islands
    • Colombia
    • Comoros
    • Congo
    • Cook Islands
    • Costa Rica
    • Cote d'Ivoire
    • Croatia
    • Cuba
    • Curaçao
    • Cyprus
    • Czech Republic
    • Democratic Republic of the Congo
    • Denmark
    • Djibouti
    • Dominica
    • Dominican Republic
    • Ecuador
    • Egypt
    • El Salvador
    • Equatorial Guinea
    • Eritrea
    • Estonia
    • Ethiopia
    • Falkland Islands
    • Faroe Islands
    • Fiji
    • Finland
    • France
    • French Polynesia
    • Gabon
    • The Gambia
    • Georgia
    • Germany
    • Ghana
    • Gibraltar
    • Greece
    • Greenland
    • Grenada
    • Guadeloupe
    • Guam
    • Guatemala
    • Guernsey
    • Guinea
    • Guinea-Bissau
    • Guyana
    • Haiti
    • Honduras
    • Hong Kong
    • Hungary
    • Iceland
    • India
    • Indonesia
    • Iran
    • Iraq
    • Ireland
    • Israel
    • Italy
    • Jamaica
    • Japan
    • Jersey
    • Jordan
    • Kazakhstan
    • Kenya
    • Kiribati
    • North Korea
    • South Korea
    • Kosovo
    • Kuwait
    • Kyrgyzstan
    • Laos
    • Latvia
    • Lebanon
    • Lesotho
    • Liberia
    • Libya
    • Liechtenstein
    • Lithuania
    • Luxembourg
    • Macau
    • Macedonia
    • Madagascar
    • Malawi
    • Malaysia
    • Maldives
    • Mali
    • Malta
    • Marshall Islands
    • Martinique
    • Mauritania
    • Mauritius
    • Mayotte
    • Mexico
    • Micronesia
    • Moldova
    • Monaco
    • Mongolia
    • Montenegro
    • Montserrat
    • Morocco
    • Mozambique
    • Myanmar
    • Nagorno-Karabakh
    • Namibia
    • Nauru
    • Nepal
    • Netherlands
    • Netherlands Antilles
    • New Caledonia
    • New Zealand
    • Nicaragua
    • Niger
    • Nigeria
    • Niue
    • Norfolk Island
    • Turkish Republic of Northern Cyprus
    • Northern Mariana
    • Norway
    • Oman
    • Pakistan
    • Palau
    • Palestine
    • Panama
    • Papua New Guinea
    • Paraguay
    • Peru
    • Philippines
    • Pitcairn Islands
    • Poland
    • Portugal
    • Puerto Rico
    • Qatar
    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
    • Saint Kitts and Nevis
    • Saint Lucia
    • Saint Martin
    • Saint Pierre and Miquelon
    • Saint Vincent and the Grenadines
    • Samoa
    • San Marino
    • Sao Tome and Principe
    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
    • Sierra Leone
    • Singapore
    • Slovakia
    • Slovenia
    • Solomon Islands
    • Somalia
    • Somaliland
    • South Africa
    • South Ossetia
    • South Sudan
    • Spain
    • Sri Lanka
    • Sudan
    • Suriname
    • Svalbard
    • eSwatini
    • Sweden
    • Switzerland
    • Syria
    • Taiwan
    • Tajikistan
    • Tanzania
    • Thailand
    • Timor-Leste
    • Togo
    • Tokelau
    • Tonga
    • Transnistria Pridnestrovie
    • Trinidad and Tobago
    • Tristan da Cunha
    • Tunisia
    • Turkey
    • Turkmenistan
    • Turks and Caicos Islands
    • Tuvalu
    • Uganda
    • Ukraine
    • United Arab Emirates
    • United Kingdom
    • United States
    • Uruguay
    • Uzbekistan
    • Vanuatu
    • Vatican City
    • Venezuela
    • Vietnam
    • British Virgin Islands
    • Isle of Man
    • US Virgin Islands
    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
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    PLEASE NOTE: There are no makeup or roll over days. You will receive an invoice 1-3 business days upon submitting the form. Additional children will receive a 10% discount (will reflect on invoice)!
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    PLEASE NOTE: Late pickup fee is $1 each minute after 6:05PM. Lunch Hour and Clubs charged separately. There are no makeup or roll over days. You will receive an invoice 1-3 business days upon submitting the form. Additional children will receive a 10% discount (will reflect on invoice)!
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    PLEASE NOTE: Late pickup fee is $1 each minute after 6:05PM. Lunch Hour and Clubs charged separately. There are no makeup or roll over days. You will receive an invoice 1-3 business days upon submitting the form. Additional children will receive a 10% discount (will reflect on invoice)!
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    FINANCIAL TERMS AND CONDITIONS

    The School’s Before and After Care programs are paid monthly during the school year. These payments take into account school holidays, absences due to illness or vacation, and school closings due to inclement weather. Therefore, no adjustments will be made to any Care Plans throughout the year. There are no make-up days if a child misses a day. No days can be carried into the following month.

    REGISTRATION FEE

    A registration fee of $25 will be collected at the time of enrollment to reserve a spot for your child in our Care Program. This fee is non-refundable. A child’s enrollment is not considered complete until the registration fee and initial invoice is paid.
    If a child is registered and does not attend Fervent Beginnings, their registration fee and deposit will be forfeit.

    INVOICES

    Monthly payments are due on the first of every month and considered late after the 10th of the month.

    LATE PICKUPS

    For After Care programs, a late pickup fee will be assessed $1 per minute after 6:05PM.

    LATE PAYMENTS

    Late payments will be subject to a $35 late fee.

    CANCELLATION

    If you choose to withdraw from Fervent Beginnings Care, for any reason, prior to the end of the month, you agree that you have read, understand, and will comply with the following:

    • Provide the Director of Education with a written notification, 10 days in advance, of your intention to withdraw.
    • Your registration fee and monthy payment will be forfeit.

    RETURNED CHECKS

    There will be a $50.00 fee charged for any returned checks or accounts accessed which do not have sufficient funds to cover the registration fee and/or monthly payment.

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    ENROLLMENT AGREEMENT


    This Agreement is made and entered into between Fervent Beginnings (“School”), which operates a child care facility at 904 Cooper Road, Voorhees, NJ 08043 and {parentName} (“Parent” or “Guardian”), residing at {parentAddress}. 

    The Parent/Guardian wish to enroll their child {fullName1} (“Child”) at Fervent Beginnings Before and After Care Program.
    Fervent Beginnings wishes to accept {fullName1} into their program.


    CONSENT

    I, the Parent, or Guardian, consent to the participation of my Child in all activities organized by Fervent Beginnings (“Activities”), and agree on behalf of the above minor to all of the terms and conditions of this Agreement. By signing this Release of Liability, I represent that I have legal authority over and custody of Child. 


    RELEASE OF LIABILITY 

    In exchange for participation in all activities organized by Fervent Beginnings, and/or use of the property, facilities and services of Fervent Beginnings, I agree for myself and for the members of my family, to the following: 

    AGREEMENT TO FOLLOW DIRECTIONS. I agree to observe and obey all posted rules and warnings, and further agree to follow any oral instructions or directions given by Fervent Beginnings, or the employees, representatives or agents of Fervent Beginnings. 
    ASSUMPTION OF THE RISKS AND RELEASE. I recognize that there are certain inherent risks associated with enrolling Child at Fervent Beginnings.
    I recognize there are certain inherent risks associated with School Activities, including but not limited to potential exposure to COVID-19, injury, loss, or damage to myself or my family members.
    I recognize and understand that Fervent Beginnings will abide by all state and federal guidelines in regard to the operation of a child care facility during the coronavirus, COVID-19, pandemic.
    I assume full responsibility for all of the risks associated with Child’s enrollment. I further release and discharge Fervent Beginnings for any sickness, injury, loss, or damage arising out of my or my family's use of the facilities and services of Fervent Beginnings, whether caused by the fault of myself, my family, Fervent Beginnings or other third parties. 
    INDEMNIFICATION. I agree to indemnify and defend Fervent Beginnings against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my or my family's use of or presence upon the facilities of Fervent Beginnings.
     

     

    MEDICAL AUTHORIZATION

    In the event of an injury to the above minor during School Activities, I give my permission to Fervent Beginnings or to the employees, representatives or agents of Fervent Beginnings to arrange for all necessary medical treatment for which I shall be financially responsible. This temporary authority will begin on September 1, 2025 and will remain in effect until terminated in writing by the undersigned or June 30, 2026, whichever occurs first. Fervent Beginnings shall have the following powers: 

    The power to seek appropriate medical treatment or attention on behalf of my child as may be required by the circumstances, including without limitation, that of a licensed medical physician and/or a hospital;
    The power to authorize medical treatment or medical procedures in an emergency situation; and 
    The power to make appropriate decisions regarding clothing, bodily nourishment and shelter. 
     

    HEALTH STATEMENT

    As the parent/guardian of the above named child, I certify that he/she is in good physical health and may participate in the normal activities of the program and has no conditions or specific needs that require specific accomodations, unless otherwise indicated in the medical information provided above or an attached Universal Health Record or a Care Plan for Children with Specials Health Needs. 

     

    EMERGENCY TREATMENT

    As the parent(s)/guardian(s) of the above named child, I (we) attest that the informaiton above is correct.  I (we) authorize the child care center staff to obtain emergency treatment for my child and understand that I (we) shall be promptly notified.


    MULTIMEDIA RELEASE

    I give my consent for Fervent Beginnings to photograph or record video of me and/or my child while on School premises or while participating in School Activities. I understand that the photographs, digital images, or video segments may be used in print or electronic media and that the photographs may be displayed on websites owned or sponsored by the School. I give the School permission to publish, exhibit, and distribute these materials. I understand that Fervent Beginnings will own the copyright to the multimedia material in which I, or my child may appear. 


    APPLICABLE LAW

    Any legal or equitable claim that may arise from participation in the above shall be resolved under New Jersey law. 
      

    ENFORCEABILITY 

    The invalidity or unenforceability of any provision of this Agreement, whether standing alone or as applied to a particular occurrence or circumstance, shall not affect the validity or enforceability of any other provision of this Agreement or of any other applications of such provision, as the case may be, and such invalid or unenforceable provision shall be deemed not to be a part of this Agreement. 
      

    DISPUTE RESOLUTION

    The parties will attempt to resolve any dispute arising out of or relating to this Agreement through friendly negotiations amongst the parties. If the matter is not resolved by negotiation, the parties will resolve the dispute using the below Alternative Dispute Resolution (ADR) procedure.   

    Any controversies or disputes arising out of or relating to this Agreement will be submitted to mediation in accordance with any statutory rules of mediation. If mediation does not successfully resolve the dispute, then the parties may proceed to seek an alternative form of resolution in accordance with any other rights and remedies afforded to them by law.

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    Please check the box below to move on to the signature page.
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    By signing below, I agree to payment as described. I understand that
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    Additional children will receive a 10% discount (will reflect on invoice)!
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