South Christian High School SCRIP Program Agreement

South Christian High School SCRIP Program Agreement

South Christian High School (referred to herein as "we," "us," and "our") sponsors a SCRIP program that allows participants to purchase gift cards from participating retailers. The purchase of SCRIP generates rebates provided by those retailers. Participants may choose to apply these rebates as a credit toward a South Christian tuition account, receive the rebate as cash, and/or designate the rebate as a gift to South Christian High School or its Tuition Assistance Fund. The parties agree to the following terms and conditions:
Rebates earned will be used in the following ways:
percentage% as a charitable contribution to the school (potentially deductible).
percentage% as a tuition credit for the following school family: family name
percentage% as a tuition credit for the following school family: family name
percentage% as a tuition credit for the following school family: family name
percentage% transferred to the following school: school name
percentage% as a cash rebate to you (NOT deductible).
There is a one-time $10.00 registration fee to participate in the South Christian SCRIP program. Rebates earned through the program are distributed twice each year, in May and December.

For any rebates designated as charitable contributions, South Christian High School will provide all required acknowledgements in accordance with Sections 170(f)(8) and 170(f)(17) of the Internal Revenue Code.

Participants agree to indemnify and hold South Christian High School harmless from any loss incurred due to insufficient funds associated with checks or ACH transfers used to purchase SCRIP. South Christian High School makes no representations or warranties of any kind regarding the SCRIP purchased through the program.

This agreement will remain in effect unless superseded by a new agreement and may be terminated by either party by providing 60 days' advance notice to the other party.
Please sign below to indicate your acknowledgment of this agreement.
First Name
Last Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current Family?
If answered 'No" above, year children in school:
Disclaimer of Responsibility

Complete this section if your SCRIP certificates will be picked up by someone other than the adult listed on the account or if you would like your certificates mailed to you.

I (we) authorize the South Christian High School SCRIP Committee to release my SCRIP certificates to my child, another designated adult, or to mail them to me if I provide a self-addressed, stamped envelope.

I (we) understand and agree that South Christian High School and the SCRIP Committee are not responsible for any certificates that are lost, stolen, delayed, or misplaced as a result of the actions of the designated pickup person or through postal delivery.
Pick-up person's name(s)
Participant Signature

Payment Information:

SCRIP Program Sign-Up Fee

$10.00

Total

Payment Methods

Credit Card

Apple Pay

Should be Empty: