School Application

FAIR ACRES COUNTRY DAY SCHOOL REGISTRATION APPLICATON

2021-2022 School Year
Student Information
Child's Name *

First Name Last Name
Date of Birth *

Month Day Year
Date
Age as of September, 2021 *
Primary Language *
Place of Birth *
Child's Primary Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parents' Information
Parent 1 *

First Name Last Name
Email Address *
Home Phone Number *

Area Code Phone Number
Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Cell Phone Number *

Area Code Phone Number
Work Phone Number *

Area Code Phone Number
Parent 1 Work Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Parent 2 *

First Name Last Name
Email Address *
Home Phone Number *

Area Code Phone Number
Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Cell Phone Number *

Area Code Phone Number
Work Phone Number *

Area Code Phone Number
Parent 2 Work Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Emergency Contacts

In the event parent cannot be reached
Emergency Contact #1 *
Phone Number *

Area Code Phone Number
Relationship *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Emergency Contact #2 *
Phone Number *

Area Code Phone Number
Relationship *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Child's Physician *
Phone Number *

Area Code Phone Number
Known allergies/medical conditions *
Identifying Information
Eye Color *
Hair Color *
Gender *
Race *
Height *
Weight *
Identifying Marks *
School Programs
Select the program and days for which you're applying *

3-Year-Old (2-day program = Tu/Th; 3-day program = M/W/F; 5-day program = M-F) Pre-K (select a minimum of 3 days, any combination) Kindergarten (full-time, 5 days)
Select Days *

Monday Tuesday Wednesday Thursday Friday
3-year-old pick-up time selection

12:00 PM Extended Day until 3:30 PM Extended Day until 5:30 PM
3-year-old pick-up time selection

12:00 PM Extended Day until 3:30 PM Extended Day until 5:30 PM
4-year-old pick-up time selection

12:30 PM Extended Day until 3:30 PM Extended Day until 5:30 PM
Kindergarten pick-up time selection

3 PM Extended Day until 5:30 PM
All Families: a $75.00 registration fee is due with your application. This payment holds your child’s place on our roster and is non-refundable.

New Families: a $200 non-refundable deposit is due with your application. This deposit will be applied to your September tuition.

All Kindergarten Families: a $200 non-refundable deposit is due with your application. This deposit will be applied to your September tuition.

Please mail checks to:

Fair Acres Country Day School & Summer Camp
35 Fair Acres Drive
Marstons Mills, MA 02648

Or you may call us at (508) 420-3288 to make a credit card payment.
All Families: a $75.00 registration fee is due with your application. This payment holds your child’s place on our roster and is non-refundable.

New Families: a $200 non-refundable deposit is due with your application. This deposit will be applied to your September tuition.

All Kindergarten Families: a $200 non-refundable deposit is due with your application. This deposit will be applied to your September tuition.

Please mail checks to:

Fair Acres Country Day School & Summer Camp
35 Fair Acres Drive
Marstons Mills, MA 02648

Or you may call us at (508) 420-3288 to make a credit card payment.
View the 2021-2022 Dates & Rates here:
Name of person completing this application *

First Name Last Name
Signature *

Signature of person completing this application Clear
Should be Empty:

FAIR ACRES COUNTRY DAY SCHOOL REGISTRATION APPLICATON

Student Information

Parents' Information

Emergency Contacts

School Programs