Mother's Name:*

Father's Name:*

Current Address:*

Street Address Address Line 2 City State ZIP Code

Children Attending:*

Name of Child	Date of Birth	Present Grade	Will be Returning to CBS	Will not be Returning to CBS

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Telephone Numbers:

Home:*

Mother's Work:

Mother's Cell:

Father's Work:

Father's Cell:

Parent's Email Address*

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Name of close neighbor/family member/friend authorized to care for your child(ren) in the event of an emergency or early closing, when the parents are not available.

Name:*

First Last

Phone:

Address:*

Street Address Address Line 2 City State ZIP Code

It is the policy of Cedar Brook School to have parents understand that:

1. Acceptance of your child(ren) is conditional on previous year’s tuition being paid in full.
2. Re-registration fee is due by May 18, 2014 and the 1st month’s tuition for the 2014-15 school year is due by August 18, 2014.
3. Families that are receiving tuition assistance need to work at least ten hours of volunteer service.
4. Tuition payments due every 10th of the month. Accounts are subject to a late fee of $15.00 if payments are made after the 10th, unless prior arrangements are made with the office.

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