Peace Way Christian Center

SVCA Application for Admission

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Kindergarten

If your child will be 5-years-old by September 1,  (s)he is eligible to enroll in our Kindergarten program.  We provide an excellent Kindergarten learning experience.  Our students are taught the fundamentals of reading, and most of the students are reading phonetically by the end of the first semester.  They are prepared for future academic success by establishing strong reading and math skills.  Kindergarten students must submit a a completed 1) Application for Admission, 2) the registration fee, 3) a copy of their birth certificate, and 4) a copy of their immunization record.
 

Grades 1-12

Admission to Spring Valley Christian Academy is based on an application.  Parents are expected to agree with the school's Statement of Faith, regularly attend and participate in the life of a Christian Church, and give evidence of their positive relationship with Jesus Christ.  Elementary students must submit a completed 1) Application for Admission,
2) the registration fee, 3) a copy of their birth certificate, and 4) a copy of their immunization record.
 

Grades 6-12
 
Admission to Spring Valley Christian Academy is based on an application and a Pastoral Interview.  The Pastoral Interview is a screening process for both the school and the prospective family.  During the interview, the parents will be given the
school's Statement of Faith and the Parental Support Statement.  Both parties must be in agreement that the Academy would be a good "fit" for the student.  Parents are expected to regularly attend and participate in the life of a Christian Church and give evidence of their positive relationship with Jesus Christ.  Students should demonstrate potential academic success in our program based on previous records and recommendations.  All prospective students should demonstrate good social adjustment, satisfactory behavior, and emotional stability.  Each middle school and high school student must submit a completed 1) Application for Admission, 2) the registration fee, 3) a copy of their birth certificate, 4) and a copy of their immunization record.  The Pastoral Interview is conducted with the parents of the prospective student, the student, and the Pastor. 
 
There is a $100 nonrefundable fee for the Pastoral Interview which is paid prior to the date of the Interview.  If the prospective student is denied admission, the $100 will be refunded to the family.  If admission is granted, the $100 will be applied towards the registration fee.
 
 

Fees
 
All fees are payable prior to the first day of school.
 
 

STUDENT INFORMATION

Name (first, middle, last)

Date of Application

 

 

Street Address

 

 

City, State, Zip

Date of Birth

 

 

Gender (male or female)

Place of Birth

 

 

Grade to be Entered

PARENT/GUARDIAN INFORMATION

Father’s Name

 

 

Father’s Cell

Street Address

 

 

City, State, Zip

Employer

 

 

Occupation

 

Business Phone

 

 

E-mail

 

Mother’s Name

Mother’s Cell

 

 

Address

City, State, Zip

 

 

Employer

 

 

Occupation

 

Business Phone

 

 

E-mail

 

PREVIOUS SCHOOLS

School Name/Address

Grades Attended

 

 

School Name/Address

Grades Attended

 

 

 

 

 


 


Emergency Information

In the event of an emergency, S. V. C. A. will contact the following people based upon the order in which they are listed. Please list parent and/or guardians first, then list additional individuals who are emergency contacts and authorized to pick up your children.

 

EMERGENCY CONTACTS

Name

Parent/Guardian

Cell Phone

Work Phone

 

Name

Parent/Guardian

Cell Phone

Work Phone

 

Name

Relationship

Cell Phone

Work Phone

 

ADDITIONAL PERSONS AUTHORIZED TO PICK UP CHILD

Name

Relationship

Cell Phone

Work Phone

 

Name

Relationship

Cell Phone

Work Phone

 

 

 

 

Medical Information

 

1. Does your child have a history of the following: Asthma_______________ Allergies____________

 

2. Does your child have any other health problems? __________________________________________

 

3. Is your child allergic to any medications? __________ If yes, please list_________________________

 

4. Does your child require medication? ____________ If yes, please list___________________________

 

5. Does your child’s physical activity need to be restricted in any way? __________________________

 

If yes, please explain__________________________________________________________________

 

Spring Valley Christian Academy admits students of any race, color, and national origin to all rights, privileges, programs, and activities made available to students in the school. It does not discriminate on the basis of race, color, national or ethnic origin in administration of its educational policies, administration policies, or in any other school administered program.

 

 


 

 
 SVCA Tuition Rates
 

 

Registration

Kindergarten, Elementary,

Middle, and High School

$495

Nonrefundable

Application Fee

For all Middle and High School Students

(Grades 6 and up)

$100

(Applied towards Registration/Tuition upon acceptance.)

Tuition Rates

Kindergarten

$4,000/year

Elementary

$4,500/year

Middle School

$5,000/year

High School

$5,500/year

 
 




SVCA Tuition Agreement

 

Tuition will be paid by (choose only one):

 

__________ OPTION 1 Payment in full.

 

Single payment payable on or before July 15, 2013.

 

__________ OPTION 2 Ten monthly payments, payable on the 1st of each month.

 

__________ OPTION 3 Ten monthly payments, payable on the 15th of each month.

 

__________ OPTION 4 Bi-annual payments. Two half-payments, payable on 07/01/2013 and 01/03/2014.

 

I understand that Spring Valley Christian Academy cannot function without my timely financial support and I do hereby agree to pay all tuition and fees required in accordance with the financial policy of the school. There will be a $25 return payment fee if the funds are not available. Accounts that become thirty (30) days past due are subject to student dismissal.

 

 

 

Parent/Guardian Signature: ____________________________________________________

 

Date: ___________________________________
 

 

Parent/Guardian Signature: ____________________________________________________

 

Date: ___________________________________

 

 

 

 


 

 

SVCA Exempt Status

 

Spring Valley Christian Academy is exempt from the Elementary and Secondary Education Authorization Act,

(a) an exempt private school which receives a “certificate of exemption” from the Nevada Department

of Education to confirm the school’s exempt status, as requested by the school which qualifies and

chooses to be exempt from licensing.

(b) and a licensed private school which is licensed by the Nevada State Board of Education.

The Nevada Department of Education recognizes both types of schools as alternatives to public schools.

Both types of private schools have to:

  • Provide curriculum, exclusive of religious instruction, that is equivalent instruction of the kind and amount approved by the State Board of Education – and follows the Nevada State standards as found on the Nevada State Department of Education website.

  • Provide minimal length of school day and school year.

  • Comply with all applicable state, county, and local health, safety, and fire inspections and laws, ordinances, and regulations, including those relating to fire emergency drills, vehicles and immunization of pupils.

Spring Valley Christian Academy is licensed by the Nevada State Board of Education. Thank you for helping us maintain our religious distinction and exempt status.

I/We understand that Spring Valley Christian Academy is licensed exempt.
 

 

Parent/Guardian Signature: ____________________________________________________

 

Date: ___________________________________
 

 

Parent/Guardian Signature: ____________________________________________________

 

Date: ___________________________________

 
 
 

 
 

Statement of Parental Support

 
 

We, as parents or guardians, agree to fully subscribe and comply with the required policies of Spring Valley Christian Academy. This commitment includes, but is in no way limited to the following:

Initials

[ ] [ ] 1. Subscribe to this ministry’s Statement of Faith;

[ ] [ ] 2. Demonstrate a godly pattern of Christian living as demanded in the Scripture;

[ ] [ ] 3. Cooperate with the necessary procedures designed to certify the validity of the

school’s operations including regular verifiable attendance at church services;

[ ] [ ] 4. Attend all meetings designed to benefit and inform parents enrolled in the program;

[ ] [ ] 5. Ensure parental leadership role in areas of moral and spiritual training of children by

carrying out Biblical principles of child training in the home; and

[ ] [ ] 6. Provide financial support according to the agreed upon terms.

We, as parents or guardians, pledge our support of the school and its administration. We understand the following policies and standards of the school:

Initials

[ ] [ ] 1. The school has full discretion in the discipline of my child.

[ ] [ ] 2. The school has full discretion for placing my child in the proper grade,

regardless of the grade completed prior to transfer to this school.

[ ] [ ] 3. My participation is needed in lending practical help and prayer support in a mutual

effort to train our children.

[ ] [ ] 4. The school reserves the right to suspend or dismiss any student who does not

cooperate with the educational process.
 

 

Parent/Guardian Signature: ____________________________________________________

 

Date: ___________________________________
 

 

Parent/Guardian Signature: ____________________________________________________

 

Date: ___________________________________



 





Release of Transferability
 

Spring Valley Christian Academy offers no guarantees or warranties, stated or implied, as to the literal transferability of any student’s educational progress upon termination from the Academy. All educational entities, whether public or private, have complete authority to independently assess the academic progress of any prospective student and provide appropriate placement. Once a student leaves Spring Valley Christian Academy there is no recourse directly available as to the placement of any student in any other educational establishment.

 


Parent/Guardian Signature: ____________________________________________________

 

Date: ___________________________________
 

 

Parent/Guardian Signature: ____________________________________________________

 

Date: ___________________________________



 



 

Disclaimer, Waiver, Release and Authorization

Consents, Disclosures and Waivers by Legal Guardian of a Minor

This Agreement is made and entered into this date between the parties

Peace Way Christian Center

For Spring Valley Christian Academy

A Nevada Nonprofit Corporation

Hereinafter referred to simply as “PWCC”

and

Parent Full Name (no abbreviations): _______________________________________________________________

Full Name of Minor Child(ren) (no abbreviations): _____________________________________________________

Residence Address: ____________________________________________________________________________

Telephone Number: ____________________________________________________________________________

Hereinafter singularly referred to simply as “Participant,” and

PROVIDES AS FOLLOWS:

PROPOSED ACTIVITY: Field Trips and Off Campus Events

FIRST: Participant signing below represents that he/she/they are legal guardian(s) of the minor child(ren) named above, and

SECOND: The parties acknowledge that PWCC is a Nevada Non-Profit Tax-Exempt Religious Corporation, with principal offices located in Las Vegas, Nevada, among which are large campus grounds, PWCC buildings and other multipurpose facilities and structures, including athletic fields and parking areas; all of which are distinguishable separate or isolated locations. PWCC makes no representation regarding the suitability of the premises for any reason or purpose. Participant has conducted its own independent examination of the premises determining for itself that same is suitable for its purposes contemplated by this agreement.

Disclaimer, Waiver, Release and Authorization

Page 2 of 3

THIRD: PARTICIPATION DISCLOSURES AND WAIVERS

Participant and PWCC understand and agree that there are a number of various programs undertaken by departments and groups in affiliation with PWCC, on and off the PWCC campus facilities, involving activities and individuals that are often not under direct control or supervision of PWCC, and that there is an overriding policy that each participant involved in these programs does so at their own risk of personal injury or damage to property; and Participant and/or the named minor child(ren) desires to take part in the activity mentioned hereinabove, and fully understands and agrees that such activity might involve sporting activities, travel or contacts with other individuals or groups, and that PWCC has limited or no control over other individuals involved in such activity, and that there is always the risk of physical injury, illness, and other loss, and possible costs or expenses for medical or dental diagnostic and curative treatments, and general and special damages for incidental loss or expense, and, in these premises, Participant does for himself/herself, and for and on behalf of said child(ren) and his or her family, representatives and heirs, assume the risk of all such injury, responsibility or liability, and waives any and all claims or causes of action against PWCC or its agents that might arise from or on account of any sort of loss or injury of or to person or property of any description in this regard; and as an inducement to PWCC and its agents to allow the undersigned and such child(ren) to participate in such activity, does hereby agree to hold harmless PWCC and its agents from all these things in event any such claim should arrive. PWCC does not act as insurer, guardian guarantor, or warrantor of health or safety of anyone involved in such activity. The undersigned affirmatively represent that said child(ren) has special needs and conditions or requires special medication and care only as follows:

STATEMENT OF HEALTH:

1. Does your child have any health problems? ______________________________________________________

2. Has your child ever had any physical handicaps or limitations? _______________________________________

3. Is there any history of mental illness in your family? ________________________________________________

4. Has your child ever been convicted of a criminal offense? ____________________________________________

(excluding minor traffic violations)

If you answered yes to any of the above questions, please explain. _______________________________________

List any medications or treatment that should not be given to your child because of dangerous reactions: _________

Regular medications: ___________________________________________________________________________

Last tetanus shot (date): ________________________________________________________________________

Emergency contact information (name and phone): ___________________________________________________

Insurance Company: ___________________________________________________________________________

Policy Number: ________________________________________________________________________________

I/we further agree to provide on an immediate need to know basis any change in information that may arise at any time.

Disclaimer, Waiver, Release and Authorization

Page 3 of 3

FOURTH: MEDICAL AUTHORIZATION

In the event it should become necessary, which in emergency or otherwise, where the said child(ren) cannot act for himself or herself, consent is hereby given for PWCC through its adult individuals serving as its agents to arrange for and consent to X-ray examinations, anesthesia, dental, medical or surgical diagnosis and/or treatment and hospital care, for said child(ren), on behalf of Participant, and, in such event Participant agrees to assume and pay all costs, charges, fees and expenses incurred in the premises, and to hold harmless PWCC, its agents, assigns, employees, and volunteer assistants from any liability whatsoever due to the administration of first aid and treatment arising out of injury, sickness or damage which may be sustained by said child, therefrom. Participant represents and agrees that he or she already has or will provide insurance coverage or payment of such things, at Participant’s own expense.

FIFTH: DISCIPLINE

Participant for himself/herself/themselves and on behalf of such minor child(ren) hereby submits to and agrees to abide by all rules and regulations, supervision and discipline set and applied by PWCC or its agents, and it is agreed that for violation of such rules and regulations, supervision or discipline, the participation in the activity may then be immediately terminated, without liability on PWCC or its agents. In the event your child is dismissed from the program, we, the undersigned, agree to forfeit any possible refund, make restitution for any damages and assume full responsibility for transportation home.

SIXTH: I/we consent and agree that said child may travel with the __________________________ on a trip sponsored by the Spring Valley Christian Academy of , its agents, assigns, employees and volunteer assistants from any liability whatsoever arising out of injury, sickness, or damage which may be sustained by said child during the course of said trip.

Peace Way Christian Center

Signature: ___________________________________________________ Date: _______________________
 

Name (print legibly): __________________________________________________________________________
 

Signature: ___________________________________________________ Date: _______________________
 

Name (print legibly): __________________________________________________________________________


 




SVCA Request for Student Records
 

To Releasing School Counselor: Date: ______________________________
 

School Name: ________________________________________________________________________________
 

Address: ____________________________________________________________________________________
 

City, State, Zip: _______________________________________________________________________________



The following student(s) has (have) applied for admission to Spring Valley Christian Academy. Please release the academic and behavioral records, including all standardized test scores, record of immunization, and report cards, for the current and past year.


Student Age Grade Level

___________________________________ __________ __________

___________________________________ __________ __________

___________________________________ __________ __________


 Please send the requested information to:

 

SPRING VALLEY CHRISTIAN ACADEMY

 

 

 



7570 West Peace Way, Las Vegas, NV 89147(702) 873-3216 Fax: (702) 873-5929

 

 

 

Parent/Guardian Signature: ____________________________________________________

 

Date: ___________________________________
 

 

 

Parent/Guardian Signature: ____________________________________________________

 

Date: ___________________________________

 

 
 

 
 
 
SVCA 2013/2014 Calendar

 

 
2013
 

Monday, August 26, 2013 . . . . . . . . . . . . . First Day of School – Classes Begin

Monday, September 2, 2013 . . . . . . . . . . . . 

Labor Day Holiday (No School)

Monday, October 21, 2013 . . . . . . . . . . . . . End of First Grading Period (45 Days)

Friday, October 25, 2013 . . . . . . . . . . . . .

Nevada Day Holiday (No School)

Monday, November 11, 2013 . . . . . . . . . . .

Veterans Day Holiday (No School)

Thursday-Friday, November 28-29, 2013 . . . . .

Thanksgiving Days (No School)

Monday-Friday, December 24-28, 2013 . . . . . .

Christmas Break (No School)

2014
 

Wednesday, January 1, 2014 . . . . . . . . . . .

New Year’s Day Holiday (No School)

Monday, January 6, 2014 . . . . . . . . . . . . . Classes Resume

Friday, January 10, 2014. . . . . . . . . . . . . . End of Second Grading Period (45 Days)

End of First Semester (90 Days)

Monday, January 20, 2014 . . . . . . . . . . . . .

Martin Luther King, Jr. Day (No School)

Monday, February 7, 2014 . . . . . . . . . . . . .

Presidents Day Holiday (No School)

Tuesday, March 18, 2014 . . . . . . . . . . . . . . End of Third Grading Period (45 Days)

Monday-Friday, April 14-18, 2014 . . . . . . . . .

Easter Break (No School)

Monday, April 21, 2014 . . . . . . . . . . . . . . . Classes Resume

Monday, May 26, 2014. . . . . . . . . . . . . . . 

Memorial Day Holiday (No School)

Wednesday, May 28, 2014 . . . . . . . . . . . . Last Day of School

End of Second Semester (90 Days)

End of School Year (180 Days)

 
  
 

 

 
 
SVCA School Supplies List
 
 

Grades K-5 Grades 6-8

_____ Backpack _____ Backpack

_____ Lunch Box _____ Lunch Box

_____ #2 Pencils _____ Pencil Box

_____ Pencil Top Erasers _____ #2 Pencils

_____ Handheld Pencil Sharpener _____ Erasers

_____ 1-Subject Spiral Notebook _____ Handheld Pencil Sharpener

_____ 1" 3-Ring Binder _____ Protractor

_____ 12” Ruler _____ 1” 3-Ring Binder

_____ Junior Scissors with 5” Blunt Tip _____ 1-Subject Spiral Notebook

_____ Crayons _____ Antibacterial Hand Soap

_____ Pencil Box _____ 1 8 ½ x 11 Clear Plastic Envelope

_____ Tissues _____ Tissue Box

_____ Antibacterial Hand Soap _____ King James Bible

_____ 1 8 ½ x 11 Clear Plastic Envelope _____ NIV Study Bible (Optional)

_____ King James Bible _____ Dry Erase Markers (for Classroom)

_____ NIV Study Bible (Optional) _____ Package of Red Pens (for Score Table)

_____ Package of Red Pens (for Score Table) _____ Package of Green Pens (for Teacher)

_____ Package of Green Pens (for Teacher)

_____ Colored Construction Paper (for Classroom)

_____ Loose-leaf Filler Paper, Wide Rule (for Classroom)

Grades 9-12

_____ Backpack _____ Tissue Box

_____ Lunch Box _____ NIV Study Bible

_____ Pencil Box _____ Package of Red Pens (for Score Table)

_____ #2 Pencils _____ Package of Green Pens (for Teacher)

_____ Erasers _____ Package of Dry Erase Markers (for Classroom)

_____ Handheld Pencil Sharpener

_____ Protractor

_____ Compass

_____ Calculator

_____ 1-Subject Spiral Notebook

_____ Thesaurus/Dictionary

_____ Antibacterial Hand Soap

_____ 1 8 ½ x 11 Clear Plastic Envelope



 


 

SVCA Proper Uniform Attire
 

Use this checklist to make sure your child is in proper uniform attire. School uniform appearance guidelines will be enforced. The following checklist covers areas most frequently addressed.

FEMALES

Appearance is to be conservative, modest, and neat.

 

  • Hair:

  • Hair must be a natural color, no fads.

  • Hair must be a feminine style (no shaved heads, crew cuts, etc.)

 

  • Jewelry:

  • Jewelry must be conservative and minimal.

  • Only one earring (smaller than a nickel in size) per earlobe is permitted.

 

  • Shirts:

  • White or red uniform polo from Dennis Uniform.

  • Uniform shirt must be clean and tucked into skorts.

  • Please, keep the uniform shirt a little loose and non-form-fitting.

 

  • Skorts:

  • Navy blue Dennis Uniform skort.

  • Hemlines of skorts must be no shorter than 5 inches above the knee.

 

  • Shoes:

  • Navy blue or black dress shoes may be worn with white socks.

  • White tennis shoes may be worn with white socks. Tennis shoes must be all white, without any colored striping or logos.

  • Shoelaces are to be neatly tied.

 

  • Jackets:

  • Any cold weather coat/jacket may be worn outside on the playground during school hours, however, only uniform jackets may be worn in the classroom.

 

I will evaluate each of these areas daily to ensure my child is in proper uniform attire before coming to school.

 

 

Parent/Guardian Signature: ____________________________________________________

 

Date: ___________________________________
 

 

Parent/Guardian Signature: ____________________________________________________

 

Date: ___________________________________








SVCA Proper Uniform Attire

 

Use this checklist to make sure your child is in proper uniform attire. School uniform appearance guidelines will be enforced. The following checklist covers areas most frequently addressed.
 

MALES

 

Appearance is to be conservative, modest, and neat.

 

  • Hair:

  • Young men must have neat, trimmed, conservative haircuts – no fads.

  • The hair is to be tapered or blocked, not touching the ear or collar.

  • Sideburns may be no lower than the middle of the ear.

  • No dying or coloring the tips of the hair is allowed.

  • No braided or spiked hairstyles are permitted.

  • Extra curly or afro hair is not to exceed one inch in length.

 

○ Facial Hair:

  • No facial hair is permitted on students.

 

○ Shirts:

  • Uniform shirt must be clean and tucked into pants.

 

○ Pants:

  • Navy blue Dennis uniform pant.

  • Pants are to be worn properly (at the waistline).

  • Navy blue or black belt must be worn with pants..

 

  • Shoes:

  • Navy blue or black dress shoes may be worn with navy blue or black socks.

  • White tennis shoes may be worn with white socks. Tennis shoes must be all white, without any colored striping or logos.

  • Shoelaces are to be neatly tied.

 

  • Jackets:

  • Any cold weather coat/jacket may be worn outside on the playground during school hours, however, only uniform jackets may be worn in the classroom.


  •  

I will evaluate each of these areas daily to ensure my child is in proper uniform attire before coming to school.

 

 

Parent/Guardian Signature: ____________________________________________________

 

Date: ___________________________________
 

 

Parent/Guardian Signature: ____________________________________________________

 

Date: ___________________________________

 

 
 
 

 
 
 

Peace Way Christian Center (Spring Valley Assembly of God, Inc.) (702) 873-1200
Spring Valley Christian Academy (702) 873-3216 | Building Blocks Preschool (702) 873-7340 | 7570 West Peace Way, Las Vegas, NV 89147
SVCA - During Summer Call For More Info: (702) 460-3210

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