GEORGETOWN MIDDLE/HIGH SCHOOL FORM 1-A ATHLETIC USER FEES INSTALLMENT AGREEMENT WHEREAS, the Georgetown Public Schools (hereinafter “the School District”) charges athletic and fees for students to participate in co-curricular events; and WHEREAS the child(ren) of ___________________________ (hereinafter “the parent/guardian); (Parent’s name) Named _____________________________ of ______________________________________ (Student’s name)

(Address)

Georgetown, wish to participate in the following athletic event:___________________________. (sport) WHEREAS, the Parent/Guardian has exercised the installment option for paying their child(ren)s’ user fees for the ______________ (list season, Fall, Winter, Spring) athletic season; NOW THEREFORE, the School District and Parent/Guardian, in consideration of mutual promises and undertakings, agree as follows: 1. The Parent/Guardian shall make the following advance payment to the District at the time of registration totaling $159 per child for Football or High School Basketball - OR - $143 per child for Soccer, Field Hockey, Wrestling, LAX, Baseball, Softball. OR - $125 per child for Cross Country, MS Basketball, MS Track, Cheering 2. The Parent/Guardian shall make the following two installments for each sport for each child as follows: Football or High School Basketball th

Second Installment of $158 due by the 15 day of the month following registration th

Third Installment of $158 due by the 15 day of the 2

nd

month following registration

Soccer, Field Hockey, Wrestling, LAX, Baseball, Softball th

Second Installment of $141 due by the 15 day of the month following registration th

Third Installment of $141 due by the 15 day of the 2

nd

month following registration

Cross Country, MS Basketball, MS Track, Cheering th

Second Installment of $125 due by the 15 day of the month following registration th

Third Installment of $125 due by the 15 day of the 2

nd

month following registration

3. All checks are made payable to the “Town of Georgetown.” 4. At no time will the total amount paid exceed the $1,500 user fee family cap during the 2013-2014 academic year.

5. Any payment returned for insufficient funds shall be assessed an additional fee in accordance with the Town of Georgetown’s financial and accounting policies. 6. In the event that payments are not postmarked or received by the due dates stated in this installment agreement, the School District will assess a $15 late payment fee. 7. In the event that payments are not received within 15 days of the due dates stated in this installment agreement, the School District will remove the student-athlete from the team that he or she is on, in addition to assessing a $15 late payment fee. The student-athlete may be reinstated once this agreement is paid in full, including the $15 late payment fee. 8. In the event that a Parent/Guardian defaults on this agreement pursuant to Item 7 above, the family will be barred from entering into an installment agreement for the next season and all fees in arrears, including payment of fees for the next season will be required. Studentathletes may not register for another sport where there is an installment agreement in default. Items 6 through 8 represent default of this agreement. 9. Failure to pay fees will also result in a student-athlete’s diploma being withheld until such time as all fees are paid, along with any assessed late payment fees and legal fees or monies paid to collect such fees. Any changes or amendments to this contract must be agreed to by both parties in writing. This contract shall be considered completed when all monies due are paid to the School District.

Agreed to this ____________ day of ________________, 20__, by ______________________________ Parent/Guardian Signature ATHLETIC FEE PAYMENT SCHEDULES FALL

WINTER

First Payment Due…At Registration, August

First Payment Due…At Registration, November

Second Payment Due…September 15

Second Payment Due … December 15

Third Payment Due…….October 15

Third Payment Due ……. January 15 SPRING

First Payment Due … At Registration, March Second Payment Due… April 15 Third Payment Due … May 15

Receipt and Payment Schedule for Installments Parent’s Name _____________________________________ Student’s Name ____________________________________ Sport _____________________________________________

ATHLETIC FEE PAYMENT SCHEDULES FALL

WINTER

First Payment Due…At Registration, August

First Payment Due…At Registration, November

Second Payment Due…September 15

Second Payment Due … December 15

Third Payment Due…….October 15

Third Payment Due ……. January 15 SPRING

First Payment Due … At Registration, March Second Payment Due… April 15 Third Payment Due … May 15

Football and High School Basketball = initial payment of $159 plus 2nd and 3rd payments of $158 (for a total of $475) Soccer, Field Hockey, Wrestling, LAX, Baseball, and Softball = initial payment of $143 plus 2nd and 3rd payments of $141 (for a total of $425) Cross Country, MS Basketball, MS Track, Cheering = initial payment of $125 plus 2nd and 3rd payments of $125 (for a total of $375) Remember, unpaid installments mean players will be removed from play after 15 days of nonpayment. Please make all checks payable to “Town of Georgetown” Drop off in Athletic Office or Mail to: Athletics Georgetown High School 11 Winter St. Georgetown, MA 01833 Admin Use only below line Amount Received ___________________________________ Check # ___________________________________________ Date _______________________ Athletic/Admin signature _______________________________

ATHLETIC FEE PAYMENT SCHEDULES – TEAR OFF FALL

WINTER

First Payment Due…At Registration, August

First Payment Due…At Registration, November

Second Payment Due…September 15

Second Payment Due … December 15

Third Payment Due…….October 15

Third Payment Due ……. January 15 SPRING

First Payment Due … At Registration, March Second Payment Due… April 15 Third Payment Due … May 15 Football and High School Basketball = initial payment of $159 plus 2nd and 3rd payments of $158 (for a total of $475) Soccer, Field Hockey, Wrestling, LAX, Baseball, and Softball = initial payment of $143 plus 2nd and 3rd payments of $141 (for a total of $425) Cross Country, MS Basketball, MS Track, Cheering = initial payment of $125 plus 2nd and 3rd payments of $125 (for a total of $375) Remember, unpaid installments mean players will be removed from play after 15 days of nonpayment. Please make all checks payable to “Town of Georgetown” Drop off in Athletic Office or Mail to: Athletics Georgetown High School 11 Winter St. Georgetown, MA 01833

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