CCISP



Program Requirements and Tuition Costs

Please note: CCPSP is a separate entity from MCA, Calvary Chapel Junior High, and Calvary Chapel High Schools. The schools are not obligated to serve CCPSP families in any capacity.

CCPSP requirements (full program)

CCPSP full program is a low-key program designed to meet the basic needs of the independent, self-reliant families and their students.

-$30.00 non-refundable registration fee (subject to change) -Tuition (see Tuition Chart)

-HSLDA membership required

-Proof of curriculum per student

-Immunization record required (signed waiver acceptable)

-Attendance record required four times per year

-Four parent meetings required

-Work samples required per student four times per year

-CCPSP yearbook offered at significant discount

-Occasional No cost/low cost CCPSP activities*

-CCPSP Resource Library (not MCA or CCHS library)

TUITION CHART:

Tuition cost for CCPSP: (subject to change)

Elementary

1st elementary student $200.00 per year

each additional student $50.00 per year

High School

1st High School student $250.00 per year

each additional high school student 150.00

High School & Elementary

Elementary charges + High School charges = total per year

Effective September 2005: All new families must first enroll in the CCPSP full program. The Annex division, a record-keeping service, is available to established CCPSP families that are in good standing at time of re-enrollment.

*Students enrolling in the CCPSP who were expelled or asked to leave another school will be placed on a probationary status from participation in activities with CCPSP and/or the Calvary Schools.

Home School Resource Information

Book Resources

-Christian Book Distributors

or 1-800-247-4784

-Christian Home Educators’ Curriculum Manual by Cathy Duffy

-Mary Pride’s home school manuals: Volume 1 - Getting Started Volume 2 - Preschool and Elementary

Volume 3 – Jr. High through College

-Mary Schofield High School Handbook

-Typical Course of Study by World Book



click on “Student Activities”,

click on “Typical Course of Study”

Book Stores/Curriculum

-Carol Joy Seid Seminars

-Hope Country School 714/534-6733

-Shekinah Curriculum Cellar

or 903/643-2760

-Sycamore Tree Warehouse and Catalog 714/668-1338

Organizations

-Biola “Star Program” 7th – 12th grades 562/903-4734

-CHEA (Christian Home Educators’ Association) 1-800-564-CHEA

Contact CHEA for a list of ISPs and home school organizations in your area.

-CHEP (Community Home Education Program) is a public school

sponsored program for K – 12th grades. Check phone book for local listings.

-Homeschool Family Ministries/PE co-op offers Academic/PE classes for K-12th grade home schooled families.

Contact Lesie Blankshain at 714/964-0869

-HSLDA or 540-338-5600

Testing

-ACT (American College Test)

-CHSPE (California High School Proficiency Exam)

-Stanford Achievement Test

-SAT (Scholastic Aptitude Test)

Date Received: _____________________________________OFFICE USE ONLY___________________________________________________

REGISTRATION $____________ CK#____________ TUITION $_____________ CK# _____________ HSLDA____________GL:______________ ____________

1ST YR MEMBER_____ PREVIOUS_____ RENEWAL_____ CCPSP_____ ANNEX _____ CCHS Sports/Coach _________________________________________

Application for Calvary Chapel Private School Program

Applying for: Present school year________ or Next fall semester________ Today’s Date: ____________________________

Parents’ names: _____________________________________________________ Ph number: _______________________________

FIRST NAMES of both parents LAST NAME

Address: ____________________________________________________________________________________________________

Street Address City Zip Code

E-mail address: _________________________________________________ Do you have an answering machine? _____________

If none, please indicate “NONE”

Are you self-employed or operating an in-home business? ________________ Full time/Part time? __________________________

Father’s Employer: _______________________________________________ Wk Number: _______________________________

Mother's Employer: _____________________________________________ Wk Number: _______________________________

*If Mother working, complete section #2 on page #3

Father’s cell/pager number: _______________________________ Mother’s cell/pager number: ______________________________

Referred by: ___________________________________________________ Years completed in Home Education: _________

Do both parents and children attend church regularly? Yes / No Name of Home Church/City location: ___________________________________

*Please refer to section #3 page #3 to complete church attendance.

Contact name/phone number for church reference (i.e. Pastor, Elder of church):_______________________________________________________

Marital Status: (check all that apply) Married _______ Single _______ Widow_______ Divorced* (from child’s parent) _______

If married, both signatures required on all pages.

*If biological parents do not live at the same address, please list information of parent not living with child in the corresponding section “marital status continued” page #4.

Student Information

| |(If different from parents) |GENDER |AGE |DOB |

|Example |Calvary Chapel PSP |Mrs. Lounsbury |Sept. 01-04 |Transferred to MCA |

|K- 3rd |3000 W. MacArthur Blvd. |714/549-8727 | | |

| |Santa Ana CA 92704 | | | |

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Student’s name: ______________________________ Enrollment grade level: _____

|Grades Attended |Name of School - Address |Contact Name - Phone Number |Entrance/Exit Date |Reason for Leaving |

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All grade levels per student(s) MUST be accounted for on School Record form. CCPSP reserves the right to contact previous schools to verify information. Make additional copies as needed.

School History

Student’s name: _____________________________ Enrollment grade level: ______

|Grades Attended |Name of School - Address |Contact Name - Phone Number |Entrance/Exit Date |Reason for Leaving |

|Example |Calvary Chapel PSP |Mrs. Lounsbury |Sept. 01-04 |Transferred to MCA |

|K- 3rd |3000 W. MacArthur Blvd. |714/549-8727 | | |

| |Santa Ana CA 92704 | | | |

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Student’s name: _____________________________ Enrollment grade level: ______

|Grades Attended |Name of School - Address |Contact Name - Phone Number |Entrance/Exit Date |Reason for Leaving |

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All grade levels per student(s) MUST be accounted for on School Record form. CCPSP reserves the right to contact previous schools to verify information. Make additional copies as needed.

CCPSP PARENTAL AGREEMENTS

Statement of Faith

The Calvary Chapel Church has been formed as a fellowship of believers in the Lordship of Jesus Christ. We believe: Jesus Christ is the foundation and the cornerstone of the church; The Bible is the inspired, infallible word of God and is relevant and applicable to man today. God is worthy of all worship, praise, reverence and love. Our supreme desire is to know Christ and to be conformed into His image, likeness, and example by the power of the Holy Spirit. Love is the greatest virtue and demonstration of the reality of Jesus Christ. Christian Service is part of the Christian life and is the responsibility of all believers.

Please read the following statements. Initial each line to affirm your cooperation with these policies.

____ 1. I/We understand that due to the obscure political and legal position of private home education, I/we understand that CCPSP/The Annex cannot offer any legal immunity.

____ 2. I/We understand that CCPSP/The Annex is a separate entity from MCA (Maranatha Christian Academy), Calvary Chapel Junior High School, and Calvary Chapel High School, and that the schools are not obligated to serve CCPSP families in any capacity.

____ 3. I/We understand that CCPSP/The Annex is a non-accredited program designed to meet the basic needs of support and accountability for independent, self-reliant families in the schooling of their children and that CCPSP/The Annex is not responsible for their actual education.

____ 4. I understand that I must be a member of the Home School Legal Defense Association (HSLDA) at my/our own expense.

Final enrollment in CCPSP/The Annex is contingent upon acceptance by HSLDA.

____ 5. I/We agree to abide by California State Law by submitting a copy of my/our child(ren)’s Immunization Record (provided by my/our pediatrician) or a signed Waiver for all students enrolled in the CCPSP/The Annex..

____ 6. I/We agree to diligently and consistently teach my/our child(ren) a course of study fitting to his/her physical and mental capabilities and will provide parental as in Father/Mother supervision during school hours.

____ 7. I/We understand that CCPSP/The Annex does not provide curriculum and/or guidance counseling. Therefore, I/we acknowledge that it is my/our responsibility to learn about the different learning styles and methods of teaching. I/we will provide and pay for all curriculum, teaching materials, and extra-curricular activities.

____ 8. I/We realize that although CCPSP/The Annex will be holding my/our child(ren)'s cumulative records, I/we are responsible for maintaining a duplicate cumulative file for my/our home records.

____ 9. I/We agree to turn in all required paperwork, registration, and tuition in accordance with the deadlines so stated in the CCPSP/The Annex calendar.

____10. I/We agree that it is my/our responsibility to attend the mandatory parent meetings (CCPSP full-program members only) per the dates so stated in the CCPSP calendar.

____11. I/We understand the CCPSP/The Annex cannot provide a high school transcript if my/our son/daughter’s cumulative file is incomplete. The CCPSP/The Annex cannot be responsible to provide paperwork and/or information above and beyond what has been submitted and filed in my/our child(ren)’s cumulative file.

____12. I/We understand that due to the obscure political and legal position of private home education, it is my/our responsibility to research the entrance requirements and the legalities regarding transferring my/our student(s) from the CCPSP/The Annex program into another school (public/private) and/or college or university.

____13. I/We understand that the registration fee is non-refundable except in the case that my/our application is denied by the CCPSP.

____14. Due to the legalities of filing a Private School Affidavit, CCPSP will not accept students that are dual enrolled/affiliated with any accredited/non-accredited private/public/charter school, ISP or organization that may/may not file a public/private school affidavit.  

____15. I/We understand that CCPSP/The Annex reserves the right to transfer my/our family and/or student from the full program to the Annex at the discretion of the CCPSP.

____16. I/We understand that CCPSP can relinquish my/our family and/or student(s)’ enrollment in the CCPSP/The Annex at the discretion of the CCPSP.

____17. A copy of the CCPSP/The Annex Policy Handbook is provided on our website “”. I/We agree to read and abide by all policies and procedures. (An assigned group leader will be available to answer any questions you may have regarding the CCPSP/The Annex Policy Handbook.)

____18. I/We understand that any infraction of any of the above stated policies and /or the CCPSP/The Annex Policy Handbook could result in dismissal from CCPSP/The Annex.

___________________________________________ _____________________________________________

Parent’s signature Date Parent’s signature Date

STATEMENT OF POLICY CONCERNING PARENTAL RESPONSIBILITY AND MANDATORY RELEASE OF LIABILITY

Calvary Chapel Private School Program (“CCPSP”), a ministry of Calvary Chapel of Costa Mesa, California, requires participating Members to execute and abide by this Statement of Policy Concerning Parental Responsibility and Mandatory Release of Liability, and also requires Members to sign a comprehensive release of liability as a condition to participation in group activities.

CCPSP’s policy, philosophy and practice are that at every event/activity, parents are responsible and liable for their own children. No child is allowed to attend any CCPSP event and/or activity without being supervised by the parent or adult designated by that child’s parent to take complete responsibility for him/her. The only exception to the parent/ designated-adult rule is in regards to some of the junior high/high school events and/or activities. In the case of junior high/high school events and/or activities, adult chaperons will be available for supervision, but the designated CCPSP chairperson(s) will not be held responsible/liable for any behavior, injuries or property damage, etc., caused by any enrolled CCPSP student and/or his/her guest.

Any person, whether member or not, who has a claim or dispute arising out of, touching or in any way related to any CCPSP activity will be directed to discuss the offense individually with the party he believes to be responsible. CCPSP does not assume or undertake any responsibility concerning mediating or resolving such disputes. If any disputes cannot be handled by the parties individually, those parties are expected and by subscribing this Statement agree to follow the guidelines of Matthew 18 concerning resolution of disputes by church-based mediation, through their own churches and church leadership.

COMPREHENSIVE RELEASE OF LIABILITY

As a condition of my family’s participation in Calvary Chapel Private School Program, a ministry of Calvary Chapel of Costa Mesa, California, and in consideration of good and valuable consideration, receipt of which is hereby acknowledged, the undersigned hereto agree as follows:

I/We do hereby absolutely, fully and forever, release, relieve, waive, relinquish, and discharge Calvary Chapel Private School Program (“CCPSP”), and Calvary Chapel of Costa Mesa, California, their successors, assigns, representatives, agents, attorneys, and each of them, of and from any and all manner of action or actions, cause or causes of action, suits, debts, deficiencies, liabilities, demands, obligations, costs, expenses, sums of money, controversies, damages, accounts, reckonings, and liens which relate to my participation or the enrollment and/or participation of my children, wards, guests or any person in my custody, under my supervision or control, in the activities of Calvary CCPSP on or after the date set forth below, including, but not limited to, all responsibility in the event of any property damages or physical injuries to my children, my guests or myself.

I/We acknowledge and agree that the provisions of this Release shall be deemed to obligate, extend to, and inure to the benefit of the legal successors, assigns, transferees, grantees, and heirs of each of the parties hereto, who may assume any and all of the above-described capacities.

I /We further acknowledge and agree that the provisions of this Release shall be binding upon the parties hereto, their successors, heirs, and assigns.

I/We expressly waive any and all rights under Section 1542 of the Civil Code of the State of California, which provides as follows: "A general release does not extend to claims which the creditor does not know or suspect to exist in his favor at the time of executing the release, which if known by him must have materially affected his settlement with the debtor."

I have read the STATEMENT OF POLICY CONCERNING PARENTAL RESPONSIBILITY AND MANDATORY RELEASE OF LIABILITY

and COMPREHENSIVE RELEASE OF LIABILITY above and accept its terms and agree to follow this policy in connection with any and all CCPSP activities.

Dated: Dated:

____________________________________________________ ____________________________________________________

Parent/Guardian signature Parent/Guardian signature

MEDICAL AUTHORIZATION

I/We, the undersigned parent, parents or guardians of the children named below do hereby authorize and consent to any x-ray examination, anesthetic, medical or surgical diagnosis, treatment and emergency hospital care which is advisable by and is to be rendered under the general or specific supervision of any member of the medical staff and emergency room staff licensed under the provisions of the Medical Practice Act and on the staff of any acute general hospital holding a current license to operate a hospital from the State of California Department of Health Services. It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital care being required, but is given to provide authority to render care which the physician, listed below, in the exercise of his/her best judgment may deemed necessary. It is understood that every effort shall be made to contact the undersigned prior to rendering treatment to the patient, but that any of the above treatment will not be withheld if the undersigned cannot be reached. This authorization is given pursuant to the provisions of Section 25.8 of the Civil Code of California. The undersigned also assumes the responsibility for any of the costs connected with such treatment and hereby releases the leaders and members of Calvary Chapel Private School Program therefore. I have read the above statement for the Medical Authorization and agree to the defined provisions.

____________________________________________________ ____________________________________________________

Parent/Guardian signature Date Parent/Guardian signature Date

Children’s Names:

_____________________________________ _____________________________________ _____________________________________

_____________________________________ _____________________________________ _____________________________________

Home Phone_________________________ Emergency Phone_____________________ Cell Phone ______________________________

Address____________________________________________________________ City_________________________________ Zip _____________

Physician’s/Medical Group’s Name ____________________________________________________ Phone # ______________________________ Insurance Company and Policy #_______________________________________________________Phone # ________________________________

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