Consent and Certification
AGREEMENTS
In the event of an emergency, while our child is under MESA supervision, I hereby give permission for the administrator or person in charge to take our child to the emergency room for medical treatment.
I consent to my child participating in neighborhood trips (e.g., to the library, park, and playground) away from the program under proper supervision.
I hereby release MESA from all liability during supervised activities.
I agree to adhere to all the school’s policies and regulations.
I agree to allow my child’s pictures to be used in advertisements and on social media.
IMMUNIZATION POLICY
Magen Ephraim Sephardic Academy is committed to compliance with New York State Law to protect the health and safety of all students and faculty.
New York State requires students to receive and remain current with age-appropriate immunizations and boosters for poliomyelitis, mumps, measles, diphtheria, Hemophilus influenza type b (Hib), rubella, varicella, pertussis, tetanus, pneumococcal disease, meningococcal disease, and hepatitis B, and prohibits students from attending school without submitting appropriate documentation relating to these immunizations.
I agree to comply with New York State Law and to provide documentation concerning my child’s compliance with the law on or before their first day at MESA. New York State no longer accepts religious exemptions.
The following items are required to complete the registration:
Completed and up-to-date Medical Forms
Immunizations Record
An original Birth Certificate
Fees due at submission:
$150 Application Fee
(applied toward tuition)
$350 Screening Fee
(non-refundable; not
applied toward tuition)
FINANCIAL AGREEMENT*
Credit Card payments are accepted with a 3.5% credit card fee for each transaction. (Through ParentLocker)
*ParentLocker will add a $45 charge if the 10-month plan is chosen.
Electronic Signature of Parent 1*
Date:*
Electronic Signature of Parent 2
Date: