Payment Agreement
Synergy Magnet K12
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Email *
Parent/Guardian Name *
Student Name *
I, the parent/guardian of my child, agree to pay all money due to Synergy in a timely manner.  All payments will be made according to the attached agreed upon schedule. *
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I understand that I am responsible for any late fees or returned bank fees.  If any refund is due back to me, it is my responsibility to contact the finance department before the end of the quarter or I may forfeit any money owed back to me. *
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I, the parent/guardian of my child, understand that if payments for scholarships, tuition, or before/aftercare are not kept up to date and are more than 7 days late, Synergy Magnet K-12 has the right to suspend all services to my child, up to full dismissal from the school and/or program and all access to grades will be denied until all late payments are resolved. *
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Parent/Guardian Initials *
Date *
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Parent/Guardian Name *
If more than one child, please add here:
Child's Name
Child's Name
Child's Name
Child's Name
Child's Name
Child's Name
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