AcadeMir Charter School A. Preparatory and Middle. April Enrichment
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1 AcadeMir Charter School A Preparatory and Middle April Enrichment
2 ACADEMIR CHARTER SCHOOL PREPARATORY AND MIDDLE PAID: ONE REGISTRATION FORM PER STUDENT AND PER CLUB! DO NOT COMBINE CHECKS! ENRICHMENT REGISTRATION FORM This form must be completed each month and returned to school with payment attached. Checks will only be accepted. Please complete one registration form and attach one check for each enrichment. Do not combine enrichment programs. Month Registering for: Enrichment: Student Information: Student Name: Teacher: Grade: Age: Is the Student in After Care? yes no Parent/Guardian Information: First Name: Last Name: Phone Number: Emergency Contact Name: (other than listen above) First Name: Last Name: Relationship to Student: Phone Number: Additional Information Allergies or pertinent information regarding student:. Enrichment programs are non-refundable, except for hospitalization or the cancellation of a program. Parents must enter the office to pick up students at their enrichment dismissal time. Students must be picked up promptly. Students who are not picked up on time will be charged a late pick-up fee. I have read the program procedures and agree to the guidelines above. Parent/Guardian Signature: Date: Office Use Only: Payment: Check # (Checks only) Amount Paid: Received by:
3 1. Insurance of $16 MUST be paid by all students. This is a one-time fee. If the student is enrolled in after-care and already made this payment, you do not need to be pay this fee again. **Form is in the main office and must be stapled to enrichment registration form.** 2. All checks must be payable to ACSW. 3. If you are registering for more than one program, payments CANNOT be combined. 4. There is a $1 per minute late fee for those students who are not picked up by the club dismissal time. 5. Payments should be dropped off in the main office ENRICHMENT BOX.
4 Art Club with Mrs. Migoya Tuesdays (4 th & 5 th ) Thursdays (2 nd & 3 rd ) Expand the skills of your young artist! Applications are on a first come, first serve basis. To maintain quality of instruction, only 15 applicants will be selected to attend each group. Requirements: - Either an A or B in all subject areas - Receive an S or above in all conduct areas - Homeroom Teacher appoval You will be informed of the application result. If your child is not invited to attend at this time, their name will be placed on a waiting list for future consideration. Invitation to the Art Club is based on a score of combined factors: student interest, parental consent, and recommendation from the child s classroom teacher. Such factors as motivation, responsibility, and behavior are considered as well as artistic ability. Thank you for your interest in the Art Club, and thanks also for nurturing your child s creative spirit! Feel free to contact Mrs. Migoya with any questions at mmigoya@dadeschools.net
5 Teacher Recommendation for Art Club Dear Teacher, The following student has applied for Art Club. Please complete this form and return it to Mrs. Migoya for evaluation. Name Teacher Please rate the student on the following scale with 5 being the best. Independent Worker Excited about Learning Self Starter Works well with others Overall behavior Total Score Comments: Your comments are greatly appreciated. Thanks for taking the time to give your earnest opinion about this student s attitude and work habits.
6 Prac%ce will be every 3:30 4:30 p.m. School Insurance must be purchased online and the receipt must be abached to the registraaon form. IF INTERESTED IN THE TRYOUT, MUST FILL OUT THIS FORM BY MARCH 17th Student Name: ID Grade Parent Name: Rela%on: Parent Signature: Date: Parent Phone # ( ) ( ) Emergency Contact Person: Emergency Contact Phone # ( ) ( )
7 If you want to learn the fundamentals of basketball AND how to play the game the RIGHT way, sign up TODAY and take lessons with Coach Andrews! Open to 3rd-8th grade students and its $ / month PracMce every 3:30 4:30 p.m. Students must be picked up by 4:30 p.m. * School Insurance must be purchased IF INTERESTED IN PARTICIPATING, MUST FILL OUT ALL BASKETBALL FORMS BY MARCH 22nd. Student Name: ID Grade Parent Name: RelaMon: Parent Signature: Date: Payment Amount: Payment Method: check cash School Insurance must be purchased online and the receipt must be azached to the enrichment form.
8 If you want to learn the fundamentals of soccer AND how to play the game the RIGHT way, sign up TODAY and take lessons with Coach Andrews! Open to 3rd 8th grade and its only $ / month PracLce every 3:30 4:30 p.m. Students must be picked up by 4:30 p.m. IF INTERESTED IN PARTICIPATING, MUST FILL OUT ALL SOCCER FORMS BY MARCH 22nd. Student Name: ID Grade Parent Name: RelaLon: Parent Signature: Date: Payment Amount: Payment Method: check cash School Insurance must be purchased online and the receipt must be ayached to the enrichment form.
9 If you want to learn the fundamentals of basketball AND how to play the game the RIGHT way, sign up TODAY and take lessons with Coach Andrews! Open to 6th-8th grade students and its $ / month PracMce every 3:30 4:30 p.m. Students must be picked up by 4:30 p.m. * School Insurance must be purchased IF INTERESTED IN PARTICIPATING, MUST FILL OUT ALL VOLLEYBALL FORMS BY MARCH 22nd. Student Name: ID Grade Parent Name: RelaMon: Parent Signature: Date: Payment Amount: Payment Method: check cash School Insurance must be purchased online and the receipt must be azached to the enrichment form.
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