RVUSD EXTENDED CARE REGISTRATION FORM

Size: px
Start display at page:

Download "RVUSD EXTENDED CARE REGISTRATION FORM"

Transcription

1 RVUSD EXTENDED CARE REGISTRATION FORM Child #1 Name School Grade Child #2 Name School Grade Start Date of Care: A one-time annual program registration fee is required upon registration. This fee is $50 per child, $75 per family. Tuition rates are based on 180 school days. Holidays and School In-Service days are not included.. Rates below are the cost per month and have been divided into 9 payments, September-May. Payments are due by the 1st of each month. Morning Only Care begins at 7 a.m. Afternoon Care until 6 p.m. and includes Morning Care on the same day. 1 day a.m. M T W TH F..$28 1 day a.m./p.m. M T W TH F $64 y. 2 days a.m. M T W TH F..$56 2 days a.m./p.m. M T W TH F $128 3 days a.m. M T W TH F..$84 3 days a.m. /p.m. M T W TH F $192 4 days a.m. M T W TH F..$112 4 days a.m./p.m. M T W TH F..$256 5 days a.m. M T W TH F..$140 5 days a.m./p.m. M T W TH F..$320 *If your days vary due to custody or your work schedule, please contact your site coordinator. Please check the applicable boxes below if apply: Drop-In Policy: We offer a pre-paid voucher for using our drop in care. Morning Only Drop-In is $10 per morning; Afternoon Drop In is $20 per day. Preapproval for drop in days is required 24 hours in advance and must be approved by the Site Coordinator. Minimum purchase price is $100. (Complete a Drop-In Voucher form)... Applying for Reduced Rate: Submit form with registration. Split Pay: Each responsible adult must submit their own contract Agency: (Outside agency responsible for payments) Parents/ Guardians using the Extended Care Program services agree to the following: I understand that I am responsible for payment for my scheduled contracted days whether my child is in attendance or not. I further understand that extended care has the right to immediately drop any child whose behavior endangers themselves or others. I understand that my payment is due on the 1st of every month and no balances can carry over. I understand that extended care closes promptly at 6:00pm, and I understand that a rate of $5.00 per min/ per child is assessed for late pickups. I agree to the rates, terms and conditions of this contract. (Please print name and date on line) ADMIN USE ONLY Registration Fee: $ Check#: Initials: Date: Waitlist: Staff

2 RVUSD Day Care Student Information/Medical Form Child #1 Name Birthdate / / Sex M F Age Allergies Child #2 Name Birthdate / / Sex M F Age Allergies Home Address City Zip Responsible Adult Information: Name Phone (W) Cell Relationship Name Phone (W) Cell Relationship Primary Language The following people (in addition to the adults above) are authorized to pick-up my child: Pick-up #1 Name/Relationship Phone # Pick-up #2 Name/Relationship Phone # Pick-up #3 Name/Relationship Phone # Pick-up #4 Name/Relationship Phone # Any other information we should know? Parent Comments:

3 Welcome to the School Year for RVUSD Extended Care! Our priority is to ensure your child is provided daily with a safe, nurturing and fun environment. Registration packets can be picked up at each extended care site and the district office. Forms may also be accessed on the website at rvusd.org. For any questions contact Joy Lindeman, Extended Care Director: ext.4113 / jlindeman@rvusd.org. Please read and become familiar with our policies and procedures! WHAT WE OFFER: Each day your child will be given the option to participate in Homework Club and an Outdoor or Creative activity. A snack is provided once a day in the afternoon to all participants. HOURS: We provide before school care at 7 A.M and after school care until 6 P.M. RATIOS: We strive to keep a 1 staff per 15 student ratio. Therefore space is limited and sites may become full. REGISTRATION FEE: A annual program registration fee of $50 per child/ $75 per family will be required upon registration. TUITION: Tuition rates are based on 180 school days. Holidays and School In-Service days are not included. Rates below are the cost per month and divided into 9 payments, September- May. Payments are due the 1st of each month. EXAMPLE: If you need morning care on Monday and afternoon care on Tuesday, Wednesday and Fridays, your total tuition cost for the month will be 1 day morning $ day afternoon $128 = $156 Morning Only Care begins at 7 a.m. Afternoon Care until 6 p.m. and includes Morning Care on the same day. 1 day a.m. M T W TH F..$28 1 day a.m./p.m. M T W TH F $64 2 days a.m. M T W TH F..$56 2 days a.m./p.m. M T W TH F $128 3 days a.m. M T W TH F..$84 3 days a.m. /p.m. M T W TH F $192 4 days a.m. M T W TH F..$112 4 days a.m./p.m. M T W TH F..$256 5 days a.m. M T W TH F..$140 5 days a.m./p.m. M T W TH F..$320

4 DROP IN ONLY: There is a pre-paid voucher for drop-in care to assist families who may need periodic care throughout the year. Participants will be required to pre-purchase a minimum of $100 towards their voucher. All drop-ins need to be pre-approved by your site coordinator 24 hours in advance of care needed. Our drop-in rates are $10 per day for morning care and $20 for afternoon care. A registration packet must be submitted with the drop-in voucher form. PAYMENTS: All payments are due by the 1 st of the month. We Do Not Send Invoices or Reminders. You may submit payments to your extended care site coordinator, by mail or to the district office. Cash only payments will only be taken at the district office. Payments must be paid in full, we do not carry over any outstanding balances from previous months. (Example; May extended care fees will be due by May 1 st ) You are responsible for payment for all days you contract for whether your child is in attendance or not. We Do Not Give Credit for Any Missed Days. This includes vacations, sickness, family in town, sports etc. RETURN CHECKS: A $20 bank fee will be applied to all returned checks. COLLECTIONS: Payments that are not received are subject to be sent to collections. We make every attempt to avoid this step. Please contact the programs director if necessary, we are committed to working with families. CHANGES: A change form submission is needed for all scheduling changes and cancellations. A Two Week notice is required for any reduction of days or cancellations. You are able to change your schedule a total of 3 times, throughout the 180 days of school at no cost. A $20 book keeping fee will be applied to any schedule changes made after your 3 rd change. SPLIT PAY: If payments are split between two responsible parties, each party must have their own registration forms on file and submit their own payments. REDUCED RATE: We offer a reduced rate for those families who qualify. A reduced rate day care form is available on our website or at our day care sites. For more information please contact Joy Lindeman ext INTERSESSIONS: A separate registration is required for all intersession programs. We provide care for, some days during the Thanksgiving, Winter, Spring and Summer breaks. CURRENT CONTACT INFORMATION: It is the responsibility of the child s guardian to inform the extended care coordinator of any changes to their child s contact information. Ex: phone number, address, authorized pick-up list etc. RECEIPTS/TAX INFORMATION: Upon your request we will provide you with a receipt and your yearly tax information. Our TAX ID is # CHILD S ATTENDANCE: Because your child s safety is important to us, it is the responsibility of the guardian to inform the day care site of any absences. The extended care program reserves the right to terminate enrollment in the extended care program after the fifth (5) unannounced absence. Please call and leave a message for your site coordinator any time of the day.

5 SIGN IN/SIGN OUT: The extended care program requires that children be signed in and out by their parents or guardian, daily. All sign-in sheets are legal documents and are a permanent part of a student s record. Please inform your site coordinator if someone different is picking up your child and please keep your authorized pickup list current! We will ask to see a photo ID if the staff does not know the person. LATE PICK-UP POLICY: If children are not picked up by closing time (6 pm all sites), a late fee of $5 will be charged for every minute beyond closing time. If your child is not picked up after 30 minutes we will call people on your emergency contact list. If we cannot contact anyone, we will call the police and CPS. If your child/children are picked up late more than 5 times, we reserve the right to terminate enrollment in the program. MEDICATION/SICK CHILDREN: Medication will be administered only after the Permission to Administer Medication Form has been completed or is on file. Your school extended care coordinator per doctor s orders will administer the medication. If your child becomes ill or hurt we will contact the parent immediately. We reserve the right to send a child home if we see that he/she has a fever or is vomiting. SNACKS: Extended care provides a light snack each afternoon. Parents/guardians may provide extra or supplemental snack for their child, if desired. Please do not send snacks high in sugar. A healthy snack is preferred. HOMEWORK POLICY: Each site provides a supervised homework time during the afternoon Monday thru Thursday. A staff person supervises and helps children during homework time, however is not able to provide 1:1 tutoring. Children are encouraged to do their homework but they are not required to. TOYS FROM HOME/CELL PHONE: No toys or electronics from home are allowed in the extended care program. All cell phones must be kept in the child s back pack. Children are welcome to use the day care phone to contact their parents if necessary, and parents are encouraged to call the extended care if they need to speak with their children. YOU MUST RE-ENROLL EVERY YEAR: We do not assume you will be returning to our program. To secure your spot in extended care please re-register every year.

6 IMPORTANT EXTENDED CARE CONTACTS Joy Lindeman: After School Programs Director ext.4113 / jlindeman@rvusd.org 1000 Yulupa Ava Santa Rosa Kathy Poznanovich: Assistant to Director ext.4113 / kpoznanovich@rvusd.org 1000 Yulupa Ava Santa Rosa Sequoia Elementary School Austin Creek Elementary (Mornings Only) 5305 Dupont Ave. Santa Rosa Snowy Egret Dr. Santa Rosa ext.4691/p3, P4 & P ext /Multi-Purpose Rm. Coordinator: Kathryn MacDonald Coordinator: Kathryn MacDonald sequoiadaycare@rvusd.org sequoiadaycare@rvusd.org *Afternoon bused to Sequoia Madrone Elementary School Binkley Elementary School 4550 Rinconada Dr. Santa Rosa Canyon Dr. Santa Rosa ext.4494/rm. P5 & P ext. TBA Coordinator: Tracie Pulliam Coordinator: TBA madronedaycare@rvusd.org binkleydaycare@rvusd.org jlindeman@rvusd.org Spring Creek Elementary School Matanzas Charter 4 th -6 th (Mornings Only) 4675 Mayette Ave. Santa Rosa Yulupa Ave. Santa Rosa ext.4750/ Rm ext. 4750/ Rm. 11 Coordinator: Julie Galante Coordinator: Julie Galante springcreekdaycare@rvusd.org springcreekdaycare@rvusd.org *Afternoon bused to Spring Creek Village Elementary School Whited Elementary School 900 Yulupa Ave. Santa Rosa Sonoma Hwy. Santa Rosa ext.4890/rm.18 & Computer Lab ext. 4919/ Rm. 17 &19 Coordinator: Debbie DeVore Coordinator: Loretta Mederios villagedaycare@rvusd.org whiteddaycare@rvusd.org

HTSACC Registration Materials

HTSACC Registration Materials HTSACC Registration Materials September 2017-June 2018 NEW for the 2017-2018 School Year: To secure enrollment for September, registration materials must be received by Monday, July 31, 2017. Registration

More information

Pottstown Parks & Recreation Summer Adventure Registration

Pottstown Parks & Recreation Summer Adventure Registration Pottstown Parks & Recreation Summer Adventure Registration Please complete ALL information; registration will not be processed without ALL information. Please note, your enrollment is not guaranteed NOR

More information

Good Afternoon Parents,

Good Afternoon Parents, Good Afternoon Parents, Thank You for looking into the Calvary Christian Mentor Program, we appreciate the opportunity to serve you and your family for the duration of summer break. Though this is a pilot

More information

VACATION CARE. June/July 2017 HOLIDAY PROGRAM GOOD SHEPHERD LUTHERAN COLLEGE OUTSIDE SCHOOL HOURS CARE. Enrolment process:

VACATION CARE. June/July 2017 HOLIDAY PROGRAM GOOD SHEPHERD LUTHERAN COLLEGE OUTSIDE SCHOOL HOURS CARE. Enrolment process: VACATION CARE GOOD SHEPHERD LUTHERAN COLLEGE OUTSIDE SCHOOL HOURS CARE June/July 2017 HOLIDAY PROGRAM Welcome to our April holiday Vacation Care period. At Outside School Hours Care our programs assist

More information

SIGN-UP PAGE FOR HOLIDAY STEP CHILD CARE

SIGN-UP PAGE FOR HOLIDAY STEP CHILD CARE SIGN-UP PAGE FOR HOLIDAY STEP CHILD CARE - 2018-2019 Contact 856-429-6564 ext. 2 for assistance and information. This sign-up page needs to be in the STEP/SACC office no later than 5 business days prior

More information

If there is any home custody issues (i.e. divorce, restraining orders, etc.), it is imperative that we are made aware.

If there is any home custody issues (i.e. divorce, restraining orders, etc.), it is imperative that we are made aware. June 1, 2016 Dear Parents: Welcome to the New Lenox Community Park District ACES Program! We are very excited to be able to be the sole provider for District #122 with our quality before and after school

More information

Home Address City State Zip. ( ) Parent/Guardian First Name Last Name Home Phone Number. Home Address City State Zip ( ) Cell ( )

Home Address City State Zip. ( ) Parent/Guardian First Name Last Name Home Phone Number. Home Address City State Zip ( ) Cell ( ) GREENKNOLL SCHOOL AGE CHILD CARE 2018-2019 School Year Fees due at the time of registration: $25 Registration Fee + First Week s Tuition Weekly tuition rates listed on payment sheet Child s First Name

More information

BANGOR REGION YMCA CHILDCARE REGISTRATION FORM

BANGOR REGION YMCA CHILDCARE REGISTRATION FORM On-Site Registration Required BANGOR REGION YMCA CHILDCARE REGISTRATION FORM Childcare Information & Program Attending - Please Print ( )Early Childhood Education ( )Y-Works ( )Before School ( )After School

More information

2016 Old Sacramento History Camp Registration Guide

2016 Old Sacramento History Camp Registration Guide General Camp Information: 2016 Old Sacramento History Camp Registration Guide Old Sacramento History Camp is held in Old Sacramento. It is located in the Sacramento History Museum s Living History Center,

More information

WILSON HALL AFTER SCHOOL CARE PROGRAM

WILSON HALL AFTER SCHOOL CARE PROGRAM WILSON HALL AFTER SCHOOL CARE PROGRAM Welcome! Welcome to Wilson Hall After School Care Program! We are so excited to enjoy our new Randle Learning Center! It is a wonderful, comfortable place to relax

More information

Introduction to Day Hospital

Introduction to Day Hospital Introduction to Day Hospital Information for clients and their families 3G Day Hospital: 905-521-2100, ext. 72831 1 Introduction to Day Hospital Introduction to Day Hospital The Day Hospital on 3G is part

More information

Faith Formation sessions begin the week of September 18 th, 2017

Faith Formation sessions begin the week of September 18 th, 2017 SAINT MAXIMILIAN KOLBE CATHOLIC CHURCH FAITH FORMATION REGISTRATION FORM Faith Formation sessions begin the week of September 18 th, 2017 To register in St. Maximilian Kolbe Faith Formation program the

More information

Kids Connection After School Extended Care Program And 3K Wrap Around Care

Kids Connection After School Extended Care Program And 3K Wrap Around Care Kids Connection After School Extended Care Program And 3K Wrap Around Care Mission: Holy Apostles Catholic School embraces our mission by creating a compassionate atmosphere which promotes faith, knowledge

More information

New Morning Registration and Emergency Information

New Morning Registration and Emergency Information 2018-2019 New Morning Registration and Emergency Information This form must be completed for each of your children who will be enrolled in the program and must be updated whenever information changes.

More information

Red House Account details are: Sort Code Cash will only be accepted for a late booking during a holiday club period.

Red House Account details are: Sort Code Cash will only be accepted for a late booking during a holiday club period. Holiday Club Booking Conditions 1. Places will only be allocated upon a fully completed booking form with an indication of how the cost is to be paid. Confirmation of your booking will follow and payment

More information

Dynamo After School Academy: Child Registration Form

Dynamo After School Academy: Child Registration Form Please Initial and Sign Below: The automatic draft payment will be deducted every Monday, 7 days prior to the start of the week, from the card on file. I understand that I must have a card on file, but

More information

Registration Guidelines

Registration Guidelines Registration Guidelines 2018 2019 Providing a Quality Education in a Christian Atmosphere Registration for 2018-2019 In order to reserve your child s spot in a class at Hillcrest School for the coming

More information

Fultondale Elementary After School Care & Summer Program

Fultondale Elementary After School Care & Summer Program Fultondale Elementary After School Care & Summer Program Child Care Handbook Fultondale Elementary (205) 285-4904 Community School Office: Phone (205)379-5650 Fax (205)379-5652 Kay Sharp - Zone Coordinator

More information

ENROLMENT FORM. for VACATION CARE. You must answer all questions please print & use a black or blue biro

ENROLMENT FORM. for VACATION CARE. You must answer all questions please print & use a black or blue biro ENROLMENT FORM for VACATION CARE You must answer all questions please print & use a black or blue biro You ll need to fill in separate forms for each child Child s Surname First Name Child s CRN Is this

More information

2014 Matt s Climb Scholarship Application Guidelines. Frequently Asked Questions

2014 Matt s Climb Scholarship Application Guidelines. Frequently Asked Questions 2014 Matt s Climb Scholarship Application Guidelines Frequently Asked Questions What is the Matt s Climb Scholarship? The Matt s Climb Scholarship was established in memory of Matthew Kennedy, who graduated

More information

Attachment N RESPITE SERVICE MANUAL

Attachment N RESPITE SERVICE MANUAL RESPITE SERVICE MANUAL 1 RESPITE WORKER 1. SCHEDULING Scheduling of the respite worker is done by the Respite Office ( Respite ). Parents or guardians of the clients hereinafter referred to as Parent(s)/Guardians

More information

C2E Before and After Care Program Parent Handbook

C2E Before and After Care Program Parent Handbook 2017-2018 2018-2019 C2E Before and After Care Program Parent Handbook Challenge To Excellence Charter School 16995 E. Carlson Drive, Parker, CO 80134 303.841.9816 Ext: 783 FOCUS OF C2E BEFORE AND AFTER

More information

The City of Yucaipa S.T.A.R.S. BEFORE/AFTER SCHOOL 2018/2019 PARENT HANDBOOK

The City of Yucaipa S.T.A.R.S. BEFORE/AFTER SCHOOL 2018/2019 PARENT HANDBOOK The City of Yucaipa S.T.A.R.S. BEFORE/AFTER SCHOOL 2018/2019 PARENT HANDBOOK Program Sites Program Phone Numbers Calimesa Elementary School (909) 855-8784 Chapman Heights Elementary School (909) 855-8752

More information

Buddies Out of School Care Day Care of Children Budhill Family Learning Centre Hallhill Road Budhill Glasgow G32 0PR Telephone:

Buddies Out of School Care Day Care of Children Budhill Family Learning Centre Hallhill Road Budhill Glasgow G32 0PR Telephone: Buddies Out of School Care Day Care of Children Budhill Family Learning Centre Hallhill Road Budhill Glasgow G32 0PR Telephone: 0141 774 3311 Inspected by: Karen Irvine Type of inspection: Unannounced

More information

YMCA Before and After School Care School Year YMCA OF PIERCE AND KITSAP COUNTIES

YMCA Before and After School Care School Year YMCA OF PIERCE AND KITSAP COUNTIES PARENT INFORMATION PAGE YMCA Before and After School Care 2018-2019 School Year YMCA OF PIERCE AND KITSAP COUNTIES All fields must be completed for TACOMA registration PUBLIC packet to SCHOOLS be considered

More information

OSHC Vacation Care Program Acting Director: Monica Velea Acting Assistant Director: Kimberly Bohmer

OSHC Vacation Care Program Acting Director: Monica Velea Acting Assistant Director: Kimberly Bohmer Phone: 8332 5762 Email: mpsoshc@chariot.net.au www.magillschool.sa.edu.au OSHC Vacation Care Program Acting Director: Monica Velea Acting Assistant Director: Kimberly Bohmer Monday 16 th April 2018 Friday

More information

National Honor Society HANDBOOK

National Honor Society HANDBOOK Alan B. Shepard High School National Honor Society HANDBOOK 2016-2017 Mrs. Meghan Sisk Mrs. Lisa Mahoney Sponsors FORWARD: This handbook was compiled in order to provide students with the information needed

More information

2014/2015 SICK CHILD AND EMERGENCY/BACK-UP CARE Program Guidelines for Employees and Students

2014/2015 SICK CHILD AND EMERGENCY/BACK-UP CARE Program Guidelines for Employees and Students 2014/2015 SICK CHILD AND EMERGENCY/BACK-UP CARE Program Guidelines for Employees and Students INTRODUCTION The Sick Child and Emergency/Back-Up Care Program (SCP/EBCP) is an important work/life service

More information

The Arc of the St. Johns Summer Program

The Arc of the St. Johns Summer Program The Arc of the St. Johns Summer Program Phone 904.824.7249 Ext. 124; Fax 904.824.8063 lbolt@arcsj.org We are excited to offer you a summer program for your child! Listed are a few topics that we want you

More information

Frank Augustus Miller Middle School. Color Guard Team

Frank Augustus Miller Middle School. Color Guard Team Frank Augustus Miller Middle School Color Guard Team 2017 2018 Frank A. Miller Middle School Color Guard 17925 Krameria Ave. Riverside CA 92504 (951) 789-8181 Beth Salyers Color Guard Advisor Dear Parents,

More information

AcadeMir Charter School A. Preparatory and Middle. April Enrichment

AcadeMir Charter School A. Preparatory and Middle. April Enrichment AcadeMir Charter School A Preparatory and Middle April Enrichment ACADEMIR CHARTER SCHOOL PREPARATORY AND MIDDLE PAID: ONE REGISTRATION FORM PER STUDENT AND PER CLUB! DO NOT COMBINE CHECKS! ENRICHMENT

More information

The City of Yucaipa S.T.A.R.S. BEFORE/AFTER SCHOOL 2017/2018 PARENT HANDBOOK

The City of Yucaipa S.T.A.R.S. BEFORE/AFTER SCHOOL 2017/2018 PARENT HANDBOOK The City of Yucaipa 2017-2018 S.T.A.R.S. BEFORE/AFTER SCHOOL 2017/2018 PARENT HANDBOOK Program Sites Program Phone Numbers Calimesa Elementary School (909) 855-8784 Chapman Heights Elementary School (909)

More information

Date: PATIENT REGISTRATION Chart # PLEASE PRINT FILL OUT ALL AREAS PATIENT INFORMATION CHILD S NAME BIRTHDATE SSN SEX CELL PHONE# (14 YRS & OLDER)

Date: PATIENT REGISTRATION Chart # PLEASE PRINT FILL OUT ALL AREAS PATIENT INFORMATION CHILD S NAME BIRTHDATE SSN SEX CELL PHONE# (14 YRS & OLDER) PEDIATRIC ASSOCIATES OF MADISON 21 Hughes Rd., Suite 2 Madison, Alabama 35758 256-772-2037 Fax 256-772-9523 www.pedsofmadison.com Tonya T. Zbell, M.D. Robbie F. Dudley, M.D. Charlotte M. Meadows, M.D.

More information

Parent & Guardian Handbook

Parent & Guardian Handbook Parent & Guardian Handbook 1 We are pleased to welcome you to Canton Parks and Recreation and to offer exciting programs and activities for the upcoming summer season. You will find the answers to most

More information

YMCA Before and After School Care School Year YMCA OF PIERCE AND KITSAP COUNTIES

YMCA Before and After School Care School Year YMCA OF PIERCE AND KITSAP COUNTIES PARENT INFORMATION PAGE: Please save for All your fields reference must be completed for TACOMA registration PUBLIC packet to SCHOOLS be considered complete. YMCA Before and After School Care 2017-2018

More information

2018 CAMP Registration Packet. Roxborough YMCA PHILADELPHIA FREEDOM VALLEY YMCA. Important Registration Information:

2018 CAMP Registration Packet. Roxborough YMCA PHILADELPHIA FREEDOM VALLEY YMCA. Important Registration Information: 2018 CAMP Registration Packet Roxborough YMCA PHILADELPHIA FREEDOM VALLEY YMCA Important Registration Information: Financial Aid Applications are due no later than 2 weeks before desired camp start date.

More information

Name: Mr. /Mrs. /Ms. Last Name First Name Middle Initial Maiden Name

Name: Mr. /Mrs. /Ms. Last Name First Name Middle Initial Maiden Name VOLUNTEER APPLICATION Please check which volunteer programs you are interested in: Birthday Cheer Friendly Shopper Mobile Foodshare C.A.R.E.S. Hello Neighbor Senior Center Office Food Bank Home Helper

More information

Happy Nursery Day Terms & Conditions

Happy Nursery Day Terms & Conditions Happy Nursery Day Terms & Conditions REGISTRATION To reserve a place for your child, you must complete and return your application form; pay an administration fee of 30- your cheque must be made out to

More information

YOUTH VOLUNTEERS. Dear Parent and Prospective Camp Teen Volunteer:

YOUTH VOLUNTEERS. Dear Parent and Prospective Camp Teen Volunteer: YOUTH VOLUNTEERS Dear Parent and Prospective Camp Teen Volunteer: Thank you for your interest in the Zoo Miami Foundation Camp Teen Volunteer program! The Zoo Miami Foundation Camp Teen Volunteer program

More information

International Student Orientation Schedule Spring 2018

International Student Orientation Schedule Spring 2018 International Student Orientation Schedule Spring 2018 Wednesday, January 10 8:30 am 9:00 am Check-in for International Student Orientation AMU, Room 163 9:00 am 11:30 am Welcome and Schedule Overview

More information

Summer Camp Parent Handbook

Summer Camp Parent Handbook Summer Camp Parent Handbook Page 2 Mount Dora Recreation Services Page 15 Welcome to Mount Dora Community Recreation Services. This parent handbook is designed to familiarize parents/guardians with our

More information

Hospital Name. Medical Record Number: Hours/Days of Operation: Clinic: Physician: Contact Person / Title: Phone: Fax: Hours/Days of Operation:

Hospital Name. Medical Record Number: Hours/Days of Operation: Clinic: Physician: Contact Person / Title: Phone: Fax:   Hours/Days of Operation: Hospital Name City, State, Zip Code: Phone Numbers: Main Number: Emergency Room: Medical Record Number: Clinic: Hours/Days of Operation: Physician: Contact Person / Title: Phone: Fax: Email: Clinic: Hours/Days

More information

WATCH ME GROW FAMILY REGISTRATION FORM SHEET 1 OF 6

WATCH ME GROW FAMILY REGISTRATION FORM SHEET 1 OF 6 WATCH ME GROW FAMILY REGISTRATION FORM SHEET 1 OF 6 Parent/Guardian Information Registration Mother/Guardian First Name: M.I. Last Name: Date of Birth: Address (please include city, state and zip code):

More information

Glastonbury YMCA 29 Welles Street, Glastonbury CT Dear YMCA Family,

Glastonbury YMCA 29 Welles Street, Glastonbury CT Dear YMCA Family, s Dear YMCA Family, Thank you for choosing the Glastonbury Family YMCA Preschool for your early childhood child care needs. We are excited to welcome you and your family to our program! The Y s focus is

More information

Town of Madison Beach and Recreation Department After/Before School Program 8 Campus Drive Madison, CT Phone: (203) /Fax: (203)

Town of Madison Beach and Recreation Department After/Before School Program 8 Campus Drive Madison, CT Phone: (203) /Fax: (203) Per Connecticut General Statute 19a-77 we are required to disclose that our programs are not licensed by the State Office of Early Childhood. Dear Parent: To enroll your child(ren) in the, please complete

More information

FH GRAD NEWS. Save the Date. Grads of 2017: Leaving the Nest. Commencement. Gradua on Banquet. In This Issue

FH GRAD NEWS. Save the Date. Grads of 2017: Leaving the Nest. Commencement. Gradua on Banquet. In This Issue FH GRAD NEWS Frank Hurt Secondary Information for Graduates March 2017 Grads of 2017: Leaving the Nest This is a very exciting and somewhat anxious time for our Graduates. They are busy making decisions

More information

TORRINGTON MIDDLE SCHOOL 8 TH GRADE TRIP TO WASHINGTON D.C. MAY 22, 2018 MAY 25, 2018

TORRINGTON MIDDLE SCHOOL 8 TH GRADE TRIP TO WASHINGTON D.C. MAY 22, 2018 MAY 25, 2018 TORRINGTON MIDDLE SCHOOL 8 TH GRADE TRIP TO WASHINGTON D.C. MAY 22, 2018 MAY 25, 2018 Meeting Agenda Part One: Company Information Part Two: Trip Information Part Three: Behavior Guidelines Part Four:

More information

FH GRAD NEWS. Save the Date. Grads of 2016: Leaving the Nest. Commencement. Graduation Banquet. Dry Grad. In This Issue

FH GRAD NEWS. Save the Date. Grads of 2016: Leaving the Nest. Commencement. Graduation Banquet. Dry Grad. In This Issue FH GRAD NEWS Frank Hurt Secondary Information for Graduates March 2016 Grads of 2016: Leaving the Nest This is a very exciting and somewhat anxious time for our Graduates. They are busy making decisions

More information

YMCA Before and After School Care School Year YMCA OF PIERCE AND KITSAP COUNTIES

YMCA Before and After School Care School Year YMCA OF PIERCE AND KITSAP COUNTIES PARENT INFORMATION PAGE: Please save for All your fields reference must be completed for PENINSULA registration packet SCHOOL to be considered DISTRICT complete. YMCA Before and After School Care 2017-2018

More information

Welcome To. School Information:

Welcome To. School Information: Welcome To School Information: School Address: 130 E. Brigham Road, Stansbury Park, UT 84074 School Phone: 435-833-9754 Fax: 435-833-9759 Principal: Shanz Leonelli 435-833-9754 sleonelli@tooeleschools.org

More information

COOKIE PROGRAM SERVICE UNIT GUIDE Winter 2017 February 5 - March 19 Cookie Program

COOKIE PROGRAM SERVICE UNIT GUIDE Winter 2017 February 5 - March 19 Cookie Program COOKIE PROGRAM SERVICE UNIT GUIDE Winter 2017 February 5 - March 19 Cookie Program Girl Scout Service Unit Product Chair Thank you for volunteering to manage your Service Unit s Cookie Program! Use this

More information

STEP SUMMER ENRICHMENT CAMP 2018

STEP SUMMER ENRICHMENT CAMP 2018 STEP SUMMER ENRICHMENT CAMP 2018 Registration Deadline with deposit for each week attending is March 29, 2018. Free Registration until March 29 th. $35 registration fee if late registration is accepted.

More information

YMCA AFTER SCHOOL REGISTRATION PACKET

YMCA AFTER SCHOOL REGISTRATION PACKET YMCA AFTER SCHOOL REGISTRATION PACKET TABLE OF CONTENTS 1 Registration Instructions & Child s Personal History 2 Parent Pick-Up Authorization 3 Emergency Information, Waiver, & Medical Authorization for

More information

2018 SUMMER CAMP NANSEMA REGISTRATION NORTH SUBURBAN YMCA

2018 SUMMER CAMP NANSEMA REGISTRATION NORTH SUBURBAN YMCA 2018 SUMMER CAMP NANSEMA REGISTRATION NORTH SUBURBAN YMCA CONTACT INFORMATION Camper s Name: Grade entering Fall 2018: Gender: Female Male Not specified DOB: Age as of 1st day of camp: Address: City: Zip

More information

Extended Day Registration Packet

Extended Day Registration Packet St. Benedicts School Extended Day Registration Packet 2014 2015 School Year 4811 Wallingford Avenue North Seattle, Washington 98103 206-518.6009 l.wescott@stbens.net A Registration Packet Contents The

More information

Schedule of Classes Monday. Tuesday. Wednesday. Thursday. Friday. Saturday

Schedule of Classes Monday. Tuesday. Wednesday. Thursday. Friday. Saturday Schedule of Classes 2018-19 Studio 1 2 111 Harvard Place Studio 149 W. First Street 3:30 4:30 Primary Exam DD 4:30 5:30 Grade 1 Ballet DD 5:30 6:30 Intermediate Ballet DD 6:30 7:30 Grade 7 Ballet DD 3:30

More information

STEPPING STONES APPLICATION FORM

STEPPING STONES APPLICATION FORM STEPPING STONES APPLICATION FORM Childs Name Name Known By Date of Birth Full Address Including Postcode. Male/Female Start Date Please Note: If both parents/carers with (Full Parental Responsibility)

More information

See Back for fee schedule

See Back for fee schedule REALLY OUTRAGEOUS CHRISTIAN KIDS ROCK is a Christian program serving all families by meeting their physical, emotional and spiritual needs. Before and After school Care 2017-2018 Child s name DOB Grade

More information

How did you hear about us? (please circle one)

How did you hear about us? (please circle one) REGISTRATION Client Information Office Use Only Client #:... Last Name First Name Driver s license # Street Address (DO NOT USE PO BOX ADDRESS).... City State Zip Code ( ) -. ( ) -. ( ) -. Home Phone #

More information

ROTARY YOUTH LEADERSHIP AWARDS (RYLA) CONFERENCE Rotary District Application Form

ROTARY YOUTH LEADERSHIP AWARDS (RYLA) CONFERENCE Rotary District Application Form ROTARY YOUTH LEADERSHIP AWARDS (RYLA) CONFERENCE Rotary District 6440-2018 Application Form Applicant Name: (Please Print) Session I March 8-11, 2018 Session II: April 12-15, 2018 Would you be willing

More information

Academic Calendar. Fall Semester 2017 (August 21-December 1)

Academic Calendar. Fall Semester 2017 (August 21-December 1) Academic Calendar Fall Semester 2017 (August 21-December 1) July Orientation Session 1 July 9 11 Sunday Tuesday Orientation Session 2 July 16 18 Sunday Tuesday Orientation Session 3 July 23 25 Sunday Tuesday

More information

Fall Dear Students, Parents and Guardians,

Fall Dear Students, Parents and Guardians, Fall 2018 Dear Students, Parents and Guardians, Thank you for your interest in the Student/Partner Alliance (S/PA) scholarship program. Our scholarship is intended for motivated students who have already

More information

Vacation Care Family Handbook SUPPORT DURING SCHOOL HOLIDAYS

Vacation Care Family Handbook SUPPORT DURING SCHOOL HOLIDAYS Vacation Care Family Handbook SUPPORT DURING SCHOOL HOLIDAYS WORKING WITH PARENTS Macquarie University Children s Services endeavour to work in partnership with parents to maintain a mutual, respectful

More information

General Office and Patient Compliance Policies

General Office and Patient Compliance Policies General Office and Patient Compliance Policies Thank you for choosing Innate Wellness & Medical Center as your medical provider. We are providing you this updated information to keep you informed of our

More information

2017 Holiday Programs FAQ

2017 Holiday Programs FAQ 2017 Holiday Programs FAQ HELP s holiday programs provide holiday assistance to those who are unemployed, on a fixed income and the working poor who, without our programs, would otherwise go without. Your

More information

Fall Clubs. LES Fall Clubs 2014

Fall Clubs. LES Fall Clubs 2014 Fall Clubs LES Fall Clubs 2014 Here are the Laytonsville Elementary School s Fall Club offerings for the 2014-2015 school year. Our clubs offer many opportunities to explore new ideas and gain new knowledge

More information

July Loyalist Week. July Military Week. Child's Name: Male/Female/Other: Date of Birth: Medicare #: Expiry: Home Address:

July Loyalist Week. July Military Week. Child's Name: Male/Female/Other: Date of Birth: Medicare #: Expiry: Home Address: 2018 Summer Camp Registration Forms Payable with cheque, cash, or email money transfer (Please contact the office for more details). Make cheques payable to the York Sunbury Historical Society. Refunds

More information

Volunteer Resources Adult Volunteer Application

Volunteer Resources Adult Volunteer Application Volunteer Resources Adult Volunteer Application Bowmanville Oshawa Port Perry Whitby Contact Information: Mr. Mrs. Miss Ms. Last Name: First Name: Street Address: Apt. #: City: Postal Code: Home Phone:

More information

HILL COUNTRY DISTRICT JUNIOR LIVESTOCK SHOW & AUCTION

HILL COUNTRY DISTRICT JUNIOR LIVESTOCK SHOW & AUCTION Agriculture and Natural Resources Family and Consumer Sciences 4H and Youth Development Community Development January Newsletter 2014 Kerr County AgriLife Extension Roy Walston Angela Fiedler Laurinda

More information

VOLUNTEER INFORMATION SHEET. A safe secure environment may warm their bodies... but only people can warm their hearts...

VOLUNTEER INFORMATION SHEET. A safe secure environment may warm their bodies... but only people can warm their hearts... VOLUNTEER INFORMATION SHEET A safe secure environment may warm their bodies... but only people can warm their hearts... The Edwards Adult Day Center provides care for seniors and adults with disabilities

More information

Adventure Club. Before and After School Care Enrollment Packet. Before and After School Care Mission:

Adventure Club. Before and After School Care Enrollment Packet. Before and After School Care Mission: Adventure Club Before and After School Care Enrollment Packet Before and After School Care Mission: Our before and after school care is designed to provide children with a safe, loving and exciting environment

More information

REGISTRATION REQUEST FORM

REGISTRATION REQUEST FORM REGISTRATION REQUEST FORM PARENT S NAME ADDRESS DAY TIME PHONE# TOWN ZIP CODE EMAIL ADDRESS: HOW DID YOU FIND OUT ABOUT TODAY S CHILD? PAYMENT METHOD: Private Pay CCIS Agency: Caseworker: My family needs

More information

EASTERN MIDDLE SCHOOL POLICIES AND PROCEDURES

EASTERN MIDDLE SCHOOL POLICIES AND PROCEDURES EASTERN MIDDLE SCHOOL POLICIES AND PROCEDURES ACADEMIC HONESTY All work turned in by a student should be his or her own work, reflecting what the student has learned. Using someone else s work, words,

More information

Wayland Transportation Guidelines for Weekends and Breaks,

Wayland Transportation Guidelines for Weekends and Breaks, Wayland Transportation Guidelines for Weekends and Breaks, 2018-2019 These guidelines were established to ensure safe, convenient transportation for students. They are modified yearly based upon feedback

More information

Y Afterschool New Participant Registration Packet School Year

Y Afterschool New Participant Registration Packet School Year Y Afterschool New Participant Registration Packet 2018-2019 School Year TABLE OF CONTENTS 1. Cover Page 2. Registration Instructions & Child Personal History 3. Parent Pick-Up Authorization 4. Emergency

More information

WEEKLY BULLETIN 11/05-11/11

WEEKLY BULLETIN 11/05-11/11 WEEKLY BULLETIN 11/05-11/11 STUDENT ABSENCES This is just a friendly reminder that if your son will be absent due to an appointment, illness, college visit, or for any other reason we ask that you email

More information

Vacation Care Family Handbook SUPPORT DURING SCHOOL HOLIDAYS

Vacation Care Family Handbook SUPPORT DURING SCHOOL HOLIDAYS Vacation Care Family Handbook SUPPORT DURING SCHOOL HOLIDAYS WORKING WITH PARENTS Macquarie University Children s Services work in partnership with parents to maintain a mutual, respectful and collaborative

More information

Assistance League of Charlotte Scholarship

Assistance League of Charlotte Scholarship Assistance League of Charlotte Scholarship APPLICATION FORM FOR 2016-2017 Assistance League of Charlotte is a nonprofit volunteer organization dedicated to improving the lives of children and families

More information

Emory Johns Creek Hospital

Emory Johns Creek Hospital Dear Applicant: Thank you for your interest in the 2018 Summer VolunTEEN Program. Due to the large number of students interested in the Program, it is essential that you pay close attention to the information

More information

Dear Parent/Guardian,

Dear Parent/Guardian, Dear Parent/Guardian, Thank you for your interest in Nathan Adelson Hospice s Camp Erin. Camp will be held June 1 st 3rd, 2018. We are very excited and looking forward to another great camp experience!

More information

DELRAN CUBS S.T.E.A.M. UP SUMMER CAMP 2017

DELRAN CUBS S.T.E.A.M. UP SUMMER CAMP 2017 DELRAN CUBS S.T.E.A.M. UP SUMMER CAMP 2017 A summer camp to extend Science, Technology, Engineering, Art and Math in a fun, enriching laboratory environment! A Program for Students Currently Enrolled in

More information

We hope that your school will participate and help us make this program even more successful than last year!

We hope that your school will participate and help us make this program even more successful than last year! JUNIOR RIVER RUN TRAINING We would like to invite your school to participate in the Junior River Run training program. Last year over 2,400 children participated in this training program which is designed

More information

Summer 2017 Multimedia Madness Youth Summer Camp Registration Form

Summer 2017 Multimedia Madness Youth Summer Camp Registration Form Summer 2017 Multimedia Madness Youth Summer Camp Registration Form Mail Registration Form & Payment to MCC Business Department, 1833 West Southern Avenue, Mesa AZ 85202. Attn: Lua Maloney. PRIORITY MAIL-IN

More information

Parent s Day/Night Out. Respite Program

Parent s Day/Night Out. Respite Program Parent s Day/Night Out Respite Program Parent/Guardian & Participant Handbook Revised 12/2013 10/2014 8/2015 9/2016 9/2017-1 - I. General Program Information Easterseals Crossroads Respite Program provides

More information

ADMISSION INFORMATION

ADMISSION INFORMATION Texas Dept of Family and Protective Services ADMISSION INFORMATION Form 2935 Aug 2010 / Pg 1 of 3 Operation Name The Stepping Stone Director s Name Ashley Stock Child s Full Name Child s of Birth Child

More information

YMCA Before and After School Care School Year YMCA OF PIERCE AND KITSAP COUNTIES

YMCA Before and After School Care School Year YMCA OF PIERCE AND KITSAP COUNTIES PARENT INFORMATION PAGE: Please save All fields for your must be reference completed for registration PENINSULA packet SCHOOL to be considered DISTRICT complete. YMCA Before and After School Care 2018-2019

More information

AVON COMMUNITY SCHOOL CORPORATION NEW SCHOOL YEAR GUIDE

AVON COMMUNITY SCHOOL CORPORATION NEW SCHOOL YEAR GUIDE AVON COMMUNITY SCHOOL CORPORATION NEW SCHOOL YEAR GUIDE 08-9 FIRST DAY OF SCHOOL: Wednesday, August, 08 A Message from the Superintendent It is a joy to welcome new and returning students and families

More information

KIDZKONNECT Calgary Zoo/TELUS Spark Youth Volunteer Program KidzKonnect Leader Opportunity Description and Application

KIDZKONNECT Calgary Zoo/TELUS Spark Youth Volunteer Program KidzKonnect Leader Opportunity Description and Application Calgary Zoo/TELUS Spark Youth Volunteer Program KidzKonnect Leader Opportunity Description and Application Thank you for your interest in KidzKonnect - the Calgary Zoo and Telus Spark s youth volunteer

More information

HOME FOR THE HOLIDAYS: SCHOOL YEAR Coordinated by the New England Chapters of the Penn State Alumni Association

HOME FOR THE HOLIDAYS: SCHOOL YEAR Coordinated by the New England Chapters of the Penn State Alumni Association HOME FOR THE HOLIDAYS: 2015-2016 SCHOOL YEAR Coordinated by the New England Chapters of the Penn State Alumni Association To: cc: Parents of PSU students from New England (and parts of NY) New England

More information

Welcome to the YMCA Great Escape Before & After School Program

Welcome to the YMCA Great Escape Before & After School Program Welcome to the YMCA Great Escape Before & After School Program 2016-2017 The YMCA Great Escape Program is designed to offer well-supervised, safe, quality care for school age children. Our program is set

More information

After you register on the Painted Sky website, please take the time to review the rules and guidelines in this document.

After you register on the Painted Sky website, please take the time to review the rules and guidelines in this document. We re so excited for the 2017 Painted Sky Science Fair! We have a long history of strong student participation and a successful track record of SARSEF winners and are proud to carry on the tradition. Before

More information

Socorro Independent School District Department of Administrative Services. Coach/Sponsor Acknowledgement Form

Socorro Independent School District Department of Administrative Services. Coach/Sponsor Acknowledgement Form Coach/Sponsor Acknowledgement Form 2012-13 I,, have read and fully understand the Socorro Independent School District s Student Travel Manual.* I understand that it will be my responsibility to adhere

More information

COMMUNITY SERVICES DEPARTMENT 2018 VolunTEEN Program Information

COMMUNITY SERVICES DEPARTMENT 2018 VolunTEEN Program Information COMMUNITY SERVICES DEPARTMENT 2018 VolunTEEN Program Information The Anaheim Community Services Department provides teens, 13 17 years of age, the opportunity to give back to their community and earn service

More information

2018 TCDN SUMMER CLUB CAMP REGISTRATION FORM

2018 TCDN SUMMER CLUB CAMP REGISTRATION FORM 2018 TCDN SUMMER CLUB CAMP REGISTRATION FORM Welcome to TCDN s 34th year of Summer Club! A fun filled camp for children entering grades 1-5, located on the grounds of the Swarthmore-Rutledge School. Summer

More information

C.A.R.E.S. PROGRAM, 2018 FEBRUARY VACATION REGISTRATION Registration Deadline Tuesday January 9, 2018

C.A.R.E.S. PROGRAM, 2018 FEBRUARY VACATION REGISTRATION Registration Deadline Tuesday January 9, 2018 C.A.R.E.S. PROGRAM, 2018 FEBRUARY VACATION REGISTRATION Registration Deadline Tuesday January 9, 2018 For Office Use Only: Received on / / Registration Fee & Tuition Paid: December 1, 2017 Enrollment and

More information

2018 Recruit Class. Denville Junior Police Academy

2018 Recruit Class. Denville Junior Police Academy 2018 Recruit Class Denville Junior Police Academy Monday, July 16 th through Frida, July 20 th Morris Knolls High School 50 Knoll Drive, Rockaway, NJ 8:00 a.m. to 4:00 p.m. Fee: $50.00 (to be collected

More information

YOU MUST SUBMIT ALL PAGES TOGETHER DEADLINE IS FRIDAY, MAY 11, 2018.

YOU MUST SUBMIT ALL PAGES TOGETHER DEADLINE IS FRIDAY, MAY 11, 2018. SANTA FE PROJECT GRAD 2018 REGISTRATION PACKET June 1, 2018 12:00am-6:00am SENIOR: REGISTRATION- Please turn in all forms to Mrs. Bicknell in Room B211. Registration forms must be complete, signed, and

More information

JETER S LEADERS APPLICATION

JETER S LEADERS APPLICATION APPLICATION ELIGIBILITY CRITERIA In order to be eligible, the applicant must Be a high school freshman in the Fall Be drug and alcohol free Have a GPA of.0 (B) or better Be involved in community service,

More information

Summer Recreation/Adult Education Program

Summer Recreation/Adult Education Program H E W L E T T W O O D M E R E PUBLIC SCHOOLS HEWLETT-WOODMERE PUBLIC SCHOOLS Summer 2 0 1 7 Recreation/Adult Education Program Registration begins Monday, June 12th Evening Registration: Mondays, June

More information

EMORY NATIONAL DEBATE INSTITUTE

EMORY NATIONAL DEBATE INSTITUTE EMORY NATIONAL DEBATE INSTITUTE June 10-22, 2018 2-Week Policy Debate Commuter 1 of 6 Emory National Debate Institute 2-Week Commuter Program For over forty years, Emory University has offered the highest

More information