Summer School (Character Kids Club) Information:

Transcription

1 Summer School (Character Kids Club) Information: The CKC Department will offer before and after care for children entering kindergarten through the completion of 6th grade at the Guffey, Seckman, and Fox summer school locations. The CKC Department will offer care at Hodge (ESY) for the first session. Afternoon care only will be available. Our program will operate in the mornings from 6:15am until summer school begins, and operate in the afternoons from dismissal until 6:15pm Monday-Thursday. Every Friday (while summer school is in session) CKC will offer a Full Day program at Seckman or Fox from 6:15am-6:15pm. The cost for the Friday full day is a NON-REFUNDABLE $31.00 per child. Our Friday Full Day themes include: Buggin Out ; Nickelodeon Days ; Cowboys & Indians ; Pirates and Fire Safety. Each of the full days include activities, guest speakers, crafts, games, and so much more related to the theme of the day. Children will need to bring a lunch and drink. Snacks will be provided by the CKC department. Summer Camp (Character Kids Club) information: After the completion of summer school, CKC will host summer camp at Rockport or Seckman. Camp care is provided from 6:15am-6:15pm. Our CKC Camps will offer Weekly themes this summer! Our weekly themes include: 1. Lights, Camera, Action : the campers will enjoy a variety of activities centered on movies, television, musicals, etc. They will go skating, swimming, and take a field trip to see Cinderella at Stages. 2. Fear Factor!: the campers will play Fear Factor activities all week! In addition to skating, swimming, participating in all kinds of gross stuff, they will prepare for the BIG day when on Friday Rockport vs. Seckman Fear Factor challenge takes place!!!! Who will earn bragging rights? 3. Carnival City: the campers will skate, swim, be entertained by a Magician, and more! They will have their own REAL carnival for a day at camp with inflatables, carnival games, prizes, sno-cones, popcorn, hotdogs and more. 4. Splish, Splash, Water Bash : need we say more? The campers will engage in a week of all kinds of water related activities from swimming, water balloon contests, creek walks, and of course a dunking booth where the kids will have several opportunities to dunk their counselors!!! 5. Super Heroes Week : in addition to having a week of fun with Super Heroes costumes, mask making, activities, swimming, skating, bowling, and more, the campers will also honor real super heroes, learn about saving our environment and more. 6. Campers got Talent : So the campers will get to dress up in fun 80 s and 90 s garb (parents you must have some of that tucked away), each location will have a dance, swimming, skating and bowling are the outings, and videos will be created to capture memories of the summer! Please note that themes are based on weeks left after summer school ends. Depending on inclement weather and possible date changes, certain themes may be omitted if we do not have enough weeks of camp. Registration forms and additional information is on the following pages of this document. Please feel free to call the CKC office for additional information. Thank you!

2 2013 Summer Programming CKC Enrollment Form Summer Camp: ($15.00 registration fee 1 child, $20.00 registration fee 2 or more children) Please check a location for each category. Summer School Fox Elementary Guffey Elementary Seckman Elementary (ESY) Hodge Elementary Fridays during Summer School (A minimum of 25 students needed at each location on Fridays to operate the program at that location) Fox Elementary Seckman Elementary Summer Camp ($15.00 registration fee 1 child, $20.00 registration fee 2 or more children) Rockport Elementary Seckman Elementary Student Information: (Last name) (First name) (Gender) (Grade entering ) (Date of Birth) (_) (Address) (City) (State) (Zip) (Home Phone) What school does your child attend during the school year: Was your child in the PK/CKC Program: Yes or No Parent 1 Information: (_) (Last name) (First name) (Cell Phone) (Relationship to child) *(Phone authorization code) ( Address) (Address) (City) (State) (Zip) _ (Employer) (Employer Address) ( ) (Circle one) Married Divorced Separated Single Widowed (Work Phone) Parent 2 Information: (_) (Last name) (First name) (Cell Phone) (Relationship to child) *(Phone authorization code) ( Address) (Address) (City) (State) (Zip) _ (Employer) (Employer Address) ( ) (Circle one) Married Divorced Separated Single Widowed (Work Phone) Child lives with: Parent 1 Parent 2 Both *The phone authorization code is a password that you may be asked for when discussing your child s information over the phone.

3 2013 Summer Programming CKC Enrollment Form Parent 1 Contact information: Name: Cell #: Work #: Home #: Parent 2 Contact information: Name: Cell #: Work #: Home #: Authorized Pick-Up Information: Please list a minimum of 3 contacts (other than parents) who will be allowed to pick up your child, and who can be contacted in case of emergency. Anyone NOT listed on this form will NOT be allowed to pick up your child. You may make changes to this form at any time. All persons MUST show photo ID upon request. Name: Contact number: Relationship to child: Name: Anyone NOT allowed to pick up your child should be listed below Please note: In the event of a separation, divorce, or custody arrangement, we cannot legally prohibit a parent from picking up their child unless our office has a court order. Relationship to child: Medical Information: Please indicate if your child has any medical concerns. Condition: Yes No Describe/Explain: Special Needs Allergies Asthma Epilepsy/Seizures Diabetes Heart condition Other Character Kid s Club and the Fox C-6 School District reserve the right to reject requests for administering medication. In case of an emergency, my child should be transported to: (Hospital) Physicians Name: _ Phone #: ( ) I hereby authorize the emergency treatment of anesthesia and surgical treatment for my minor child in the event of an emergency medical situation occurring during my absence or when I am unable to be contacted. I release from responsibility and liability hospital/medical authorities for performing medical procedures deemed necessary during my absence. I do not wish my child to receive emergency medical treatment administered at a hospital or medical center in my absence.

4 2013 Summer Programming CKC Enrollment Form Summer School rate chart: Please note that a full day of Friday care will ONLY be offered at the Fox and Seckman locations during summer school. (A minimum of 25 participants per location to operate Friday program) # of sessions per week Fri Full Day Care (Flat rate) Cost per child $17 $31 $39 $47 $53 $57 $60 $63 $31 plus any addl. sessions *10% discount for 2 children enrolled *20% discount for 3 or more children enrolled Special Education Summer School Simpson Elementary (ESY): Please note that morning care will NOT be available at the (ESY) summer school location. Care is offered from noon until 6:15 pm Monday-Thursday. All day care is available at Fox or Seckman location only on Fridays from 6:15 am-6:15 pm. Days per week: Cost per child: $31 $47 $57 $66 $31 plus any addl. sessions *10% discount for 2 children enrolled *20% discount for 3 or more children enrolled Summer Camp rate chart: Days per week: Cost per child: $31 $60 $86 $110 $132 *10% discount for 2 children enrolled *20% discount for 3 or more children enrolled Do you currently receive childcare assistance through DFS or DSS? Yes No Case worker s name Phone: ( ) FULL tuition is required until CKC receives written confirmation/verification of your subsidy from DFS or DSS. A CKC Summer Camp shirt will be issued to your child. Your child s T-shirt size: child small child med. child large adult small adult med. adult large Your child is asked to wear this T-shirt on field trip days. Additional shirts may be purchased for $9.00 each. Other information: I grant CKC permission to photograph my child for his/her enrollment file. I grant CKC permission to photograph my child for website and/or promotional purposes. I grant CKC permission to show my child PG rated movies. I grant CKC permission to attach my child s immunization records currently on file with CKC. I grant CKC permission to apply sunscreen to my child. I grant permission for my child to participate in field trips and other activities off school property.

5 2013 Summer Programming CKC Enrollment Form I understand that by signing this form I am agreeing to the following: That all payments will be made on Monday, or the first day of attendance for the week of service. That if my payment is not received by the second day of attendance that my child will not be able to return until payment is made. That I will notify the CKC office of any changes with my child s participation in any summer CKC program. That when my child is ill, he/she may not be accepted in the CKC program until the child is well. That my child will not be released to anyone who is not listed on the enrollment form. That if my child is experiencing problems in the program, the parents may be called to pick up the child or to make arrangements for a parent/staff conference. That I am the person held responsible for all CKC childcare payments. (Parent Signature) (Date) Office use only: Date received: Immunizations: On file Attached Registration Fee: Payment Number: Check Cash Money order Payment made by:

6 Character Kid s Club To the Parent/Guardian: After reviewing each section, please initial as an acknowledgement of your agreement. In order for a child to participate in field trips or any activity off school property, this agreement must be signed. Student *The Fox C-6 Board of Education has authorized field trips related to specific curricular or co-curricular purposes as a valid extension of children s educational experience beyond the limits of school confines. The practice of providing field trips requires an extra measure of responsibility on the part of students. In administering these programs, neither the Board nor its professional staff can take responsibility for student safety and welfare beyond normally prudent requirements of school and classroom management. While, under Missouri law, the School District is not generally liable for injuries to students, precaution will be taken for the safety and welfare of all children. Parents are asked to discuss field trips with their children, stressing the importance of responsible behavior. The privilege of participation in these programs may be withdrawn or withheld be a parent or authorized professional personnel. Parents are asked to sign this form as evidence that they accept these conditions and authorize their child to participate in these programs. *Fox C-6 District policy states that no illegal drugs, alcohol, or other illegal substances may be used by students and that all students must assure their sponsors of field trips that they will comply with these school rules. Disciplinary measures will be taken in accordance with school district policies for infraction of these rules. My child and I understand these rules and he/she agrees to comply with them. PARENT S PERMISSION AND AUTHORIZATION FOR MEDICAL TREATMENT *In the event that my child needs emergency medical treatment and the parents or emergency contact cannot be reached, I give consent for Fox C-6 School District to obtain through a licensed, medical professional and hospital, such medical care that is reasonably necessary for the welfare of my child. Emergencies needing Ambulance Service will be dealt with as follows: Patients will be transported to the nearest hospital or medical facility where in the discretion of the paramedics appropriate medical treatment may be obtained. As the parent/guardian, I agree to assume the cost for transportation and medical treatment in such an emergency situation. *Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray exam and immunizations for the above named student. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that an attempt will be made by the attending physician to contact me in the most expeditious way possible. If said physician is not able to communicate with me, the treatment necessary for the best interest of the above named student may be given. *The MSMSAA By-Laws provide that a student shall not be permitted to practice or compete for a school until it has verification that he/she has basic school insurance coverage. My child is covered by basic accident insurance. Yes No Insurance Company Policy # Signature of Parent/Guardian (Date) Signature of Student (Date)

7 Character Kid s Club Payment Agreement Summer Programming 2013 Character Kid s Club (CKC) tuition for 2013 summer programming is due the week of service. This means that your child s CKC tuition will be due the first day of attendance for the current week. Payment MUST be made no later than the second session of attendance for the current week. Payment must be received on Monday of each week. Payments can be made by checks, cash or money order. Temporary checks will not be accepted. Please write your child s name on your check or money order. Payments MUST be made no later than the second session of attendance for the current week. If the CKC staff has not received a payment by your child s second session attended, your child may not be able to return until full payment is made. Any overpayment for the week of service will be applied as a credit for the following week. Each week you will need to notify your CKC summer programming coordinator of your child s schedule, you can do this by filling out a Weekly Anticipated Attendance form. This form informs Character Kid s Club when we are responsible for your child. If we have not received your child s schedule in writing, CKC cannot be liable for your child. If your child s schedule has not been communicated in written form, and your child goes home on the bus, CKC will not be held accountable. Your child s schedule is due by Friday of each week for the following week s attendance. If your child attends the same times each week, please indicate on the form that your child s schedule is permanent, and you will only have to fill out a Weekly Anticipated Attendance when your child s schedule will be different than indicated. You can make schedule changes anytime by notifying your child s CKC Coordinator. _ (Please print your child s first and last name) (Parent Signature) (Date) REV (1/25/13) SUMMER PROGRAM PARENT HANDBOOK ACKNOWLEDGEMENT I have received and read the Fox C-6 School District Character Kids Club Summer programming Handbook. I agree to comply with all CKC policies. School Name: Date: _ Childs Name: _ Parent s Name: Parent s Signature: REV (1/25/13)