Summer Camp at Inter-American Magnet School June 22nd through August 24th, 2015

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1 Summer Camp at Inter-American Magnet School June 22nd through August 24th, 2015 Join us this summer as we travel to Spanish speaking countries across the world! We will feature activities that highlight the culture, tradition and art of countries across South America and Spain while we stay immersed in Spanish! PUMA PASSPORT Contact: Arturo Medina Resource Coordinator

2 Viaja el Mundo Summer Camp at Inter-American We would like to invite students from Pre K to 8th grade to attend our summer camp at Inter-American! Camp will be held from June 22nd to August 28th from 8:30 A.M. to 3:30 P.M., Monday through Friday. Registration for students will be $135 dollars per student. Camp will cost $185 per week. Supplemental care is available at Inter-American in the morning from 7:30 to 8:30 AM for an additional $25 per week and from 3:30 to 6:00 PM for an extra $60 per week. Financial aid is available. Please, contact Arturo Medina for more information. Tuition includes lunch, field trips, a camp t-shirt, and all program offerings! Dear families of Inter-American, At Inter-American we enjoy a unique culture that bonds together as a strong community that is connected to our love of Spanish speaking countries across the world. This summer we would like to invite you all to camp as we highlight a different city and country on a weekly basis. Students will continue to speak Spanish this summer as we expand our understanding and appreciation of 10 countries and cities throughout the world. Our activities will feature the music, culture and traditions of each country and city through out our camp. We will also feature fun games and recreation at school to enjoy the summer together! Bellow is a list of the cities that we will be visiting while at Camp: Bogotá, Colombia. Lima, Perú San Jose, Costa Rica Buenos aires, Argentina Madrid, España San Juan, Puerto Rico. Ciudad de México, México Quito, Ecuador Santiago, Chile Santo Domingo, República Dominicana In addition to our activities we will also have fieldtrip days throughout the summer, which are included in your tuition. Field trip days will be an educational and enriching experience for our students. We will travel to our field trips via school bus. The schedule of field trips will be available April 3rd. How to apply: Camp registration forms are attached. Please complete all registration materials and submit to Arturo Medina at Inter-American. In order to secure your spot in camp please complete the registration forms and submit your registration fee. All applications are due June 1st. Please contact me if you have any questions or concerns. Best, Arturo Medina Resource Coordinator Youth Guidance for Inter-American amedina@youth-guidance.org

3 Viaja el Mundo Summer Camp at Inter-American Registration Please check the weeks that you would like to attend: City and /or Country Featured Check the countries that you would like to travel to: June 22nd to 26th Bogotá, Colombia June 19th to July 3rd Buenos aires, Argentina July 6th to July 10th Ciudad de México, México July 13th to July 17th Lima, Peru July 20th to July 24th Madrid, España July 27th to July 31st Quito, Ecuador August 3rd to August 7th San Jose, Costa Rica August 10th to August 14th San Juan, Puerto Rico August 17th to August 21st Santiago, Chile August 24th to August 28th Santo Domingo, República Dominicana

4 Viaja el Mundo Summer Camp at Inter-American Tuition Information Program Costs Registration One Time Fee Camp Tuition Total Cost for 10 Weeks Camp Tuition Weekly Cost Additional Care Tution Weekly Cost $135 per Camper (Covers field trip and management costs.) PLUS $1,850 8:30 AM to 3:30 PM camp day only only $5.29 per hour! $185 8:30 AM to 3:30 PM camp day only + $25 for 7:30-8:30am care + $60 for 3:30-6:30pm care Sibling Discounts Friend Discount ** Discounts ** Please, select one discount that is the best value for you. We give a 20% discount for additional children in your family who are enrolled in the camp. After the first child in your family, every child after that is eligible to receive the discount. If you refer two friends who register for Summer Camp the three of you will receive 15% off each. Early Bird Discount Register by February 10th > 30% OFF! That s only $ per week and $3.70 per hour! Register by March 10th > 20% OFF! That s only $148 per week and $4.20 per hour! Register by April 10th > 10% OFF! That s only $ per week and $4.75 per hour! All payments are due every Friday prior to the start of the next week at camp. Youth Guidance adopts a No Pay, No Stay policy, and late/missed payment deadlines will result in your child being unable to participate in the program until the balance is paid in full. PAY BY MAIL (check/money order*): Youth Guidance, ATTN: Tuition 1 N. LaSalle St. Suite 900 Chicago, IL PAY ONLINE: *Make checks out to Youth Guidance with your student s name in the memo section

5 Registration and Consent Form You must complete this form to register your child for Youth Guidance Community Schools/After School Programs and return to the Youth Guidance Resource Coordinator at your child s school. Please print. ALL INFORMATION WILL BE KEPT CONFIDENTIAL!!! Student Information Parent/Guardian Information Full Name Address Home Phone ( ) - Date of Birth / / Unit# City Zip Cell Phone ( ) - School CPS ID# Grade Level ( ) Race/Ethnicity (please check one of the following) African-American Latino Caucasian Asian-American Native American Pacific Islander Multi-Racial Other(please specify) Teacher/Room Gender Female Male Family Size Receive Free/Reduced Price Lunch? Yes No 1. Parent/Guardian Name Address Unit# City Zip Home Phone ( ) - Cell Phone ( ) - Work Phone ( ) Parent/Guardian Name Address Unit# City Zip Home Phone ( ) - Cell Phone ( ) - Work Phone ( ) - Health & Wellness Physician s Name Last First Phone ( ) - Allergies Other Health Issues Is your child taking any medications? No Yes Type: Does your child wear glasses? No Yes Any other special/medical needs *Students who require personal aids during school are required to have an aid (provided by the parent) during program. **It is the guardian s responsibility to provide information on any relevant medical condition if accommodations are needed. Release Information Enrollment Please check all that apply: My child has permission to Walk home Use public transportation Will be picked up The following persons have permission to pick up my child from school. Personal ID is required. 1. Name Relationship Home Phone ( ) - Cell Phone ( ) - 2. Name Relationship Home Phone ( ) - Cell Phone ( ) - *Any changes to release information must be made in writing. **It is the responsibility of the guardian to provide copies of any relevant court documents regarding custody to the Program Office. Select the following options for your child s enrollment. Full Time (Monday Friday) OR Part Time (Select days): Mon Tues Wed Thur Fri Will your child participate on Saturdays? Yes No List your child s other after school activities/programs and their schedules (i.e. After School All Stars, team athletics, Tutoring, etc.) Version 5.1 dated 07/31/14 Please continue on the next page!

6 Agreement and Consents Please review the materials in the packet provided. Then complete the remainder of this form, provide your signature on the last page, and return to your child s Youth Guidance Resource Coordinator. Student/Family Agreement I, (name of parent), understand that my child, (name of child), is expected to follow the school s behavioral expectations at all times. This includes being safe, respectful and responsible to all students, staff, and administrators at all times. Failure to follow behavioral expectations will result in a 2 day suspension from the program. Said suspension will be the result of three incidences of unacceptable behavior which will be relayed to me at the time of occurrence. After said suspension is complete, the next behavioral incident that occurs will result in the immediate termination of my child from the Youth Guidance program. For unacceptable behaviors I will refer to the CPS student code of conduct available at CPS, the Youth Guidance program office, the school s main office or by visiting the CPS website. Furthermore, I understand and my child will adhere to the following program guidelines: Students are NOT permitted to bring electronic devices to afterschool including: portable music players, hand held gaming devices, personal computers, and the like. Cell phones must remain away during afterschool activities. Calls made must be made to/from the Program office line. Unauthorized items that are out during program hours will be confiscated by program staff and returned only upon request by a parent/guardian. Youth Guidance is not responsible for lost or stolen items. Changes to student release information must be made in writing. It is the responsibility of the parent/guardian to provide copies of any relevant court documents regarding custody to the Youth Guidance Program Office. Students who require a personal aid during the school day are also required to have an aid (provided by the student s family) during afterschool. It is the responsibility of the parent/guardian to provide information on any relevant medical condition to the Youth Guidance Program Office if accommodations are needed. Consents for Services Please check the boxes below based on your consent or acknowledgement regarding service provided. Refer to Registration and Consent for Services Information Sheet. Yes No I consent to my child s participation in the Youth Guidance Community Schools/After School Program. I agree to the practices Youth Guidance uses for a) sharing information about my child; b) requesting information about my child; and c) keeping records of services provided to my child. I have been given a copy of and I understand the Notice of Privacy Practices/Statement of Student Rights and the Youth Guidance Grievance Procedure. I understand that my child has the right to fair and professional treatment and that I have the right to file a grievance if I do not feel that he or she has received that treatment. I consent to have my child photographed, videotaped, audio taped and/or interviewed by Youth Guidance staff, related entities (such as the Youth Guidance Board of Directors or partners of Youth Guidance), or the news media while my child is under the supervision of Youth Guidance staff. I give permission to Youth Guidance for the publication, copying, and use of artwork or other assignments done by my child. These consents are in effect until the beginning of next school year or until your child turns 18 years of age, whichever comes first. Version 5.1 dated 07/31/14 Please continue on the next page!

7 Permission and Consent for Program Evaluation Research IN SUMMARY, the program evaluation research Measuring Program Effectiveness for Community Schools Programs in Chicago includes two parts which you will be asked for permission and consent separately: 1. Participation in Program Evaluation Research Study (Surveys and Program Participation Records): For all participants, your child s teacher will be asked to complete a Teacher s Survey at the end of each school year and Youth Guidance will collect program participation records. For 3 rd graders and up, your child will be asked to complete some survey forms at the beginning and end of each school year while he/she participates in the program and you will be asked to complete a year-end survey. 2. CPS Records: for all participants, Youth Guidance will request your child s educational records from the CPS Central Office at the end of each academic quarter, as appropriate, while your child participates in the program. This will include: a) CPS student ID#; b) demographic information; c) school grade/promotion and enrollment/leave information; d) graduation records; e) school attendance records; f) grades, GPA and credits earned; g) standardized test results; h) service learning hours; i) disciplinary incident records (UDC violations); j) CPS student survey results. This permission and consent is valid from now until the end of the school year. Please check the appropriate box(es) and provide your signature and date below. My child s name is Date of Birth Print Name Grade Please check whether you consent 1) for you and your child to participate in this program evaluation research study, including completion of surveys and use of program participation records, and 2) to release your child s CPS educational records for use in this study. These records may be collected for the previous school year as well if your child participated in a Youth Guidance Program during that time. While the CPS information is important, you and your child may still participate in the program evaluation research study if you do not give us permission to collect this information. 1. Program Evaluation Research Study: YES, I consent to participate and I give permission for my child to participate in this program evaluation study. NO, I do not consent nor give permission for my child to participate in this program evaluation study. 2. CPS Records: YES, I give permission for my child s CPS educational records to be released. NO, I do not give permission for my child s CPS educational records to be released. Parent/Guardian Signature Parent/Guardian Signature Print Name Date Please return this completed form to the Youth Guidance Resource Coordinator! FOR INTERNAL USE ONLY: Entered in TIER/Tracker Youth Guidance Staff Signature Date Student CPS ID# Version 4.2 dated 07/20/12

8 Additional Required Consent