AFTERSCHOOL STUDENT REGISTRATION 2018-2019, JUNIOR HIGH
JUNIOR HIGH STUDENTS
Program begins the first Wednesday school is in session
Program ends the last Wednesday school is in session
*With the exception of the start and finish days the program follows the Bayfield School District Calendar and please note there is no program on September 19th.
Welcome to our Wednesday After School Program! We consider it a privilege to serve the families of our community. While at the Wednesday After School Program, your children (grades K-8th) will be given the chance to receive assistance with his/her homework, have a snack, play games and eat dinner ($1.00 suggested donation for dinner). Mealtime is from 5:00pm-6:15pm. Children K-5th eat at 4:45p.m. and 6th-8th at 5:15p.m. Parents are welcome to join their children for dinner, or come at 5:30 and eat. Dinner is served until 6:15 pm.
For your children’s safety we have established a few guidelines to be followed.
While in our care children are required to:
**Unauthorized cellphone use will result in confiscation and returned at end of evening.**
Consequences for failure to comply with behavior requirements:
For further questions contact: The Children’s or Youth Department @ 884-7196
By enrolling in the program and signing the below agreement, you are acknowledging agreement with the rules and expectations stated on the previous page. You are also acknowledging the pick-up times for your child(ren) 6:30 pm for K-8th and 8:30 pm for 9th-12th. All children must be enrolled before attending the ASP.
To enroll your child please print and return this portion along with the Bayfield School District permission/agreement transportation form to: Pine Valley Church, Attn: Children’s Ministry. You can also enroll online by going to the church website at pinevalleychurch.org. To send this form online, fill out all fields and submit. Our children’s ministry will be notified via email. Read instructions below to send in printed PDF forms.
Please use one of the four options to return these forms:
Child has read and agrees to all program conditions as stated above
CHILD CONTACT INFO
(for teens) Can we add phone number to our student TXT group? Yes No
(for teens) Can we add student to our email newsletter? Yes No
PARENT / GUARDIAN CONTACT INFO
(parents of teens) Can we add you to our student ministry email newsletter?
Gender Male Female
May we use your child’s photograph for publication? Yes No
Are you a: Pine Valley Church Member (have attended classes and signed the forms) Pine Valley Church Attendee Afterschool Program Participant
(Please complete a separate from for additional child(ren)
*** Will your child be riding the Bayfield School District bus (FREE) to the Afterschool Program? You will also need to fill out and sign the required Bayfield School District Permission and Agreement for After-School Transportation below:
BAYFIELD SCHOOL DISTRICT 10 JT-R
Permission and Agreement for After-School Transportation
has my permission to be transported after school on Wednesdays during the 2018-2019 school year between Bayfield School District (“BSD”) facilities to the Pine Church. I understand that BSD is not to be held liable / responsible for any accidents which may occur as a result of this transportation agreement.
BSD is expressly authorized by the Parents/Guardians and the Student to cancel or alter such transportation should conditions, at the sole discretion of BSD, require such cancellation or alteration. BSD shall not be required to notify Parents/Guardians and/or Students of such cancellation or alteration.
In case of a transportation emergency, BSD will make every reasonable effort to contact the Parents/Guardians and, if necessary, the Students physician, at (Phone Number). Should such contact not be possible, the Parent/Guardian hereby gives permission for emergency treatment to be given by the hospital to which the student is taken and by the treating physician whether or not such treatment occurs at the hospital.
The undersigned, for himself or herself, and for the above named Student hereby releases and agrees to hold harmless BSD and it’s School Board members, employees, agents, successors and assign, from any and all claims of whatsoever nature and kind which may arise from the participation of the Student in the transportation program described herein, including but not limited to any and all claims for injuries or damages to person or property, whether or not resulting from the negligence of BSD or its employees or agents.
In order to insure safe and comfortable transportation for all involved, students must adhere to the following rules and guidelines.
The undersigned Parent(s) / Guardian(s) understand the Bayfield School District is providing this transportation on a fee basis, and does not endorse the Church or any religious group.
The undersigned Parent(s) / Guardian(s) and the student have read and understand the Bus Regulations and the above information.
Pine Valley Church
After School Program
2018-2019 Calendar of Events
August 29 – After School Program Begins
September 19 – No After School Program
November 14 – Thanksgiving Dinner & Play
November 21 – No After School Program
December 26 – No After School Program
January 2 – No After School Program
March 27 – No After School Program
May 8 – TNT Awards 6pm -6:30pm
May 15 – The Really Big Show 6pm-8pm
May 22-Last Day After School Program
*Additional Band Practices will be required for those on the Worship Team. Parents will be notified as needed.
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If you have questions about the contents of this document, you can email the document owner.
Document Name: AFTERSCHOOL STUDENT REGISTRATION 2018-2019, JUNIOR HIGH
Agree & Sign