Afterschool Registration 2018-2019 SchoolYear


 

Wednesday After School Program 2018-2019

ELEMENTARY STUDENT FORM

 

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.

Parent / Child Agreement – PLEASE REVIEW THIS PAGE WITH YOUR CHILD

 

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.

  • We encourage parents to arrange transportation for their children to PVC. If parents are unable to provide transportation for their children, they may choose to ride the designated bus. The parent(s) must fill out the Pine Valley Church Parent Permission Slip and the Bayfield School District Permission and Agreement for the After-School Transportation and return both forms to Pine Valley Church authorizing their child to ride the bus and participate in the After-School Program. Do not return forms to the school.  Pine Valley Church is not responsible for any child choosing to walk to the church.
  • Parents are responsible for their child’s ride home; classes end promptly at 6:30 p.m.      (K-5th) and 6:30p.m. (6th-8th) at which time parents are expected to pick up their children. Please try and allow your child to stay for the entire evening whenever possible.
  • Children must be signed out. Children will only be released to those authorized on permission slip unless given written permission stating otherwise.

While in our care children are required to:

  • Participate in group activities provided
  • Respect ALL leaders, peers and facility
  • Remain in designated areas
  • Abide by bus rules.  Suspension from school bus is a suspension from the program.
  • Phones are to be turned OFF & put away during program unless authorized by a leader.

**Unauthorized cellphone use will result in confiscation and returned at end of evening.**

 

Consequences for failure to comply with behavior requirements:

  • Time out from activities and a warning about suspension if needed.
  • Two-week suspension; upon return to program with a written apology signed by child and parent; or a consequence to be determined by pastor.
  • Parents will be contacted immediately if their child departs the premises without authorization. If PVC is unable to reach the parent, we will call the emergency contact person. If neither party is available, we will contact the police department. Your child’s safety is extremely important!

For further questions contact: The Children’s or Youth Department @ 884-7196

Pine Valley Church After-School Program Permission and Agreement

 

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:

  1. Mail: P.O. Box 740, Bayfield, CO 81122
  2. Fax: 970 884-4624.
  3. Email : (K-5th) jill@pinevalleychurch.org
  4. Or you may drop them off at the church, 1328 CR 501. Office hours are Mon-Fri 9:00am-4:00pm.

 

Pine Valley Church After-School Program Permission and Agreement

 

 

 

CHILD CONTACT INFO 

  (for teens) Can we add phone number to our student TXT group?

  (for teens) Can we add student to our email newsletter?

 

PARENT / GUARDIAN CONTACT INFO

(parents of teens) Can we add you to our student ministry email newsletter?

 

CHILD INFORMATION

 

Gender

 

ADDITIONAL INFORMATION

May we use your child’s photograph for publication?

 

 

 

Are you a:

 

 

(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.

  1. Students must be at the pick-up bus stop at the appointed time each Wednesday. Bus drivers WILL NOT WAIT for individual Students who are tardy.
  2. Students may not ride the bus unless the driver has a list showing the Students name.
  3. All students shall adhere to all BSD Bus Regulations governing the transportation of students.
  4. All student discipline shall follow the guidelines as set forth in the Bus Rules / Regulations.

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 Play Practices will be required for those with speaking roles Parents will be notified as needed.

 

 

 

 

 

 

 

 

 

 

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Pine Valley Church https://pinevalleychurch.org
Signature Certificate
Document name: Afterschool Registration 2018-2019 SchoolYear
Unique Document ID: 913d1faa2c197f8de7439efda5650a5002eae3a8
Timestamp Audit
August 17, 2018 2:30 pm MSTAfterschool Registration 2018-2019 SchoolYear Uploaded by Carrie Van Hoesen - carrie@pinevalleychurch.org IP 72.249.237.34
August 28, 2018 3:31 pm MST Document owner carrie@pinevalleychurch.org has handed over this document to jill@pinevalleychurch.org 2018-08-28 15:31:25 - 72.249.237.34