after school enrichment program - atlanta …€¦ · after school enrichment program registration...

AFTER SCHOOL ENRICHMENT PROGRAM

REGISTRATION MATERIALS FOR FALL SESSION 2015

Fall Session Dates: August 31-November 20

Dear Parents,

The first day of classes for Fall Session After-School Enrichment is Monday, August 31. In addition to classes

beginning in August, there is a Pre-Fall Session available for students who are signed up for fall classes.

Registration materials are enclosed as well as information on program policies and course offerings. Please

read the information carefully to determine which classes are appropriate for your child. Students may register

for one or more enrichment classes.

The After-School Program is an incredible deal for our students and families. The estimated cost per day is

approximately $33, and if students stay until the end of program’s day, then the cost is approximately $11 per

hour. Parents who have Flex Spending Accounts for child care may also receive a receipt to submit for

reimbursement. Please note that a $15.00 supply fee is included in all of the classes. This money is used to

purchase materials specifically for a class.

Enrollment: After school enrollment is offered three times during the school year for fall, winter, and spring

sessions. Class sizes are limited, so we encourage you to register early to guarantee a space for your child.

Enrollment will be on a first-come, first-served basis. When a class size is full your child will be waitlisted, and

you will be notified if a space becomes available.

Fees: Full tuition is due at time of registration, but please feel free to contact me if you need to make

other arrangements. All paperwork contained within this packet must be complete to fully enroll a student in

after-school.

Refunds: If a class is cancelled due to low enrollment you will receive a full refund or move to another class. If

you withdraw your child from a class before September 4, 2015 you will receive a full refund. Thereafter, no

refunds will be given for withdrawal from a class.

If you have questions concerning the After School Program or need additional information, please feel free to

call or email me. I look forward to working with your children in another educational and fun-filled After-

School program this year. Thanks again for all of your feedback and support for our programs!

Sincerely,

NaShayla Jones

Coordinator for After School Enrichment 404-233-5332 or [email protected]

After School Enrichment Program

Fall Session 2015 Aug. 31- Nov. 20

Preferred

Child’s Full Name_________________________________________ Name _________________________

Grade ___________________________ Teacher ____________________________________________

Parent’s Name_______________________________________Home Phone__________________________

Business Phone_____________________________ Cell Phone_________________________________

Email address________________________________________________

I am enrolling my child in the After School Enrichment Program for the classes checked below:

Monday – Yoga –Nicole Penson (For Grades K-6)

Cost is $375 payable to Atlanta Speech School

Wednesday- Kickball – Robin Attikkson

(For Grades K-6)


Monday – Lego Sculpture- NaShayla Jones

(For Grades K-6)


Thursday- Rhythm and Cues- Casey Walker and

Sophie Ekstrom (For Grades K-6)


Tuesday – Come Cheer with us! –Jill Johnson

(For Grades K-6)


Thursday- Ultimate Frisbee- Linda Lasker

(For Grades K-6)


Tuesday – Minecraft (For Grades K-6)


Friday – Chess Club (For Grades K-6)


Tuesday – Gourmet Kids Cooking class- Robin Attiksson

(For Grades K-6)


Friday – Organized Sports and Fitness

(For Grades K-6)


Wednesday – Basic Gymnastics-Nashayla Jones

(For Grades K-6)


Friday – Directors’ Cut- NaShayla Jones

(For Grades K-6)


Date__________________________

Check________________________

Amount______________________

_

*Please note that in an effort to keep cost down for our families each class includes a $15.00 Supply Fee

integrated into the total cost. Discounts are given in tuition for students who are enrolled in more than two classes. See

fees below if you are registering for more than two or more classes/days per week and check the appropriate box to

determine your tuition. Make checks payable to the Atlanta Speech School. All fees are non-transferable and non-

refundable after the first week of class.

1 day/class per week: Mon.-Thurs. 3-6 or Fri. 1-4 $375

Fri. with extended hrs to 6:00 $440

2 days/classes per week: Mon.-Thurs. 3-6 or Fri. 1-4 $730


3 days/classes per week: Mon.-Thurs.3-6 or Fri 1-4 $1000


4 days/classes per week: Mon.-Thurs. 3-6 or Fri 1-4 $1,300

Fri. with extended hrs to 6:00 $1,365

5 days/classes per week: Mon.-Thurs. 3-6 or Fri. 1-4 $1,600

Fri. with extended hrs to 6:00 $1,665

Atlanta Speech School

After School Enrichment Program Policies

Pre-Fall Session: August 17, 2014 to August 28, 2015

Fall Session Dates: August 31, 2015 to November 20, 2015

Winter Session Dates: December 30, 2015 to February 26, 2016

Spring Session Dates: February 29, 2016 to May 27, 2016

The After School Enrichment Program is designed to offer after school options for Atlanta Speech School

Students in grades K – 6th

levels. Students must be 5 years old by September 1st to participate in the

program. Operating as an extension of the school day, the program exists to develop the whole child through

recreational activities. Students enrolled in the program have snack, enjoy enrichment classes, spend time with

friends, and play outdoors or in the gym.

The program follows the Wardlaw School calendar and operates daily until 6:00 p.m. The program does not

operate during Wardlaw planning days, Wardlaw conference days, or school wide holidays. Parents may pick

up their children promptly by 6:00 p.m. or any time before 6:00 p.m. Late fees are charged for pick up after

6:00 p.m. at the rate of $2.00 per minute.

The After School teachers are responsible for the safety and well-being of students under their care. Students

will not be allowed to leave the school without being escorted by a parent, staff member, or designated

guardians. Parents should park in the parking lot, enter the main lobby and sign-out at the front desk. Parents

may then return to the cafeteria or playground to pick up their children. Parents must provide a note each time a

child is to leave school with anyone other than a parent. If a child will not be attending his/her after school

class parents should call, email, or send a note to the After School Office. Please also notify the after-

school coordinator in the case of changes in car-pool or persons picking up your child.

Only those students who are registered for an after school class may participate in the class. Drop-ins are

not available.

Behavior during after school classes will be according to the standards indicated in the handbook for

regular school hours. Students should respect teachers, fellow students and property at all times.

After School Enrichment fees are non-transferable and non-refundable after the first week of class.

Atlanta Speech School

Pre-Fall Session

August 17 - August 28, 2015

Preferred

Child’s Full Name_________________________________________ Name _________________________

Grade ___________________________ Teacher __________________________________________

Parent’s Name_______________________________________Home Phone__________________________

Email:_____________________________________ Cell Phone_________________________________

I am enrolling my child in the Pre-Fall After-School Session from August 17 to August 28, 2015. The Pre-Fall

Session is offered free of charge, and available only to those students who register for an after school

enrichment class during the fall session. (Example: A child who is enrolled in the Monday Lego Class may stay

after school on Monday only). A combination of indoor games and activities as well as outdoor playtime, are

provided for all registered students during the Pre-Fall Day Session. Enrichment classes begin the week of

August 31-September 4.

My child will participate in the Pre-Fall Session on the following days:

Monday

Tuesday

Wednesday

Thursday

Friday

Wardlaw Kindergarten students only

I am enrolling my child for additional After-School care beginning at 12:45 during Wardlaw early dismissal

period for the days checked above. Please note, Wardlaw kindergarten students are dismissed at 12:45 for the

first three weeks of school (August 17- September 4). Stay and Play Session is offered free of charge and is

available only to those students who have registered for a fall enrichment classes. (Example: A child who is

enrolled in the Monday Webkinz Class may stay after school on Monday only). Students may stay from 12:45

until 6:00.

Kenan Kindergarten and Stepping Stones students only

I am enrolling my child for additional After-School care beginning at 1:15 during Kenan early dismissal period

for the days checked above. Please note Kenan kindergarten students are dismissed at 1:15 for the first two

weeks of school (August 11- August 22). Stay and Play Session is offered free of charge and is available only to

those students who have registered for a fall enrichment class. (Example: A child who is enrolled in the

Monday Webkinz Class may stay after school on Monday only). Students may stay from 1:15 until 6:00.

Dear Parents,

Bright From the Start: Georgia Department of Early Care and Learning (DECAL) licenses child care

and preschool programs based on a set of standards that address curriculum, health and safety, nutrition, and

facilities, among other areas. Georgia DECAL conducts annual monitoring visits to assess compliance with

these standards, and our programs have always met the standards. Several of our classes, however, are exempt

from licensure. Specifically, our part-day preschool, transitional kindergarten, kindergarten, summer programs,

before school care, and after school classes are not required to be licensed. The Department requires, however,

that parents are made aware of the exempt status of their child’s classroom and acknowledge this by signing and

returning this letter.

DECAL program exemption in no way lessens our responsibility to ensure that each child receives

educational experiences that allow him or her to reach full potential consistent with our stated mission. We

maintain the highest standards in each classroom, consistent with other licensing and accrediting standards (e.g.,

National Association of Education of Young Children (NAEYC) Accreditation, Southern Association of

Independent Schools-Southern Association of Colleges and Schools (SAIS-SACS) Accreditation) as well as our

core values regarding the quality of our services. Our commitment to providing each child with the best

educational experience remains strong.

Please feel free to contact me if you have any questions about DECAL licensure.

Sincerely, NaShayla Jones Program Coordinator After-School

_____________________________________________________________________________________

I understand that my child’s class is exempt from Bright From the Start: Georgia Department of Early Care and

Learning (DECAL) licensure.

____________________________________ Child’s Name ____________________________________ Parent Signature ____________________________________ Date

ATLANTA SPEECH SCHOOL

AFTER SCHOOL ENRICHMENT PROGRAM

EMERGENCY FORM AND WAIVER OF LIABILITY

The After School Enrichment Program of the Atlanta Speech School agrees to provide care for:

Child’s Name:_________________________________________________________________

Parental Responsibility

1. I acknowledge the responsibility to keep my child’s records current to reflect any significant changes as they occur

(e.g. telephone numbers, work locations, emergency contacts, child’s physician, child’s health status, immunization

records, etc.)

2. My child will not be allowed to enter or leave the facility without being escorted by a parent, person authorized by

parent, or facility personnel.

3. The facility agrees to keep me informed of any illnesses or injuries pertaining to my child. The Department of Human

Resources requires that the Director “report any case of communicable diseases or suspected child abuse, neglect,

exploitation or deprivation to the proper authority”.

4. My child may be released ONLY to the persons signing this agreement and to the persons listed below. Changes

must be submitted in writing by the parents/guardians.

Name Address Telephone Relationship

__________________ ____________________ ___________ _______________

__________________ ____________________ ___________ _______________

__________________ ____________________ ___________ _______________

__________________ ____________________ ___________ _______________

Please list persons to whom your child may NOT be released. (If any of those listed are parents of the child, a copy of the

court order limiting that parent’s access to the child must be on file with the school.)

Name Relationship

_________________________________ ________________________________________

_________________________________ ________________________________________

Illness/Injury

Should your child become ill or suffer an injury of any nature during the time that he/she is in the care of the After School

Enrichment Program, the facility shall attempt to contact the parents immediately. In the case of severe illness or injury,

911 shall be called and the child transported by ambulance to Piedmont Hospital, which shall be authorized to provide

necessary medical treatment. The parents shall assume responsibility for payment.

Waiver of Liability

I ________________________ as parent or legal guardian of _____________________, do hereby affirm that the

applicant is in good health and suffers no condition that requires any medication unless that condition is disclosed on this

sheet. Furthermore, I know of no reason that the applicant cannot participate in vigorous physical activity. In the event of

any injury, I understand every attempt will be made to contact the parent or guardian. I hereby give permission for school

supervisors to procure any timely medical treatment deemed advisable on the behalf of my child or ward. I hereby release

the Atlanta Speech School and all employees of the school or programs from any and all liability from injury or illness,

physical or mental, suffered by the student during or related to After School Enrichment, unless caused by a willful act or

gross negligence.

The signature below indicates that the parent or guardian understands and accepts the After School Enrichment

Program regulations as stated on this form and on the accompanying registration materials.

___________________________________________ ______________________________________

Parent/Guardian Signature Date Director’s Signature

AFTER-SCHOOL ENRICHMENT PROGRAM

ATLANTA SPEECH SCHOOL, INC.

REGISTRATION FORM

Date of

Student’s Full Name Birth Month Day Year

(Please Print)

PARENT INFORMATION PARENT INFORMATION

Dr. ________ Dr. ________ (First) (Last) (First) (Last)

Street Address Street Address

City County State Zip City County State Zip

Home Phone: Home Phone:

Cell phone: Cell phone:

Email Address: Email Address:

Employer: Employer:

Business Address_________________________________________ Business Address______________________________________

Business Phone: Business Phone:

Marital Status: Single Married Separated Divorced Remarried Widowed

Child living with: School District:

In instances of divorce or separation, it is assumed that both parents may participate in all phases of their child’s

educational process. If there are restrictions to such participation and/or visitation, it is the parent’s responsibility

to provide the school with appropriate documentation of the legal arrangements.

Parent(s) or Legal Guardian(s)

It is your responsibility to immediately inform the After School Enrichment Office of any changes in address,

phone number or marital status.

In case of emergency notify: (Please list some responsible person other than parents, in case parents cannot be

reached.)

NAME TELEPHONE RELATION TO STUDENT

1.

2.

Signature of Parent or Legal Guardian Date

MEDICAL INFORMATION

Student’s Name:

Pediatrician Name: Address Phone Number

Is student VIOLENTLY allergic to insect bites or stings? Yes No

If your answer is YES, please emphasize this to the

classroom teacher and provide her with medication

customarily used to counteract.

Is the student susceptible to convulsions or seizures? Yes No

Is the student allergic to any food, medications or insect bites? Yes No

Please list:

Do we have parental permission to administer Benadryl

in the event of insect bites or stings? Yes No

Under exceptional circumstances, medication may be administered by a student’s teacher with the

approval of the coordinator and in compliance with administrative regulations. A completed form

“ADMINISTRATION OF MEDICATION” must be on file for each child requiring medication. The form

and policy statement will be available at the beginning of school.

In the event my above-named child, while attending Atlanta Speech School, requires emergency treatment

and it is impossible to locate a parent, the person designated as emergency contact, or the physician named

herein, I hereby give my permission to an authorized staff member of Atlanta Speech School to secure the

necessary treatment and to take such steps as are immediately required.

Date Signature of Parent or Legal Guardian

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