MSD Teachers & Staff ~ Girls Inc ~ Concord Community Music School ~ City Year ~

S N A C K

4:00-5:00

BRAIN BOOSTERS 3

CO-OP GAMES 2-3

POWER HOUR 4-5

READING EGGS 1

S N A C K

WED

TAE KWON DO 3-5

POWER HOUR 4-5

THEATRE 3-5

SEWING CIRCLE 4-5

LEGO BRICKS 5

READING EGGS 1-2

SPIRIT TEAM 4-5

TREEHOUSE 3-5

BRAIN GAMES 4-5

BRAIN BOOSTERS 3 S N A C K

LEGO BRICKS 3-4

BRAIN BOOSTERS 3

STORY & CRAFT K

TUE

STUDY ISLAND 3-5

BOOK BUDDIES 2

EGGSPRESS 3-5

STARFISH CORP 3-5

POWER HOUR 4-5 3-D ART CLUB 1-2 STUART LITTLE 3-5 READING EGGS 1-2

LEGO CHALLENGE 3

UNICYCLE TEAM (FULL) 2 HOUR CLUB

THU

BRAIN BOOSTERS 3 POWER HOUR 4-5

STUDY ISLAND 3-5 READING EGGS 1 LOVE AMERICA! 3-5

FR I

ZUMBA 2

SUNSHINE CLUB 5

ZUMBA 3-5

READING EGGS K-1 EGGSPRESS 1-3 STUDY ISLAND 3-5

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S N A C K

EGGSPRESS 3-5

STORY & CRAFT 2

UNH-Manchester

S N A C K

BASKETBALL PREP 3

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COOKING MATTERS 3-5

Upcoming Events Join the 21st CCLC program and march in Manchester’s holiday parade! Saturday, December 1st

YMCA Y-START ~

Bedford Youth Performing Company

MON

3:00-4:00

Student Conservation Association

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2:30

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Fee

7:35 -8:05

Royal Palace Dance

COURSE SELECTION Course Title

THE SCHEDULE

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Day of Choice

Norma Gonzalez Site Coordinator (603) 628-6079 [email protected]

New Morning

THANKS TO OUR PROGRAM TEACHERS, PARTNERS & PROVIDERS!

FOR MORE INFORMATION CONTACT

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MORNING CLUBS MORNING READING (All Grades): Come join us as we explore a new story every morning from 7:35 to 8:05 A.M.! AFTERNOON CLUBS BRAIN BOOSTERS! (Project iSucceed) (Gr. 3): Listen to a story, read a book, or get help with your school work. Please indicate what days you will be coming. POWER HOUR! (Project iSucceed) (Gr. 4-5): Students will have an opportunity to complete their school work before heading home. Please indicate what days you will be coming. BOOK BUDDIES (Project iSucceed) (Gr. 2): Find and read some great books with Ms. Hendrickson. After reading them, you can share the ones you like with your book buddies. READING EGGS (Gr. K-2): This is a fun web based reading program for students interested in improving reading skills. STORY & CRAFT (Gr. K & 2): Come listen to Ms. Newman read a new story every week and then you can create a new and interesting art project to go along with it! Please choose the appropriate day! COOPERATIVE GAMES (Gr. 2-5): Learn what it takes to be a team player and win some friends in the end! STUDY ISLAND –COOL MATH GAMES (Gr. 3-5): Study Island is a computer based program that will help you improve your math and test taking skills. LEGO BRICKS (Gr. 1-5): If you want to invent, tinker, and assemble amazing contraptions this is the place to be! Chose appropriate times! READING EGGSPRESS (Gr. 3): This club is for Reading Eggs members who have graduated to the Reading Eggspress train! All aboard for this fun and engaging reading program! Choo Choo! SEWING CIRCLE (Gr. 4-5): Have you ever wanted to learn how to sew by hand? This is your chance! Each student will make a project to take home. MAGIC TREE HOUSE (Project iSucceed) (Gr. 3-5): Explore the wonderful Magic Tree House book series with Ms. Hendrickson. TAE KWON DO (Gr.3-5): Join Mr. Kellog to discover a new way of exercising that focuses on self respect, discipline, and confidence through the martial arts. READER’S THEATRE (Gr. 3-5): Join City Year members for a whole lot of fun by doing a little acting and a little writing. SPIRIT TEAM (Gr. 4-5): Miss Black and Miss Cassio would like to invite you to be part of our Spirit Team. We are looking for students who are serious about spreading school spirit to our school and community. Do you have what it takes? BRAIN GAMES (Gr. 3-5): Join Miss Sarah to learn some new games like Ninja and Uno that will sharpen your mind while you have fun! STUART LITTLE (Project iSucceed) (Gr. 3-5): Join us as we read about a little mouse with a big heart. Learn how he finds adventure and a loving home in the most unexpected place. We will complete our journey with the movie and popcorn! UNICYCLE TEAM (FULL): THIS CLUB IS CLOSED FOR THE YEAR. STARFISH (Gr. 3-5): In City Year’s Starfish Corps participants play games, make friends, read aloud, sing, create arts and crafts, meet interesting role models from the community, and participate in hands-on projects. 3-D ART (Gr. 1-5): Use a variety of intriguing materials to create new and interesting art in 3-D. Choose the appropriate day! SUPER SENIORS LEGO CHALLENGE! (Gr. 3): Be part of our LEGO team! We will be working on the Super Seniors LEGO challenge! Come and learn some of the challenges that our seniors face and how we can make their lives a little better. LOVE AMERICA! (Gr. 3-5): We will read, draw maps and color projects centered around famous American moments in history. BASKETBALL PREP (Gr. 3): Hey third graders! Get ready for next year’s basketball team by joining Ms. Newman. You will learn some valuable court skills that will put you in great shape for next year’s tryouts! SUNSHINE CLUB (Gr. 3-5): Join us as we make someone’s day a little brighter by making them a card or gift. ZUMBA (Gr. 2-5): Join us for a fast-paced way to exercise! Wear comfortable clothes and sneakers so we can Zumba the hour away! Choose appropriate times! COOKING MATTERS (Gr. 3-5): This is not your average cooking class! The New Hampshire Food Bank will be working with us to provide a new and exciting way to learn about healthy eating habits!

~ NH Food Bank

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BEECH STREET SCHOOL

RELEASE: As the parent/guardian, signing this form, I acknowledge, understand and agree with the 21st CCLC program procedures, policies and expectations including the following: I understand that nursing services are not provided during the afterschool program. I agree to notify the site coordinator of all medical conditions/needs related to my son/daughter. Initials: _______ I authorize the 21stCCLC program staff to take the appropriate action to protect the well-being and safety of my son/daughter including seeking emergency medical attention or hospitalization (or both) should the need arise and I am unable to be reached. Initials: _______ I give permission to the 21st CCLC staff to photograph or video graph my son/daughter for use on the school website or in promotional material (or both) for the program. Yes □ No □ Initials: _______ I authorize the release of my free/reduced school lunch status to the site coordinator. Yes □ No □ Initials: _______ I agree to hold harmless and indemnify SAU #37 and its districts, officers, agents, employees, volunteers and contractors from all claims, demands, causes of action that arise from any unintentional or claimed negligent act or omission resulting from any student’s participation in the 21st CCLC program.

Yes. I would like to make a donation to the 21st CCLC program.

$

_______________________________________________________________________ Signature Parent/Guardian Date

HOW TO PARTICIPATE 1. Choose the desired classes with your son/daughter. Sign up for as many classes as you wish. Classes are on a first-come, first-need basis and may be cancelled due to low enrollment. Circle your choices on the course schedule (on back) and keep for your records.

2. Complete both sides of the registration form below. A separate registration form is required for each student. Incomplete forms will delay registration.

3. Return the registration form to the main office of your school.

COST There is no cost to attend these clubs. We do ask that students make the commitment of coming to each and every club they get accepted into. If you would like to make a donation to the 21st CCLC program, please include amount on the course selection form. Checks may be made payable to the Manchester School District. (A $30 fee will be assessed for checks returned due to insufficient funds.)

Thank you for your support! THE FINE PRINT The 21st CCLC wants your son’s/daughter’s after-school experience to be a positive one. Our goal is to provide a fun and safe learning environment for all participants. Please review the following information with your son or daughter. BEHAVIOR STANDARDS - Students participating in the program are held to the Manchester School District’s Behavior Standards. Repeated disruptions or disrespect for others and/or for their property may result in removal from the program. DISMISSAL - Students will be dismissed as indicated on your registration form. You must notify the site coordinator in advance if you are unable to pick up your student as designated. Failure to do so will result in a maximum waiting period of thirty minutes. If we are unable to contact you during that time, we may contact local authorities. ABSENCE FROM PROGRAM - Time does not allow for parents to be contacted when students are absent from the 21st CCLC program. CANCELLATION - The program does not operate on holidays, school vacation periods or early release days and will be cancelled when schools close due to inclement weather or unforeseen events. Notification will be made through the school’s standard procedure.

Student Name _____________________________________ Date of Birth ________________Grade Level _________ Teacher__________________________________ Home Phone _______________________________ Street Address _________________________________________________________________________________ Mother’s Name _____________________________ Day Phone ______________________Cell # ___________________Email _________________________________ Father’s Name ______________________________ Day Phone ______________________Cell # ___________________Email _________________________________ EMERGENCY CONTACTS (Other than parents) Name: ______________________________________ Phone _______________________________________________ Relationship ____________________________ Name: ______________________________________ Phone _______________________________________________ Relationship ____________________________ My son/daughter has my permission to be dismissed from the 21st CCLC program as follows: □ Walk home at 4 p.m. (There are no crossing guards are not available.) □ Be picked up by __________________________________________________________ □ Go to the Y.O.U. or □ SES program __________________________(Provider) Must already be enrolled in the program. □ List all relatives enrolled in program _____________________________________________________________

REGISTRATION FORMS ARE DUE TO BEECH STREET SCHOOL BY NOVEMBER 9TH

Please complete both sides of this form. NUMBER OF FAMILY MEMBERS IN HOUSEHOLD

HEAD OF HOUSEHOLD (Please circle one)

MOTHER

FATHER