BEECH STREET SCHOOL MORNING CLUBS MORNING READING (All Grades): Come join us as we explore a new story every morning from 7:30-8:15 A.M.! All grades welcome! You must be registered and arrive on time! Class Limit: 15 AFTERNOON CLUBS LITTLE LEARNERS, BRAIN BOOSTERS & POWER HOUR! (Project iSucceed) (Gr. 1-5): Here you will have an opportunity to work on school work. Please choose the appropriate club. Class Limit: 20 DRAMA CLUB (Project iSucceed): (Gr. 2-4): Join Mrs. Slater in creating a full on production. Learn lines with friends and put on a play for your family and friends! This is a two day commitment, so please make sure you have signed up for both days. Class Limit: 14 SCRATCH JR (Gr. K-1): Scratch Jr. is an introductory programming language that enables young children to create their own interactive stories and games. Children snap together graphical programming blocks to make characters move, jump, dance and sing. Class Limit: 20 GIRLS AND BOYS BASKETBALL PREP (Gr. 4-5): Learn the fundamentals of basketball such as dribbling, lay-ups, passing and shooting the ball. Current team members are also encouraged to enroll. Please choose the appropriate day. Class Limit: 20 FIRST JR. LEGO LEAGUE (FULL): This class introduces STEM concepts to students while exciting them through LEGOs. This club is a two day commitment. Current members please make sure you note both days. (FULL) INDOOR SOCCER (Student Choice) (Gr. 3-5): If you enjoy playing soccer, come join us! All skill levels welcomed. Develop new skills, moves and friendships all at the same time. Class Limit: 20 KEYBOARD MASTERS (Gr. 3-5): Learn how to type by using a fun, online typing program that will teach you how to type like a pro! Class Limit: 20 UNO CLUB (Gr. 1-5): Challenge new and old friends with the wonderful game of UNO! Find out if you have what it takes to be an UNO master! Class Limit: 16 CITY YEAR FIRST LEGO LEAGUE (Gr. 4-5): Open to 4th and 5th graders, join the team in learning how to program your EV3 robot to engineer and solve real challenges in our “Allied Animals” world. Each meeting includes fun teambuilding games, work on your projects, and time for homework. (Students must commit through end of school year.) Class Limit: 6 OUTDOOR EXPLORERS (Gr. K-1): Enjoy the outdoors by engaging in fun games. Whether playing on the playground or enjoying a game of tag, there is plenty of fun for everyone! Class Limit: 20 POKEMON CLUB (Student Choice) (Gr. 3-5): Pokemon time! Get ready for an hour of poking around with your Pokemon. Make new friends while playing the awesome game of Pokemon. Class Limit: 14 WALKING FRIENDS (Gr. 3-5): Want to get fit? Let’s get a good start by walking around the playground. We’ll chat and make new friends in this club! Class Limit: 20 MARTIAL ARTS (Gr. 1-5): Learn discipline, self-confidence, and self-control through martial arts. Please choose the appropriate time. Class Limit: 12 UNICYCLE TEAM (FULL): This club is closed to new students. If you are a current club member, please note that on your form. (Closed) QUILLING PLUS! (Student Choice) (Gr. 4-5): Previous Quilling members are invited to return to make some new creations using colorful strips of paper with Mrs. Rust-Belfort. Class Limit: 8 WIFFLE BALL (Gr. 2-3): Got game? Want to try a new way of playing baseball? Come join Ms. Newman and Mr. Alex for a home run of a time! Class Limit: 16 CRAZY 8’S MATH (Gr. K-5): Crazy 8s is a recreational after-school math club that helps kids enjoy the math behind their favorite activities! Class Limit: 18 LEGO BRICKS (Student Choice) (Gr. 1-5): If you want to invent, tinker and assemble amazing contraptions, this is the place to be! Sorry, this is not robotics! Class Limit: 12 CITY YEAR/STARFISH CORPS (Gr. 3-5): Students will participate in games, activities, and community service projects to explore ideas such as Peace, Healthy Choices and Environmental Awareness. Class Limit: 18 OPEN GYM (Student Choice) (Gr. 3-5): Get some friends to head to the gym and have a ball! Play and learn various organized games. Class Limit: 25 LEARN TO DRAW (Gr. 1-2): Join Ms. Shea and learn how to draw animals, cartoon characters and other fun stuff. Class Limit: 16 TECH FOR KIDS (Project iSucceed) (Student Choice) (Gr. K-1): Explore the exciting world of technology! Must be willing to make mistakes and figure out problems. Class Limit: 12 I LIKE TO MOVE IT! MOVE IT! (Student Choice) (Gr. 1-5): We like to move it, move it! Have fun dancing and competing with your friends using our X-Box’s Just Dance! Program. Class Limit: 14 3-D ART CLUB (Student Choice) (Gr. 3-5): Create masks, sculptures, wood crafts and more in this new club! Class Limit: 18 * Project iSucceed is funded in part by Manchester’s Community Improvement Program (CIP) and U.S. DHUD Community Development Block Grant Program.

COURSE SELECTION Day

Hour

Circle Day

—>

Monday

1st hr

Monday

2nd hr

Tuesday

1st hr

Tuesday

2nd hr

Wednesday

1st hr

Wednesday

2nd hr

Thursday

1st hr

Thursday

2nd hr

Friday

1st hr

Friday

2nd hr

Yes

Course Title Morning Program

M T W TH F

I would like to make a donation.

*INCOMPLETE FORMS WILL AFFECT YOUR CHANCES OF GETTING INTO A CLUB. *PAST ATTENDANCE , COMMITMENT AND BEHAVIOR ISSUES WILL AFFECT YOUR CHANCES OF GETTING INTO ANY HIGHLY REQUESTED CLUBS.

FOR MORE INFORMATION CONTACT Norma Gonzalez - Site Coordinator 603-624-6314 - [email protected]

THE SCHEDULE 7:30-8:15

2:40

M O MORNING

N READING

3:15 - 4:00

4:00 - 5:00

BRAIN BOOSTERS 3

FIRST LEGO* (FULL)

POWER HOUR 4-5

S N A C K

DRAMA CLUB 2-4 * KEYBOARD FUN 3 SCRATCH JR. K-1 GIRLS B-BALL 3-5

T U E

INDOOR SOCCER 3-5

UNO CLUB 1-2

BRAIN BOOSTERS 3 OUTDOOR EX. K-1 POWER HOUR 4-5 MORNING READING

S N A C K

POKEMON CLUB 3-5 DRAMA CLUB 2-4 * LITTLE LEARNERS 1-2 BOYS B-BALL 3-5

KEYBOARD FUN 4 WALKING FRIENDS 3-5

CITY YEAR FIRST LEGO LEAGUE 4-5

W E D MORNING READING

S N A C K

BRAIN BOOSTERS 3

MARTIAL ARTS 3-5

POWER HOUR 4-5

FIRST LEGO* (FULL)

MARTIAL ARTS 1-2

QUILLING PLUS* 4-5

UNICYCLE TEAM 3 (FULL)

T H U MORNING READING

S N A C K

BRAIN BOOSTERS 3

CRAZY 8’S MATH 3-5

POWER HOUR 4-5

WIFFLEBALL 4-5

WIFFLEBALL 2-3

LEGO BRICKS 1-5

CRAZY 8’S MATH K-1

KEYBOARD FUN 5

CITY YEAR STARFISH CORPS 3-5

F R MORNING I READING

S N A C K

OPEN GYM 3-5

UNO CLUB 1-5

LEARN TO DRAW 1-2 MOVE IT! MOVE IT! 1-5 UNO CLUB 2-5 TECH FOR KIDS K-1

3-D ART CLUB 3-5

A warm thank you to all our providers, teachers, and staff who make our program a great success!

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: _______ st I authorize the 21 CCLC 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: _______ st I give permission to the 21 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. _____________________________________________________________________ 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. Please write your child’s choices on the course schedule (on back) and keep the top copy 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 and greatly lower your chances of getting into a club.

3. Return the registration form to the main office of your school. 4.

If are donating, please make checks payable to the Manchester School District. A $30 fee will be assessed for checks returned due to insufficient funds.

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’d like to make a donation to the 21st CCLC program, please include amount on the course selection form. 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 - In the event of an absence from program when the student was present for the school day, contact will be attempted by 4:00PM to both parents and a voicemail will be left if direct contact was not possible. 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________________________________ My son/daughter has the following allergies: ___________________________________________________________________________________________ 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 4:00 p.m. (There are no crossing guards are not available.) *STUDENTS WITH A 5:00 P.M. DISMISSAL MUST BE PICKED UP BY A PARENT OR OLDER SIBLING. IF YOU ARE NOT WILLING TO PICK THEM UP AT 5PM, PLEASE DO NOT SIGN THEM UP FOR A SECOND CLUB*

□ List all people who can pick up your child. ______________________________________________________________________ □ List all relatives enrolled in program ___________________________________________________________________________ __________________________________________________________________________________________________________ REGISTRATION FORMS ARE DUE TO BEECH STREET SCHOOL BY FRIDAY MARCH 17, 2017 PLEASE COMPLETE BOTH SIDES. INCOMPLETE FORMS WILL AFFECT YOUR CHANCES OF GETTING INTO A CLUB. NUMBER OF FAMILY MEMBERS IN HOUSEHOLD

HEAD OF HOUSEHOLD (Please circle one)

MOTHER

FATHER