NORTHWEST ELEMENTARY SCHOOL Morning Program (Mon-Fri Gr. K-5): Complete homework, build with LEGOs, work on puzzles and play with friends. FEE: $15/$30 Activity Hour (Gr. K-1): Play games, share with friends, play outside and enjoy your afternoon in a relaxed atmosphere. NO FEE Homework Club (Gr. 2-5): Work on your homework with the support of Northwest’s certified teachers. NO FEE Build It! (Gr. K-2 or 3-5): LEGOs, puzzles, projects… if you come, you can build it! FEE: $15/$30 FIRST LEGO League Jr. (CLOSED): This class introduces STEM concepts to K-2 students while exciting them through LEGOs. * THIS GROUP IS RESERVED FOR THOSE STUDENTS ALREADY SIGNED UP (CONTINUING YEAR-LONG COMMITMENT). NO FEE

Handi-Crafts (Gr. K-2 or 3-5): Learn to weave, knit, crochet and bead in this crafty, hands-on class. FEE: $15/$30 Game Time (Gr. K-2 or 3-5): Play board games, classroom games, computer games and outdoor games! FEE: $15/$30 Science Outside (Gr. K-2): Step outside and learn about all of the things that live and grow right outside Northwest. FEE: $15/$30 NeuroScience (Gr. 4-5): Explore the inner and outer workings of the brain through games, art and activities with City Year. NO FEE Starfish Corps (CLOSED): A service program designed by City Year to develop young leaders and a strong Northwest community. Build skills and self-confidence through fun lessons and service projects. ** THESE GROUPS ARE RESERVED FOR THOSE STUDENTS ALREADY SIGNED UP FROM PREVIOUS SESSION. NO FEE Story & A Craft (Gr. K-2): Listen to a great story and then create crafts to go along with it. FEE: $15/$30 Outdoor Games (Gr. K-2 or 3-5): It’s spring! Get out and play! (Student Choice) NO FEE BYPC Art (Gr. K-2 or 3-5): Come let your creativity flow in this cool art class taught by the professionals from Bedford Youth Performing Company. NO FEE Educational Computer Games (Gr. K-2 or 3-5): Learn and have fun while playing educational games. (Student Choice) FEE: $15/30 LEGO Land (Gr. K-2 or 3-5): Use LEGOs to design and build anything your mind can imagine. (Student Choice) FEE: $15/30 Eat Plants (Gr. 3-5): Learn about (and eat!) healthy veggies and fruits. You’ll also plant seeds and grow your own food! FEE: $15/$30 Sea-Horse Club (Gr. 3-5): Dive deep and explore marine science and ocean creatures, then come on land and learn all about horses along with City Year. NO FEE Brainiacs (Gr. K-2 or 3-5): Grow your brain by solving puzzles, riddles and math problems. FEE: $15/$30 Zombies! (Gr. 1-5): Build awesome science projects around the human anatomy like gingerbread zombies and x-ray hands along with the professionals from Unchartered Tutoring in Manchester. FEE: $15/$30 Cool Math Games (Gr. 3-5): Play fun math games using popular math websites and board games FEE: $15/30 String Fun (Gr. 3 ONLY): Have you ever wanted to learn the violin? This intro class gives 3rd graders the chance to explore the violin prior to joining the Northwest School Orchestra as fourth graders. Special opportunities will be given to play fiddle music! FEE: $15/$30 Wii Play (Gr. 3-5): Come play fun Wii games with your friends. (Student Choice) FEE: $15/$30 Ukulele (Gr. 3 ONLY): Learn to play the Ukulele! Fun and popular songs will be learned that can be performed on the ukulele, just like the stars! Take your skills to the next level with this class. FEE: $15/$30

COURSE SELECTION Course Title

Day

Hour

M-T-W-Th-F

Morn

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

Morning Program

Registration Fee Yes

Fee

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

Total Fees $

$5

FOR MORE INFORMATION CONTACT Dan Concannon Site Coordinator [email protected]

THE SCHEDULE 7:45-8:25

M O

Morning

N Program

T U Morning E Program

2:45 S N A C K

S N A C K

3:00—4:00

4:00 - 5:00

Activity Hour (K -1)

* FIRST JR (Closed)

HW Club (2-5)

Handi-Crafts (K-2)

Build It! (K-2)

Game Time (3-5)

Activity Hour (K-1)

Game Time (K-2)

HW Club (2-5)

Story & A Craft (K-2)

Sci. Outside (K-2)

Handi-Crafts (3-5)

NeuroScience (4-5)

**Starfish Corps A (Closed)

W E Morning D Program

S N A C K

Activity Hour (K-2) Outdoor (K-2) BYPC Art (3-5)

BYPC Art (K-2) LEGO Land (K-2)

Eat Plants (3-5)

Comp Games (3-5)

Outdoor (3-5) LEGO Land (3-5)

T H Morning U Program

S N A C K

Activity Hour (K-1)

Brainiacs (K-2)

HW Club (2-5)

Zombies! (1-5)

Comp Games (K-2)

Build It! (3-5)

Sea-Horse (3-5)

**Starfish Corps B (Closed)

F R Morning I Program

S N A C K

Activity Hour (K-1)

Comp Games (K-2)

HW Club (2-5)

Brainiacs (3-5)

Cool Math (3-5)

Wii Play (3-5)

String Fun (3)

Ukulele (3)

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: _______ 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-serve 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 along with payment (check, money order, cash) to the main office of your school. Please make checks payable to the Manchester School District. A $30 fee will be assessed for checks returned due to insufficient funds.

COST A non-refundable registration fee of $5 will be assessed for each student enrolling in the afterschool program. The cost for each class is as follows: $15 if the student receives free or reduced lunch $30 for all others. Unless noted, the fee per course covers the entire session. Families with more than one student enrolled may qualify for reduced rates. Financial aid and scholarships are available. Please contact your site coordinator for more information.

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 21st CCLC

The 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 from the program 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. A late fee of $5 may be assessed for every fifteen minutes after the designated pick up time. ABSENCE FROM PROGRAM - Time does not allow for parents to be contacted immediately when students are absent from the 21st CCLC program. Fees will not be refunded. 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. In these cases, courses will not be rescheduled and fees will not be refunded.

Student Name ______________________________________ Date of Birth _____________Grade Level _________ Homeroom Teacher___________________ Home Phone __________________________ Street Address ________________________________________ City _________________ Zip _______________ 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. ( I am aware that crossing guards are not available.) Go to the ______________________________ program.

□

Be picked up by ______________________________

REGISTRATION FORMS ARE DUE TO THE NORTHWEST MAIN OFFICE BY WEDNESDAY, MARCH 21, 2018.

Please complete both sides of this form.