Riverside Elementary School GISD
21st Century Community Learning Centers Family Handbook
Riverside Elementary School GISD
Learning Center Coordinator: Name: Marlene Flores Phone Number:575-646-7524 Email: mflores2@nmsu.edu
Local Program Director: Name: Nicole Delgado Phone Number: 575-646-7649 Email: pazubiat@nmsu.edu
School Campus Principal: Principal Name: Teresa Navarro Phone Number: 575-824-0060 Email: rwiggs@gisd.k12.nm.us
Contents
PARENT/GUARDIAN ACKNOWLEDGMENT FORM............................................................1 STUDENT REGISTRATION .....................................................................................................2
MEDICAL AUTHORIZATION FORM ..................................................................................2 PARENTAL PERMISSION FORM............................................................................................3 SECTION I: 21st CCLC INTRODUCTION ...............................................................................5
OVERVIEW ...........................................................................................................................5 GOALS AND PERFORMANCE MEASURES .......................................................................5 SECTION II: ENROLLMENT AND ATTENDANCE...............................................................6 ATTENDANCE POLICY .......................................................................................................6 SECTION III: PROGRAM HOURS AND ACTIVITIES ...........................................................7 HOURS OF OPERATION ......................................................................................................7 HOLIDAY & STORM DAY POLICIES .................................................................................8 DISMISSAL ............................................................................................................................8 EARLY PICK-UP ...................................................................................................................8 LATE PICK-UP ......................................................................................................................9 FAMILY PARTICIPATION ...................................................................................................9 SECTION IV: BEHAVIOR POLICY........................................................................................9 SECTION V: 21st CCLC STAFF AND VOLUNTEERS ..........................................................10 SECTION VI: COMMUNICATION........................................................................................10 SECTION VII: ADDITIONAL DETAILS ...............................................................................11 SNACK/MEAL .....................................................................................................................11 MEDICATIONS ...................................................................................................................11 HEALTH & SAFETY ...........................................................................................................11 21st CCLC EMERGENCY POLICY......................................................................................12 NATURAL DISASTERS & OTHER EMERGENCIES.........................................................12 FIELD TRIP PERMISSION..................................................................................................12 PERSONAL BELONGINGS.................................................................................................13
1
PARENT/GUARDIAN ACKNOWLEDGMENT FORM 21st Century Community Learning Centers (CCLC) is an out of school time program
offered free of charge through a federal grant administered by the New Mexico Public Education Department. The program offers academic, leadership, and enrichment opportunities for students and families. Program is offered Monday through Thursday, directly after the regular school day. All 21st CCLC students must participate on a regular basis. If program is offered both morning and afternoon, students are not required to attend both sessions.
Family group activities will be offered on some evenings throughout the fall and spring semesters. Please attend as many activities as possible! Family participation is very important to our grant because 21st CCCL has a dual capacity framework, meaning we serve both students AND families!
Your daughter/son is expected to meet expectations and participate. Instructors use positive reinforcement during the out of school time program to keep a positive and fun learning environment! To maintain a good learning environment, we will not allow harassment or bullying. We have a "zero tolerance" policy for any weapons or controlled substances. We follow the school district's Code of Conduct Handbook practices and procedures. Expectations during the out of school time program are the same as during the traditional learning day. We have a behavior/discipline policy that states if a student has a discipline issue, the teacher and instructional assistants will determine the cause of the behavior issue and act accordingly. If your child is disruptive and disrespectful to the instructor, guests, peers, and materials and supplies, parents will be notified. If this occurs regularly (more than three times) the student may be asked not to return. If the behavioral issue is resulting in an issue stemming from home, we will make special accommodations to meet that individual's needs during the out of school time opportunities. We reserve the right to suspend or terminate a student from the out of school time program immediately, if a student's behavior warrants it. Please refer to the Code of Conduct Handbook on the Parents-Students section the school district webpage or the remainder of this family handbook for more information.
The afternoon program hours are 2:30pm ? 4:30pm Monday through Thursday. We will not be open on non-school days. There won't be morning program on delayed schedule days or afternoon/evening services on early release days. Please read and discuss this family handbook with your child. Then, please sign this form and return it to the out of school time learning center coordinator along with the completed registration forms. The program is based on first come, first serve so return your student application to the front office to be date stamped and recorded. Bus services will be available on Sept. 26th and you will be notified if your child is eligible for transportation.
Student Name
School Parent/Guardian Name (Print) Parent/Guardian Signature
/
/
Date
/
/
Date
Please return this signed form to your 21st CCLC School Coordinator with your 21st CCLC registration forms.
1
STUDENT REGISTRATION
Riverside Elementary School - GISD NMSU STEM Outreach 21st CENTURY COMMUNITY LEARNING CENTER PROGRAM
Student information: Name (First)
(Middle)
(Last)
Preferred Nickname (if applicable)
Grade student will be in during Academic Year 2018/2019
Name of School: Riverside Elementary
Date of Birth
Race (optional)
Age
Gender (select one) Female
Male
Transgender
Mailing Address:
Street
City
State
Zip Code
Parent/Guardian Information:
Name
Parent/Guardian 1 Information
Parent/Guardian 2 Information
(if applicable)
Cell Phone
Home Phone
Work Phone
Email Address
How will your child get home from the program? (select one)
Walk
Parent/Guardian Pick-Up
Bus
Other:
Person(s) authorized to pick up child besides parent/guardian(s)
Name
Contact Phone Number
1.
2.
3.
Signature of Parent or Guardian
Date
MEDICAL AUTHORIZATION FORM Student's name (please print):
2
First
Middle
Last
Person to be contacted in case of emergency: Name Phone
Relationship
Alternate person to be contacted in emergency: Name Phone
Relationship
Please list below any health-related condition the director of the program should know about your child. (Reporting such conditions will not prevent your child from participating and will be kept confidential.) Allergies/food (explain) Allergic to any drug(s) (explain) Diabetes Heart Condition Epilepsy Convulsions Emotional Upsets Asthma Other Conditions?
List below any medication being taken now (including aspirin): Circle any medications that your child will be bringing to the program.
1. 2. 3. 4. 5.
Are there any activities in which the child should not participate?
Are there any physical restrictions?
I, being a person authorized by law to give such permission, do hereby give my permission for emergency medical treatment to be given to the student listed on this form. I understand that all reasonable attempts will be made to contact me as soon as possible after the condition necessitating treatment arises, and, if unable to reach me, all reasonable attempts to contact the alternate listed above will be made. I understand that all reasonable precautions will be taken for safety at all times. I further release 21st Century Community Learning Centers and all persons associated with this organization from any liability associated with any accident, injury or disease to the person who is the subject of this form.
Signature of Parent/Guardian
Date
PARENTAL PERMISSION FORM
3
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