West Intermediate 2012 -2013 School Year

Community Learning Centers

Mt. Pleasa

nt's

Part

ners

Empo

wer

ing

KidsAll

For Office Use Only: Cash/Check #: ___________ RecTrac Receipt #: ___________ Parent Packet Issued:

Parent or Guardian Signature Required for Enrollment Date

PEAK West IntermediateRegistration Form

Child's Last Name: Child’s First Name: M/F:

Date of Birth: / / School (as of 9/6/2012): Teacher: Grade:

Primary Guardian

Email

Address (required)

City State Zip Code

Home Phone ( )

Work Phone ( ) Ext.

Cell Phone ( )

Secondary Guardian

Email

Address (required)

City State Zip Code

Home Phone ( )

Work Phone ( ) Ext.

Cell Phone ( )

Dates Rate

9/8 - 9/10 $10.00/week

Total: (Cash or Check Only Please) $10.00

Total: (Cash or Check Only Please)

EXAMPLE

1. I, the undersigned, parent/guardian having legal guardianship of said minor, give permission to attend any of the PEAK After School activities. Said minor is physically and mentally prepared to participate in all activities as described for said program. I hereby voluntarily and knowingly assume all risks and dangers inherent and incidental to the activities for which I have given my permission and, thereby, will not hold the PEAK Program, Mt. Pleasant Parks and Recreation, or Mt. Pleasant Public Schools liable for any injuries incurred dur-ing these activities.

2. I do hereby grant permission for photos and/or videos of my/our child to be used by the PEAK Program and Mt. Pleasant Parks and Recreation for promotional and educational purposes.

3. I do hereby grant permission for my/our child to participate in PEAK Program surveys and program evaluations.

PEAK After School Frequently asked questions

Who can attend PEAK?Children, grades 7 and 8, will discover the awesome benefits of education, recreation, and service learning through a variety of daily activities: sports, arts, crafts, creative expression, cultural and educational enrichments.

When is PEAK offered?PEAK follows the Mt. Pleasant Public Schools calendar. PEAK will be offered on all full days of school. PEAK is closed on school holidays, snow days, professional development days or early dismissal, scheduled or otherwise.

How much does it cost to attend?There is a weekly rate of $10 for a child to attend the PEAK Program at West Intermediate.

What does the daily schedule look like? Monday – Thursday 2:53 - 3:15 p.m. | Program sign-in/activity sign-up/snack3:15 - 4:30 p.m. | Academic time (required for all students)4:30 - 6 p.m. | PEAK fun activities6 p.m. | PEAK closes

Friday 2:53 - 3:15 p.m. | Program sign-in/activity sign-up/snack 3:15 - 6 p.m. | FUN Friday 6 p.m. | PEAK closes

Is transportation available?Transportation is the responsibility of the parent/guardian. Please have your student picked up by 6 p.m. each day. A late fee will be assessed if the student is not picked up by 6 p.m. The fee is $5.00 per student for the first 10 minutes you are late and an additional $1.00 for every minute thereafter.

What is academic time?Time is set aside for homework assistance Monday-Thursday. Participants who do not have homework will participate in hands-on educational related activities.

Is there a snack provided?The program will provide an afternoon snack each day. If your child has specific food needs, please send your own.

What is a FUN Friday?FUN Fridays consist of special events, movies, assemblies, and local area field trips. All on-site activities are closed when field trips are planned. Participants must attend the field trip or find an alternate activity for that day; the site will be closed. Field trip fees, if any, will be announced in advance.

How do I register?Please return the attached registration form to the main office or the PEAK office at West Intermediate School. Please fill out a separate for each student in your family.

United Way of Isabella County

Contact InformationMonday - Friday 8 a.m. - 4:30 p.m.

Main Office: 779-5331

PEAK partners:

Experience PEAKwww.mt-pleasant.org/PEAK

Enrollment ProcessAdvance registration is required. All enrollments will be taken at the Mt. Pleasant Parks and Recreation Office in City Hall, by mail or walk-in, using the attached registration form. An individual registration form must be completed for each child and submitted prior to attendance. Please allow 48 hours to process your registration.

Late Pick UpYou will be assessed a $5 per child late fee for the first 10 minutes you are late picking up your child(ren) and an additional $1 for every minute thereafter.

Assistance for Special NeedsPEAK provides an educational and fun outlet for people of all abilities. Persons with disabilities needing assistance to participate may call the Parks and Recreation Office at 989-779-5331. Seven day advance notice is necessary for accommodation. Persons requiring speech or hearing assistance may contact the City through the Michigan Relay Center at 1-800-649-3777.

Payment Schedule - Updated from 2011-12 school yearAll payments must be received before services rendered. Payments for the first two weeks are expected at the time of enrollment and will be accepted at PEAK site. After that, payments will accepted (in advance) on a weekly basis. Services must be paid in exact amounts. Check or cash payments are accepted. Past due balances may result in suspension of services. Contact our office at 989-779-5331 to make payment arrangements.

Opting OutYou may choose to opt out of participation in the PEAK program at any time. Please inform the site coordinator at your school if your child will no longer be attending.

Monday - Friday 2 - 6 p.m. Site Coordinator 9 8 9 - 944-3922