Continuing Ed Fall 2011

FREQUENTLY ASKED QUESTIONS

How do I contact the office?The phone number for the Continuing Education Office is 592-3125.

How do I register?Register by mail immediately. Using a separate registration card for each course inwhich you wish to enroll. Enclose a separate check for each course, made payableto Half Hollow Hills CSD, unless otherwise noted. Cash cannot be accepted. Mailregistration card with any required fee to: Office of Continuing Education, HalfHollow Hills Schools, 50 Vanderbilt Parkway, Dix Hills, NY 11746.

What if I cannot attend a class that I am registered for?Please notify the office as soon as possible. Many classes have waiting listsand someone else may attend the class in your place.

Can I register online?No, but you can view the current brochure at the District website,www.hhh.k12.ny.us.

What is the refund policy?No refunds will be made unless the class is canceled. Once classes have begun,only a credit slip can be issued. If it is necessary to cancel a class, your check will be returned.

How do I know my registration has been accepted?No letters of confirmation are sent. Registrants will be notified if a class iscanceled for any reason.

What if aclass is notheld on ap a r t i c u l a rnight?W h e n e v e rinclement weathercauses the closingof District schools,there will be noclasses held thatevening. Listento WBAB-FM orWALK-AM forclosings or callthe office and listento the recordedmessage. In theevent that aninstructor has tocancel a session,he/she will notifythe students. Noclasses will be heldon legal holidaysor during schoolholidays.

Who may attend continuing education classes?Adults over the age of 18 years may register for these classes.

What about senior citizens?Citizens who are over 60 and reside in Half Hollow Hills Central School DistrictNo. 5 are invited to register for our courses at no fee, with the exception of outsideagencies that charge a “per-person fee.” These are designated as no senior discountcourses. A copy of your District Gold Card need only be submitted once in order toattend classes at no charge, and will be kept on file. Gold Cards may be obtained atthe Manasquan building. Call Mrs. Marini at 592-3013 for more information.Material fees MUST be paid by each student. Please note that non-resident seniorsmay pay the lower “resident fee.”

Where are the classes held? All classes are in the High School East building, unless noted otherwise. A daily listof classes and map is displayed at the Continuing Education Office. Maps of theschool are available upon request.

MEDICAL ADVISEMENT:We strongly advise that you consult your physician before undertaking any programinvolving strenuous physical activity. Participation in any class and/or activity is atyour own risk. For each of our “Sports and Movement” classes, you or yourphysician must first sign the form enclosed in the bulletin to verify your general goodhealth and ability to participate in the activity without risk.

C E N T R A L S C H O O L D I S T R I C Twww.hhh.k12.ny.us FALL 2011

Continuing Education Guide

Attention Half Hollow Hills Seniors!(those 60 and over)

Apply now for a District Gold Card and obtain free admission to District-sponsored athletic events, concerts, plays and most Continuing Education

classes! Apply for your Gold Card at the District Clerk’s Office at theManasquan building, Monday through Friday from 10 am to 1 pm.

CONTINUING EDUCATION CLASS CALENDAR FALL 2011Please use this calendar as a reference throughout the session.

KEY: * first night of classes, unless noted otherwise in the brochure.The gray shaded area indicates that there will be no classes held on these nights.

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Monday

Tuesday

Complete Financial Management WorkshopThis in-depth course, which has been taught nationally at universities, as well as Fortune 500companies, will help you establish a written financial plan for your retirement. Topicsinclude stock, bonds, mutual funds, asset allocation, Social Security, Medicare, long termcare, estate planning strategies, pension plans, IRA’s, insurance and more. A comprehensiveworkbook, which will be a valuable resource for the rest of your life, is included in the fee.An optional personal financial analysis plan is also included. This plan may help you reducetaxes, establish retirement income, and enhance investment returns.You may bring a guest with you at no extra cost.Tuesdays 4 sessionsBegins October 11th 7:00-9:30 pmInstructors: Alex DiMartini, Jr., Financial Advisor

James M. Rosica, Financial Advisor Gerald DeMeo, Financial Advisor

Room 101Fees: Regular: $45

Out of district: $50There is no senior discount for this class.A $25 material fee made payable to Emerald Publishing will be collected at thefirst class.

Debt Free LifestyleGet completely out of debt including your mortgage! Owe nothing to anyone! Thisworkshop is designed for MIDDLE CLASS families and individuals who want to live a

stress-free, debt free lifestyle. How would you like to pay off all your consumer debt, creditcards, car payment, etc., in one to three years? Then pay off your 30 year mortgage inanother three to four years, saving thousands of dollars in interest along the way? You cando this with your current income. LEARN SPECIFIC, POWERFUL AND TIME PROVENSTRATEGIES THAT WORK-EVERY SINGLE TIME. This workshop will help youeliminate all your debt and then operate 100% on cash never needing credit again. Bring alist of your debt (for your viewing only) with balances and monthly payments) principle andinterest only for mortgage). During the class you will begin to develop your own debtelimination plan that can be implemented into your lifestyle. Please bring a pocketcalculator to class.Wednesday 1 sessionNovember 16th 7:00–10:00 pmInstructor: Robert ZambitoRoom 201Fees: Regular: $14

Out of district $17

How to Manage your 401k or 403b Moneyin Today’s MarketYour company has provided you with a retirement plan that you can contribute your hard-earned money into and be able to someday retire comfortably. But your company does verylittle when it comes to helping you invest that money in the mutual funds available in yourretirement plan. This two session course will show you some simple yet effective techniquesthat anyone can use to make sure their money is being invested properly in their 401k or403b plans. All class participants are asked to bring to session 1, a complete list of themutual fund choices available in the company’s retirement plan. You will receive a detailedreport on which mutual funds you should be investing in at the end of session 2.Wednesdays 2 sessionsOctober 5th & October 12th 7:00-8:00 pmInstructor: Paul PitsironisRoom 105Fees: Regular: $22

Out of district: $27

How to Pay for College without Going BrokeDiscover how you can literally save yourself thousands of dollars when sending your childoff to college! This workshop teaches parents the best-kept secrets of getting the mostmoney possible, providing guaranteed secrets that most others would prefer you never foundout! The truth about college funding and financial assistance programs will provide you withthe right knowledge when you are ready to fill out applications. Avoid the costly mistakesso many others make. Discover how to help your child choose the right college and actuallypay for your child’s education without going broke.Tuesday 1 sessionOctober 11th 7:30-9:30 pmInstructors: Jan & Tony EspositoRoom 111Fees: Regular: $14


Financial Planning

WednesdayFa l l 2011 C lasses byDay/N ight

Adults in Transition Beginner’s Ballroom DancingFitness First

Intermediate Ballroom DancingOpen Gym Basketball

Aerobics and/or Power WalkingBeginner’s Acrylic

or Watercolor PaintingBeginner’s YogaBoating Skills and SeamanshipChair YogaChange your Thinking/

Change your Life…Learn How to Live your Best Life Possible

Complete Financial Management Workshop

Crochet for BeginnersHow to Pay for College without

Going BrokeUsing your Exchange-Traded Funds

in your Investment PortfoliosNYS Young Boater’s CourseTai Chi/Health Guidance

ThursdayAerobics and/or Power WalkingBeginner’s Spanish (Part 2)Exploring the Fall SkiesExploring the Winter SkiesIntroduction to Stocks and Bonds

Notary Public Training CourseNotary Signing Agent CoursePreserving your Wealth in RetirementSpanish II (Part 1)

Boating Skills and SeamanshipCrochet for BeginnersDebt Free LifestyleFitness FirstGentle YogaHow to Manage your 401k/401b

in Today’s Market

How to Sell Items using eBayIntermediate Acrylic

or Watercolor PaintingNYS Young Boater’s CourseYuangi Energy Music

Therapeutic Dance

SaturdayDefensive Driving

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Continuing Education GuideContinuing Education Guide

Fine Arts and Crafts

Introduction to Stocks & BondsTo have complete knowledge and awareness of how the market works, people need a greatdeal of information. We will discuss stocks and bonds in a clear, concise way, whatinvestments are, and issues of how supply and demand affect you and the market. Learn howto analyze Standard & Poor’s reports, and the risk/reward tradeoff.Thursdays 6 sessionsBegins October 27th 7:30-9:30 pmInstructor: David Gustin, AAMSRoom 201Fees: Regular: $55


Preserving Your Wealth in RetirementAsset allocation and diversification need to be constantly monitored, and assets need to beprotected and preserved. This one session course will deal with this topic as well as otherfinancial issues in a clear, concise way.Thursday 1 sessionOctober 6th 7:30-9:30 pmInstructor: David Gustin, AAMSRoom 201Fees: Regular: $14


Using Exchange Traded Fundsin your Investment PortfoliosExchange Traded Funds (ETF’s) provide a unique approach to investing that the averageinvestor can take advantage of. In this two-session course, we will cover the details of howExchange Traded Funds work and how you can use them in your investment portfolios.Tuesdays 2 sessionsOctober 4th & October 11th 7:00 – 8:00 pmInstructor: Paul PitsironisRoom 109Fees: Regular: $22


Beginners Acrylic or Watercolor PaintingThis course will give you all you need to produce beautiful watercolor and acrylic paintings.We will explore color mixing, drawing perspectives, and creative seeing. On the first nightof class, bring pencil, paper and your imagination.Tuesdays 8 sessionsBegins October 4th 7:00-10:00 pmInstructor: Anna HorehladRoom 555Fees: Regular: $55


Crochet for Beginners-Tuesday Maximum 12In this beginner crochet class you will learn how to chain and make single and doublecrochet stitches. Make new friends and have fun creating your own beautiful blanket. Onthe first night of class bring a “J” crochet hook and one skein of medium weight yarn.RIGHT HANDED CROCHETERS ONLY.Tuesdays 6 sessions

Begins October 4th 7:00–9:00 pmInstructor: Debbie PolidoraRoom: HSE LibraryFees: Regular: $47


Crochet for Beginners-Wednesday Maximum 12In this beginner crochet class you will learn how to chain and make single and doublecrochet stitches. Make new friends and have fun creating your own beautiful blanket. Onthe first night of class bring a “J” crochet hook and one skein of medium weight yarn.RIGHT HANDED CROCHETERS ONLY.Wednesdays 6 sessions

Begins October 5th 7:00–9:00 pmInstructor: Debbie PolidoraRoom: HSE LibraryFees: Regular: $47


Intermediate Acrylic and Watercolor PaintingThis course is for those who have taken acrylic and watercolor for beginners. It willcontinue with color theory and painting exercises. Some abstract painting is included alongwith traditional paintings. You must have attended beginning watercolor and acrylic or talkto the teacher about taking this course. Bring all paints and other equipment from previousclasses to the first night of this class. Those who have taken intermediate painting before arewelcomed back.Wednesdays 8 sessionsOctober 5th 7:00-10:00 pmInstructor: Anna HorehladRoom 555Fees: Regular: $55


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Adults in TransitionThis course is designed to provide the opportunity for self-exploration and understanding and tosupport the development of a life, career and educational plan. Exercises and discussions willfocus on adult issues such as adult development through the life cycle, transitions, careerexploration and development, life pattern differences between men and women, values and thecreation of meaningful, realistic goals.Mondays 2 sessionsOctober 17th & October 24th 7:00-8:30 pmInstructor: Jean Nobile, MBARoom 101Fees: Regular: $21

Out of District: $26

Change your Thinking/Change your Life…Learn How toLive your Best Life PossibleThis course will teach you how to use the inherent power of your mind to create positiveoutcomes in your life. Learn how to program your subconscious mind to create a powerful beliefsystem by using specific mental tools that will empower you to choose thoughts of strength inall situations. This course will help you improve your confidence and self-esteem, as well as,help you improve performance in areas of your life. A MUST course for those seeking to livetheir best life possible. Tuesdays 3 sessionsBegins October 4th 7:30 - 9:00 pmInstructor: Glenn PoveromoRoom 203Fees: Regular: $33


Personal EnrichmentExploring the Fall Skies Maximum of 30As the nighttime hours grow long, we are left with the brisk coolness of fall. The skyfills with the wonderful constellations of Pegasus, Andromeda and Cassiopeia, all partof the great Myth of Medusa. The Big Dipper slowly sinks into the western glow ofsunset, as do the stars of Sagittarius. As Venus begins to enter the early evening sky inthe southwest, it draws closer to the planet Jupiter. Both are seen in the early eveninghours. Why not spend an evening beneath the stars of Half Hollow Hills planetarium,and witness the beauty of the Fall Skies.The entire family is encouraged to attend. This program is intended for families withkids 3rd grade and up. Thursday 1 sessionOctober 6th 7:30-9:30 pmInstructor: Tom Affatigato HSE PlanetariumFees: Regular: $11 individual or $15 per family

Out of district: $13 individual or $17 per family

Exploring the Winter Skies Maximum of 30“With the realization that I miss the show, while snug within my cave, it is only when Iventure into the cold that I experience this gift.” Chris McClurePerhaps there is no night sky more beckoning than that of winter. That great ancienthunter Orion leads his entourage onto the cold stage of the winter sky. One of his wintercompanions, Canis Major (the large dog), contains the brightest of all stars, Sirius. Wealso see the prominent zodiacal stars of Taurus and Gemini flanking the great hunter. Theearly evening sky features the planets Jupiter and Venus close together in a celestialdance low in the southwest. Why not spend an evening beneath the stars of the HalfHollow Hills planetarium, and witness the beauty of the Winter Skies.The entire family is encouraged to attend. This program is intended for families withkids 3rd grade and up. Thursday 1 sessionDecember 1st 7:30-9:30 pmInstructor: Tom Affatigato HSE PlanetariumFees: Regular: $11 individual or $15 per family

Out of district: $13 individual or $17 per family

How to Sell Items using eBayTurn your household items into cash by selling them on eBay, one of the nation’s largeston-line auction houses. This class is designed to teach you all the steps required to listand sell items on eBay, including: authorization number set-up, uploading photographs,information to include in your item’s description, settling your auction, correspondence,shipping arrangements, pricing, choosing your item’s category and feedback.Course includes a take-home, step-by-step guide covering pertinent class topics anda sample auction from beginning to end. Items virtually sell themselves. Sit back andenjoy the income.Wednesday 1 sessionNovember 9th 7:00-10:00 pmInstructor: Dina Elardo, MBARoom 707Fees: Regular: $55

Out of district: $57There is no senior discount for this course.

Notary Public Training CourseStand out among the competition! Add a new certification to your resume and be an assetto your company by enhancing your credentials! All companies need to have documentsnotarized. The objective of the Notary Public Training course is designed to educateindividuals with the legal terminology, concepts and clauses contained in the frameworkof the NYS Notary Public Exam. Price includes: Supplemental study guide, NotaryFact sheet, Practical exam, National Notary Organization pamphlets and brochures,Sample forms, Notary Public Application, NYS exam schedule and booklet, lifetimemembership to Notary Public Central & LEGAL UPDATES. Students are required tobring a pen and/or a highlighter. Commissioned notaries are always welcome to attend.Thursday 1 sessionNovember 3rd 7:00-10:00 pmInstructor: Dina Elardo, MBARoom 305Fees: Regular: $55


Notary Signing Agent CourseDiscover a rewarding career as a Notary Signing Agent in the Lending Industry! Beyour own boss either part-time or full-time. This course is designed to equip you withthe essential skills you will need to properly perform Loan Document Signings.Topics covered include: document preparation, identifying documents in a loanpacket and the various loan types, proper execution of documents, what is expectedof the Signing Agent (your responsibilities and limitations thereof), lender lingo,identifying individuals, current industry trends, and where and how to find work.(Signing Companies will be provided as possible leads.) *Fee includes a full yearplacement on our website’s Signing Agent section and a full take-home packet.

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Pre-requisite: Be a Commissioned New York State Notary Public or have at least attendedor completed a Notary Public Training Course prior to taking this course.Thursday 1 sessionNovember 10th 7:00-9:00 pmInstructor: Dina Elardo, MBARoom 305Fees: Regular: $60


Spanish I – Beginner’s (Part 2)The course is for students who have recently completed the Beginner’s Spanish (Part 1)class and wish to continue to learn more basic grammatical concepts while improvingspeaking, pronunciation, reading and writing skills. Also great for those who wish to reviewand improve basic skills and build upon them.Thursdays 8 sessionsBegins October 6th 7:30-9:00 pmInstructor: Elizabeth AdamsRoom 203Fees: Regular: $75

Out of District $80Instructor will collect a $6 workbook fee at the first class.

Spanish II – (Part 1)This course is for students who have recently completed Beginner’s Spanish and wishto continue to learn more basic grammatical concepts while improving speaking,pronunciation, reading and writing skills. Also great for those who wish to review andimprove basic skills and build upon them. Thursdays 8 sessionsBegins October 6th 6:00-7:30 pmInstructor: Elizabeth AdamsRoom 203Fees: Regular: $75

Out of District $80Instructor will collect a $6 workbook fee at the first class.

Sports and Movement

from weddings, parties and other social occasions, ballroom dance clubs, Latin and swingclubs and discos. Beginner classes will work on developing posture, dance frame, technique,movement and basic dance steps. The curriculum includes Smooth (Waltz, Foxtrot, Tango),Latin (Rumba, Cha Cha, Salsa/Mambo, Meringue), and Rhythm (Swing and Hustle).Couples and singles of all ages are welcome. Mondays 8 sessionsBegins October 3rd 8:00-10:00 pmInstructors: Phyllis HintzeCafeteria AFees: Regular: $75 per couple, $38 single

Out of district: $80 per couple, $40 single

Intermediate Ballroom DancingBallroom Dancing is a rewarding experience that promotes both physical and mental health.The intermediate class is available for those with previous dance experience. Students willenjoy learning more advanced dance concepts and skills while engaging your body inaerobic activity and building self-confidence. With continued practice, you will soon becomfortable in any dance venue from weddings, parties and other social occasions, ballroomdance clubs, Latin and swing clubs and discos. Intermediate classes will work onmore advanced technique and movement concepts while incorporating more challengingdance steps and amalgamations. The curriculum includes Smooth (Waltz, Foxtrot, Tango,Quickstep, Viennese Waltz), Latin (Rumba, Cha Cha, Salsa/Mambo, Meringue, Samba),and Rhythm (Swing and Hustle). Specific material covered will depend on student interestand ability.Couples and singles of all ages are welcome. Mondays 8 sessionsBegins October 3rd 6:30-8:00 pmInstructors: Phyllis HintzeCafeteria AFees: Regular: $60 per couple, $30 single

Out of district: $65 per couple, $33 single

Fitness FirstThis is an entry level exercise class for individuals of any age who have never exercised orhave not exercised in a long time. The class consists of low impact cardio, stretching,strength training, balance and flexibility. Exercises can be done from a standing or seatingposition. Wear comfortable clothing, and bring a water bottle, light weights (2 to 5 lbs.) anda 6 to 9 inch ball. Mondays & Wednesdays 16 sessionsBegins October 3rd 7:00-8:00 pmInstructor: Malinda Dobrins - Cert. Health Fitness InstructorCafeteria B/CFees: Regular: $70


Open Gym Basketball Minimum of 12 to runthe program Maximum 30

Full court and/or half court basketball games will be played. Open gym and pick-up games encouraged.Mondays 8 sessionsBegins October 3rd 8:00-10:00 pmInstructor: Deborah SorgHSE - West GymFees: Regular: $50


Aerobics and/or Power WalkingWeather permitting, the outdoor track is used exclusively for the entire 60 minutes of classwhich will cover 3.0 miles of walking. Weather not permitting, the class will take a brisk 40minute walk, within the perimeters of the building, which will cover approximately 2.0 milesfollowed by 20 minutes of intense strength training exercises for the arms, legs and abdomen.Instructor is A.F.A.A. certified.Tuesdays and Thursdays 16 sessionsBegins October 4th 6:30-7:30 pmInstructor: Joanne EisenbergCafeteria B/CFees: Regular: $70


Beginners Ballroom DancingBallroom Dancing is a rewarding experience that promotes both physical and mental health.Whether you are a beginner or already have some dance experience, you will enjoy learningbasic dance concepts and skills while engaging your body in aerobic activity and buildingself-confidence. With continued practice, you will soon be comfortable in any dance venue

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Chair Yoga Maximum of 30Yoga practice sitting in a chair. Learn how to get the kinks out while sitting at your desk orfor those with less mobility. No prior yoga experience required. Wear comfortable loosefitting clothing and please do not wear perfume to the class. It is recommended that you donot eat a heavy meal for 2 hours prior to the class.Tuesdays 8 sessionsBegins October 4th 6:30-7:30 pmInstructor: Susan CameanCafeteria AFees: Regular: $60


Gentle Yoga Maximum of 30Contact the yoga movements with the breath and connect the postures at a gentle pace.Wear comfortable loose clothing and please do not wear perfume to the class. It isrecommended that you do not eat a heavy meal for 2 hours prior to the class. Bring a yogasticky mat and a yoga blanket. If you would like to purchase a mat or blanket, [email protected] to order.Wednesdays 8 sessionsBegins October 5th 6:30-8:00 pmInstructor: Susan CameanStudent CenterFees: Regular: $60


Yuanji Energy Music Therapeutic DanceA special Yuanji Energy Music is designed for each of the five Yuanji therapeutic dances.This kind of music harmonizes and energizes one’s mind, heart, body and energy systemsand uplifts one’s spirit. The graceful movement along with the peaceful music helps tostrengthen the immune system. The movement balances the body’s organ systems (yin-yang.) The steps are easy, lively and are fun to do. They can also be adjusted according tothe individual’s physical and/or health conditions. One can choose which dance or whichsections of a particular dance to do at a time. The dances can be practiced by a group andindividually. Now including the Fan Dance (Tai Chi Fan.)Wednesdays 8 sessionsBegins October 5th 7:30-9:30 pmInstructor: Lucille ChangCafeteria AFees: Regular: $55


Sports and Movement

Tai Chi/Health GuidanceLearn the art of Tai Chi, which combines meditation with a series of slow body movementsthat are designed to reduce stress. Coupled with the Tai Chi are discussions and assistancetowards implementing a healthier lifestyle. Come have fun; learn at your own pace, andallow Tai Chi to reveal its various benefits.Tuesdays 8 sessionsBegins October 4th 7:00-9:00 pmInstructor: M.J. KalischewskiStudent CenterFees: Regular: $50


YOGA – 3 Variations

Beginner’s Yoga Maximum of 30Learn the yoga poses and basic practices. Start from where you are and learn to practice thepostures. No prior yoga experience required. It is recommended that you do not eat a heavymeal for 2 hours prior to the class. Bring a yoga sticky mat and a yoga blanket. If youwould like to purchase a mat or blanket, contact [email protected] to order.Tuesdays 8 sessionsBegins October 4th 7:30-8:30 pmInstructor: Susan CameanCafeteria AFees: Regular: $60


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The following courses are presented in cooperation with the U.S. Coast Guard AuxiliaryFlotilla 22-01. There is no senior citizen discount.

Boating Skills and SeamanshipThis class is designated for those over the age of 18 who are either interested in brushingup on their existing skills, or who have not previously taken a boating course. The areas tobe covered include: seamanship techniques, personal safety for crew and passengers, boathandling, rules of the road, the latest federal boating regulations and general legalrequirements, weather, radio/telephone use, knot tying and other subjects. Most insurancecompanies recognize this course and will provide a 10% discount on boat insurance uponcompletion of the class.New York State has enacted legislation that requires all operators of Personal Watercraft(PWC) to have completed a course such as our adult Boating Skills and Seamanship, or elsethey will be in violation of the law. Persons who have not completed the course will not beallowed to operate a PWC until they have successfully completed the course and have beenissued a certificate.Tuesdays and Wednesdays 6 sessionsBegins October 25th 7:30-9:30 pmRoom: 703Fees: $59 payable to USCGA Please call to register directly with the USCGA at 631-586-1456.

NYS Young Boaters CourseThis course is mandatory throughout the state for young persons, 18 years and under, whodesire to operate any type of propelled boat in the waters of New York State. Uponcompletion of the course, students will be given a certificate of completion as well as awallet-sized card, which must be in the young boater’s possession when operating a vessel.Tuesdays and Wednesdays 6 sessionsBegins October 25th 7:30-9:30 pmRoom 701Fees: NonePlease call to register directly with the USCGA at 631-586-1456.

Boating

Defensive DrivingEmpire Safety Council’s Defensive Driving CourseThis 6-hour course is open to all drivers, including high school students, 16 and older.Upon completion of this course, you will be eligible for a discount on your collision andliability insurance premiums for 3 years. This is in addition to the discount received forcompleting a certified Driver Education program. Upon completion, a certificate will bemailed to you which can be presented to your insurance company.

Choose from nine different dates. (ALL CLASSES ARE HELD AT HS EAST)

Class #1 8:00-2:00 pmSaturday, September 24th Lecture Hall

Class #2 8:00-2:00 pmSaturday, November 5th Room 705

Class #3 8:00-2:00 pmSaturday, December 3rd Room 705

Class #4 8:00-2:00 pmSaturday, January 21st Lecture Hall

Instructor: Bob D’AgostinoFees: $50Please make checks payable to “Empire Safety Council”There is no senior citizen discount for this class.

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Course Night

Name

Telephone

Address

Town Zip Code

I understand that I am enrolling in a class that involves strenuousphysical activity and that I am participating at my own risk.

Signature

Date

Physician’s signature (optional)

Date

Fall 2011Continuing Education Registration Form

(Please Print)

Fall 2011Office of Continuing Education

Medical Liability Release Form - Required for All Sports and Movement Classes

(Please print information and sign below)Course Night

Name

Telephone

Address

Town Zip Code

Check #

Are you a resident of HHH? Yes No

Are you a senior citizen? Yes No

Do you have a HHH Gold Card? Yes No

Please send a separate check for each course (payable to Half HollowHills CSD) with this completed card to:

Office of Continuing EducationHigh School East50 Vanderbilt ParkwayDix Hills, New York 11746

Registration and Medical Liability Forms for Continuing Education Enrollment

Course Night

Name

Telephone

Address

Town Zip Code


Signature

Date


Date


(Please Print)




Name

Telephone

Address

Town Zip Code

Check #






Course Night

Name

Telephone

Address

Town Zip Code


Signature

Date


Date


(Please Print)




Name

Telephone

Address

Town Zip Code

Check #






Documents

Continuing Ed Fall 2011