Westford Partnership for Children After School Enrichment Program ABBOT SCHOOL SESSION 4: February 29-April 29, 2016

Child’s Name:_____________________________________ Teacher’s Name:_____________________ Grade:______ Best # to Reach:____________________ Name at this #:_____________________ Participation in the WPC program(s) may involve some risk of personal injury. I hereby release and covenant to hold harmless the Recreation Dept., its agents and employees from any and all actions, claims and damages for personal injuries that my child(ren) may have sustained and/or may have incurred as a result of participation in the program(s) for the 2015-2016 school year.

I, _____________________________________ (Parent/Guardian), agree to the above disclosure and have read and understand the WPC Policies listed in the Parent Handbook. Signature:____________________________________Date:______________

FIRST TIME SIGNING UP FOR THE 2015-2016 SCHOOL YEAR? PLEASE FILL OUT ALL OF THE FOLLOWING INFORMATION. FOR RETURNING PARTICIPANTS OF 2015-2016, IF ANY INFORMATION HAS CHANGED, PLEASE UPDATE BELOW.

DOB:____________________ Age:____________ M/F:_________ Allergies/Medical Concerns:________________________________________________________________________________Carries EpiPen®? Y N

Home Address:____________________________________________________________________ Home Phone: ________________________________________ Email: _______________________________________________________

Guardian Name: _________________________________________________ Relationship to Child: ______________________________ Work #: ______________________________ Cell #:_________________________________

Guardian Name: _________________________________________________ Relationship to Child: ______________________________ Work #: ______________________________ Cell #:_________________________________

Alternate Emergency Contact: ________________________________________ Relationship to Child: _____________________________ Home #:____________________________ Cell #:_____________________________

Each Block is $11 Mondays (8) Tuesdays (8) Wednesdays (8) Thursdays (7) Fridays (7) Session Total

Block 1: 2:30-3:45 Includes Snack

Circle one

Homework Homework Homework Homework

TGIF!

Enroll full time (Mon-Fri until 5:45 p.m.) and pay only

$1000/session. If using credit/debit card, pay either full

amount or $500/month.

Credit/debit card payments & Annual Enrollments must

submit WPC Charge Card Authorization

Form.

Flag Football Sports Mixer Soccer Floor Hockey (limit 14)

Simple Sewing (add $20)

LEGO® Mania Creation Station: Robotics

(add $165; limit 10) EFK: Mechanical

(add $145; limit 22)

Block 2: 3:45-4:45 Please circle which activity you would like your child to

participate in

Homework Homework Homework Homework TGIF! Thank goodness it’s

Friday! Choice activities include crafts, sports &

games, educational programming, & more!

Capture the Flag Basketball Snow Much Fun Dodgeball

Brain Games Trivia Newsflash Beading

General Art Creative Science

(add $20) No-Bake Cooking

(add $20) Build and Design

Block 3: 4:45-5:45

Room 1 Gym Room 1 Gym Room 1

Multiply $11 by # of blocks child is

attending

Daily Total:$__________

Daily Total:$__________

Daily Total:$__________

Daily Total:$__________

Daily Total:$__________

Multiply daily totals by # of days

Subtotal (Daily Total X 8):

$__________________

Subtotal (Daily Total X 8):

$__________________

Subtotal (Daily Total X 8):

$__________________

Subtotal (Daily Total X 7):

$__________________

Subtotal (Daily Total X 7):

$__________________

Block Total:

$ ___________

10% Sibling Discount part time only

-____________

*Activity/Late Fee(s) +_______

TOTAL DUE: $____________

Westford Partnership for Children After School Enrichment Program

Abbot School

Session 3: January 2-February 28, 2014

Westford Parks & Recreation PO Box 2444

35 Town Farm Road Westford, MA 01886

P: 978-692-5532; F: 978-392-4471 www.westfordrec.com

“In with the new…”

Sibling Discount Part time participants are granted a 10% sibling discount

for the 2nd & each successive sibling registered for equal

or lesser value.

*Discount does not apply to additional blocks or activity fees.

SESSION 3 SCHEDULE NO SCHOOL/NO WPC

*Jan. 20: Martin L. King Day *Feb. 17: Presidents’ Day

SPECIAL PROGRAMS *Feb. 18-21

Full-day programs offered

PLEASE NOTE: Beginning this session,

registration forms will be due by 6:00p.m.,

ONE WEEK prior to your child’s start date.

Activity Descriptions

Make a World of Difference: Give a little of your time being helpful around the school by recycling, cleaning up & other important tasks that make a positive impact. Computer Lab (limit 10): Play educational games, take virtual field trips & complete internet scavenger hunts from a list of approved, appropriate websites. Creative Corner: Show off your artistic side by creating cool drawings & funky projects. Tae Kwon Do (limit 20): A non-violent modern martial arts form from Korea, training the mind & body. Uniform included. Lego® Mania: Let your imagination run wild while building unique & intricate Lego® creations! Outdoor Fun: Have fun in the sun &/or snow! Appropriate outerwear including coat, gloves & hat is required. TGIF: A time to unwind! Activities include crafts, sports & games, educational programming, & more!

SESSION 4 SCHEDULE

EARLY RELEASE/NO WPC *April 18: Early Release

SPECIAL PROGRAMS

*March 13: Conferences *April 8: Prof. Development *April 21-25: Spring Break Full-day programs offered

For Office Use Only: COPIED

Date Rec’d:______/________ Rec’d:_______:_______ a.m. p.m.

Rec’d By:____________________ from _________________________

Processed By:____________________ on__________/__________

Notes:

Westford Partnership for Children After School Enrichment Program

Abbot School Session 5: May 5 – June 18, 2014

METHOD OF PAYMENT

Check: Payable to “Town of Westford”- CK#______________ Cash

Credit/Debit Card (Rec. Dept. must have WPC Charge Card Authorization Form on file) - Please check the appropriate box below:

Pay the full amount now Pay two equal installments *Activity/late fees are included in 1st payment Annual Enrollment

Signature: ___________________________________________________________________________________________ Date: _______________________________________

Start Date: _____________________

Forms released on February 8, 2016

Westford Parks & Recreation PO Box 2444

35 Town Farm Road Westford, MA 01886

P: 978-692-5532; F: 978-392-4471 www.westfordrec.com

Westford Partnership for Children After School Enrichment Program

Abbot School Session 4: February 29–April 29, 2016

ACTIVITY DESCRIPTIONS Snow Much Fun: If there’s snow, we’ll be playing in it; snow forts, snow men, snow much fun! Must have appropriate snow gear including a coat, snow pants, gloves, hat, & boots. No-Bake Cooking (add $20; limit 15): Make yummy snacks & learn about fractions, kitchen safety, & hygiene. NOT RECOMMENDED FOR CHILDREN WITH FOOD ALLERGIES. Intermediate Creation Station: Battle w/ Sumobots (add $165; limit 10; 2:45pm-3:45pm): If you participated in Battle w/ Sumobots during Session 3 & are already familiar w/ LEGO® Mindstorms EV3 kits, you’ll learn higher level robot building techniques; building complex robots & systems that can sort color blocks, balances, & react to surroundings. The session will culminate w/ building & programming a pick & place robot challenge: “Who can pick first?” Beginner Creation Station: Battle w/ Sumobots (add$165; limit 10; 2:45pm-3:45pm): Use LEGO® Mindstorms EV3 kits to learn the basics of robotics, computational thinking, collaboration, & team work. Also learn the concepts behind motors, sensors, robot navigation, & building attachments to solve challenges that include navigating a maze & moving uphill. We’ll finish up w/ the building of a robot to battle against other robots in a Sumobot Challenge! Build & Design: Build with a variety of LEGO®, Tinker Toys, Lincoln Logs, Knex, recyclables, etc. E .F. K: Mechanical Engineering (add $145; limit 22; 2:30pm-3:45pm): Use the Engineering Design Process to design, create, test, & improve a variety of machines & mechanical systems while learning the basics of energy, traction, aerodynamics, & durability while constructing roller coasters, eggstreme defense vehicles, & an incredibly fast air-powered custom dragster. Simple Sewing (add $20): We will create no-sew blankets! Brain Games: Play some of the games that take a bit longer & use your noggin; including Settlers of Catan, Monopoly, Apples to Apple, Scrabble, etc. Newsflash: Help create WPC’s newsletter so you will know what is new & happening here at WPC. Bead Mania: Fuse beads, jewelry beads, all things beads!

Sibling Discount Part-time participants are granted a

10% sibling discount for the

2nd & each successive sibling

registered for equal or lesser value.

*Discount does not apply to full-time

participants, additional blocks, or

activity fees.

How To Register Fax: Those who have a WPC Charge Card Authorization Form on file may fax completed registration forms to 978-392-4471.

Mail: Complete form, include check and/or WPC Charge Card Authorization Form & mail to: PO Box 2444, Westford, MA 01886 Walk-In: Registrations & payment accepted Mon-Fri, 8am-4pm. After hours: use mail slot in front door.

No forms will be accepted by sites/staff. No emailed registration forms will be accepted.

Registration forms & payment must be received by noon, one week prior to start date. Late forms incur a $25 late fee. NO EXCEPTIONS. Payment MUST include late fee/no registration fee(s) if applicable.

WPC POLICIES AT A GLANCE •You must register for at least 1 block, 1 day a week for the entire session. We do not allow any withdrawal/switching of days. •No credits/refunds will be given for inclement weather, illness, absences or other conditions beyond the control of the Rec. Dept. •Forms must be submitted by noon, 1 week prior to start date. Late forms incur a $25 late fee. NO EXCEPTIONS. Children who attend program w/out being registered for that session will pay $15/day in addition to the late fee, as well as daily block fee(s). A child is registered only after form & payment have been received & processed by the Rec. Dept. •Each child must have a Child Info Form filled out by a parent/guardian & submitted to Rec. Dept. prior to start date. •Absences must be reported to the Rec. Dept. by noon that day, or you will incur a $10 finder’s fee. After three occurrences, the fee will increase to $15. Absentee lists are not relayed to us. •If someone other than those listed as authorized to pick up your child will be picking them up, we must be notified in writing. •You are expected to pick up your child(ren) promptly after their scheduled block ends or they will be placed in the next block & you will incur the full block fee of $11. You will be charged $1/minute after 6 p.m. After three occurrences, the fee will increase to $2/minute & you will be asked to schedule a meeting w/ the WPC Director. •Charge card payments can only be made by submitting a WPC Charge Card Authorization Form. Any additional blocks/days you would like to add to your child(ren)’s schedule must be paid via credit/debit card. For a full list of our policies and procedures, please refer to the

WPC Parent Handbook which can be found at www.westfordrec.com

SESSION 4 SCHEDULE

NO WPC March 25: Good Friday

NO SCHOOL/SPECIAL PROGRAMS *March 10: K-5 Conferences *April 18-22: Spring Break Full-day programs offered

EARLY RELEASE *March 17: Prof. Dev. *April 13: Prof. Dev.

Early release days are included as a regular registration day.