bethel community services - MMSD Communications

2013 - 2014
Registration Deadline: October 4th
START DATE: Tuesday October 8th
INFORMATION FOR PARENTS/GUARDIANS
(Please save these instructions for future reference)
Bethel Community Services (BCS), the
Social Branch of Bethel Lutheran Church,
offers
recreational
and
tutoring
st
afterschool at no cost, for kids 1 to 5th
grade residing
in
the
Southdale
(Granada)
neighborhoods.
and
Moorland
Rd
Program Mission
Eagle’s Wings is dedicated to encourage
good character qualities in children as a
foundation to succeed in school and life.
Through real life stories, inspiring role
models and a variety of enrichment
activities like art, group discussions,
service projects, etc, we provide the
children with the necessary tools to make
positive life choices.
We are also committed to help our
students to grow academically through
the reinforcing of grammar and math
learned in school.
Program Highlights
The program runs every Tuesday,
Wednesday and Thursdays from 3:30 to
6:00 pm.
Classes are held for the entire academic
year at Bethel Lutheran church and
Transportation is provided from Frank
Allis and Nuestro Mundo to Bethel
Lutheran Church, and from Bethel to 4
different Bus Stops in Southdale
(Granada) and Moorland Rd.
Registration Process
To register a child, a parent/guardian has
to fill out the form included in this
package and turn it in to the School
Office. Once the Registration form has
been returned to us, you will be called
and confirmed that your child is
registered. No child can start the club
before
we
have
contacted
the
parent/guardian, so please, make sure to
give us the right phone number to call.
If you do not have a phone number,
provide a safe one where we can leave a
message. We will use that phone number
to let you know your child is registered.
Along with the registration form, you have
to sign the waiver part if you agree on we
collect only academic information from
your child’s teacher. This information will
be used to see the child progress and
evaluate whether our program is helping
your child or not. This also will allow us to
develop a better program.
Program Policies:
Attendance: Every child registered is
expected to attend the program every
day. If your child will not be able to
attend the afterschool you must notify us
at 257-3577.
If your child does not attend twice in a
month without notifying us, he/she will
lose his/her spot. NOTE: There is not
afterschool on not-school days or if there
is any early release on a Tuesday,
Wednesday or Thursday.
Transportation and Parent Pick-up
Kids will be transported from Allis
Elementary/Nuestro Mundo School to
Bethel Lutheran Church, and from Bethel
to 205 Deer Valley Rd at Southdale (In
front of Joining Forces for Families).
The Bus will leave Bethel between 6:00
and 6:05 pm and expect to be at the Bus
stop at around 6:20pm. It is fundamental
for us that your child arrive home safe, so
we encourage you to pick your child up at
that bus stop. If you are not able to do
this and you allow your child to walk home
from the bus stop, you must sign the
waiver
part
on
the
bottom
of
registration form. If you wish to pick up
your child at church you must notify
Yolibeth (577 8306). Kids are not allowed
to go home themselves from church or to
be picked up by somebody else than the
parent signing the registration form.
Behavior Expectations
The club follows the MMSD Student Code
of Conduct. Every child is expected to
behave respectfully from the time he/she
board the bus to Bethel to the time
he/she leave the premises.
Any misconduct like hitting, verbal
offense, littering, etc will be disciplined
by either temporary or permanent
suspension from the program, depending
on the offense.
Registration
4th
Contact us:
Deadline:
October
Bethel Lutheran Church: 608 257 3577
Yolibeth FitzGibbon: 608 577 8306
REGISTRATION FORM
Eagle’s Wings Afterschool Program
October 8th 2013 – May 29th 2014
Child’s Name / Nombre del niño(a):______________________________________________________________
Birth Date / Fecha de Nacimiento:______________________ Boy/niño_____ Girl/Niña______
School/Escuela _________________________Teacher’s Name/ Maestra(o)__________________ Grade________
Parent/guardian’s Name / Nombre del representante: ________________________________________________
Phone / Teléfono: Home/Hogar__________________Work/Trabajo____________Cell/Celular______________
Address/Dirección: ____________________________________________________________________________
Contact name in case of an emergency (name and phone) / Contacto de emergencia (nombre y teléfono):
____________________________________________________________________________________________
Child’s Health Information/ Datos de Salud del niño(a)
Known Allergies/ Alergias conocidas
• Food/Alimentos:___________________________________________________
• Medicines/Medicinas:_______________________________________________
• Others/Otras:______________________________________________________
Special needs/Necesidades especiales:________________________________________
 PICK-UP/ RECOJER AL NIÑO
yes/ si____ no______ (if no, please sign below/ si marca no, por favor firme debajo)
My childs has permission to walk home from the bus stop at Southdale _________________________________________
Mi hijo/a tiene permiso de caminar a la casa despues de bajarse del bus en Southdale _________________________________
 ACADEMIC INFORMATION/INFORMACIÓN ACADÉMICA (sign if you agree/ firme si está de acuerdo)
I give permission to EWAP to collect information of my child academic progress from his/her teacher _______________________________
Doy permiso a EWAP de colectar información de los maestros sobre el progreso académico de mi hijo/a______________________________
*This is not a school sponsored activity and the Madison Metropolitan School District does not approve, support,
supervise, or endorse this program/activity
Southdale Afterschool is sponsored by Bethel Community Services (BCS), a non- for- profit, non-denominational, Christian
based organization. My Child has permission to take part of the Afterschool activities including off-site sessions. I agree that
BCS or its personnel will not be held responsible for accidents or personal injury arising. I am responsible for any medical
obligations incurred during the activities and give BCS staff permission to seek medical treatment for my child in case of injury
or illness. I hereby give consent to BCS to use pictures of my child involved in the afterschool activities for future publications.
* Esta no es una actividad patrocinada por la escuela y el Distrito Escolar Metropolitano de Madison no aprueba,
respalda, o supervisa este programa o actividad
El Programa de tareas dirigidas Southdale es un programa patrocinado por Servicios Comunitarios Bethel (SCB), Organización sin fines de
lucro basada en la fe cristiana. My hijo(a) tiene permiso para participar en las actividades del programa de tareas dirigidas
patrocinado por SCB, incluyendo aquellas fuera de sus instalaciones. Entiendo y estoy de acuerdo en que SCB o su personal
no se hace responsable por accidentes o heridas alusivas. Yo soy responsable de cualquier obligación médica surgida durante
las actividades y doy mi consentimiento para que el personal que trabaja para el programa busque asistencia médica para mi
hijo(a) en caso de ser necesario. Asimismo, doy permiso para que SCB usen fotos de mi hijo(a) que hayan sido tomadas
durante las actividades para ser publicadas en el futuro.
Parent’s Signature / Firma del padre, madre o representante
Date / Fecha
__________________________________________________
__________________