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SCHOOL AGE CHILD CARE

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SCHOOL AGE CHILD CARE Powered By Docstoc
					                                             Rochester Community Education
                                                 School Age Child Care
                                                  201 8th St. NW, 287-2179
                                                 Non-School Enrichment Day
                                      at Bamber Valley and Jefferson
                        FRIDAY, DECEMBER 5, 2003
                                          Please Post This Information
                              DUE DATE for this form is Thursday, November 20, 2003,
                                 to the School Age Child Care office by 4:30 p.m.

1. School Age Child Care will be OPEN at Bamber Valley (door # 1, or door #11) and Jefferson (door #2) from
   6:30 a.m. to 6:00 p.m.
2. Children need to BRING a sack lunch and beverage if NOT going on the field trip. Refrigeration is not available,
   so please plan accordingly.
3. Children are required to WEAR a gray School Age Child Care T-shirt or sweatshirt and tennis or regular soft-
   soled tie/velcro shoes. Shirts may be purchased at the School Age Care Office for the following price: T-shirt
   $8.00/sweatshirt $15.00. Remember to bring appropriate outdoor clothing--coat, hat, mittens/gloves, boots etc.
4. COST per day per child for care is $24.00 - full day, $16.00 - 5.5 consecutive hours or less.
5. PAYMENT for care and trip will be billed to your SACC account. NO CANCELATIONS FOR CARE OR
   FIELD TRIP CAN BE MADE AFTER THE DUE DATE.
6. REGISTRATIONS, will be accepted only at the School Age Child Care Office. Drop-In care is not available on
   Non-School Enrichment Days - Varied and Set Schedules will not be valid.
7. (1) Print forms from our website (www.rochester.k12.mn.us/community-ed/sacc), (2) send through the U.S. mail,
   postmarked on or before the due date, (3) place in the blue Northrop Community Education drop box located
   across from the main entrance by the flagpole no later than 4:30 p.m. on the due date, or (4) fax the form to
   287-1962. Please call 287-2179 when you fax to ensure receipt.
8. School Age Child Care encourages children to BRING A LARGE BAG to put coat/belongings into to prevent
   the spread of lice.

                           NO DROP OFF AT OR PICK UP FROM FIELD TRIP LOCATION.
---------------------------------------------------------------------------------------------------------------------------------------------
                    Please Detach and Return This Information to the School Age Child Care Office
                           Due No Later Than Thursday, November 20, 2003, by 4:30 p.m.
Check the box of the NSED site of your choice:  BAMBER VALLEY OR  JEFFERSON
on December 5, 2003.

My child(ren) currently attends School Age Child Care at: ______________________________________________

Child(ren)’s Name(s)/Grade(s): ___________________________________________________________________

             CARE
  DATE      NEEDED                        FIELD TRIP                           APPROX                      FEE               TRIP
           (Check One)                                                          TIME                                       YES NO
            5.5 hrs                   Lunch and a Movie
   12/5         or                   at Chateau Theatre                 10:30 a.m. - 3:30 p.m.            $12.50
            Full Day              “G” or “PG” rated movie

                                                                 -OVER-




                                               December 5, 2003
                                          Non-School Enrichment Day
                                          at Bamber Valley & Jefferson




                                                  Lunch and a movie at
                                                    Chateau Theatre
                                                  10:30 a.m. - 3:30 p.m.


---------------------------------------------------------------------------------------------------------------------------------------------
APPROXIMATE DROP-OFF TIME: ___________________ PICK-UP TIME: ___________________

MEDICATION REQUIRED: YES _______ NO _______

Reminder: Medications cannot be administered unless a current Medication Authorization form is on file, which
includes physician’s order and signature. Please bring only the doses of medication needed for the day in the
prescription-labeled bottle. Medication, forms, and prescription-labeled bottle must match in order for
medication to be administered by School Age Child Care staff.
I have read and understand all of the above:
______________________________                ____________           ______________ ____________ ________________
Parent/Guardian Signature                     Date                   Work #         Home #        Other #(Cell/Pager)
                                                                      Mom  Dad  Mom  Dad  Mom  Dad

I understand my account will be billed _____________
                                             Parent/Guardian
                                             Initials
                                                                                            SACC Office Initials _________
Maryd/NSED/0102SY/Non School Days Public School/Dec 5.doc 10/01/03

				
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