After-School-Middle-School by csgirla


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									After-School Middle-School
(ASMS) Program Program Information Manual

(Revised March 2, 2009) Direct Line to Holy Grounds (410) 421-5943 Severna Park Community Center Offices (410) 647-5843

Chris Marsala Executive Director Severna Park Community Center

Julia Dray Director ASMS Program

Program Overview Enrollment/Registration Information Fees and Billing Hours/School Closings/Dismissals/Absences Daily Procedures Arrival/Departure/Snacks Daily Schedule/Emergency Drills Social Matters, Discipline & Parent Communications Social Matters Discipline/Parent Communication Health and Safety Policies Health and Safety Overview Staff Certifications and Medication Management Injury Emergency Information Certificate of Intent Information for Leaders Contract Consent and Contact Parent Permission Slip Individualized Plan Maryland Immunization Certificate DHMH Form 896 Maryland Health Inventory OCC 1215 Emergency Form OCC 1214 10 10 10 11 12 13 14 15 16 17 18 19 21 8 9 6 7 2 3 4 5

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We welcome your participation, comments, ideas and questions, and invite you to visit us at any time!

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Program Design

1. Certificate of Intent Form

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Registration can occur at any time throughout the school year; children who cannot be immediately enrolled will be placed on a waiting list. When an opening occurs, enrollment is made based upon the date of the registration.

Fees and Refund Policy

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Hours of Operation

ASMS operates every day for which school is scheduled from dismissal (including early scheduled dismissals) until 6:00pm.

School Closings and Unscheduled Early Dismissals

ASMS follows the Anne Arundel County Public School systems schedule. When school is closed for any reason, so are we. If school is dismissed early due to inclement weather, ASMS will NOT be open.

Scheduled Early Dismissals

ASMS is open on days in which schools have a scheduled 1, 2 or 3 hour early dismissal.


Please inform us if your child will not be attending due to illness or an after-school
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activity. You may call us at our direct line (410) 421-5943 and leave a voice-mail message. You may also send us a written note in advance or inform a staff member when you are at ASMS prior to the absence. If we have not been informed in advance, your child’s absence from the program will be followed up by a phone call to ascertain if there is any reason for concern.

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Daily Procedures
Arrival Roll is taken of all students and parents of those absent without prior notification are contacted to ensure there is no reason for concern. Children scheduled to be arriving late on the activity bus are assumed to be present until the bus arrives and we can take roll of those students. The same procedure will be followed if a student does not arrive on the activity bus. Departure Parents or authorized contacts are required to enter the building and sign the child out unless prior arrangements have been made with the program Director. No student will be released to an unauthorized person under any circumstances. Parents may send in a written authorization with the student if there are exceptional pickup circumstances. The Director will contact the parents/guardians if there are any questions about authorization. A driver’s license or other official photo identification may be required by our staff


A snack is provided every day of the program. We enjoy a wide variety of healthy snacks that have an average calorie count of 300 (including beverage). Children are encouraged to help prepare and serve the daily snack and we welcome suggestions! Children with special nutritional needs can be accommodated after consultation with the Director. Special snacks may be provided by parents of program participants. For regulatory reasons, we must insist that all snacks be purchased from a licensed food service facility (bakery, restaurant, etc.) or that they be sealed in their original packaging. Homeprepared snacks are not permitted.
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Daily Schedule The daily schedule varies depending upon the scheduled arrival time of students. Each day is roughly broken into the follow components.    First Hour: Arrival, Roll Call, Snack & Free Play, Craft Activities, Enrichment Programs and Outdoor Play Second Hour: 45 Minute Quiet Time for Homework or Individual Activities Third Hour: Free Play, Craft Activities, Enrichment Programs, Organized Games, Videos Students may “opt out” of certain activities but are still required to remain in the area where the activity is taking place so that supervision can be maintained. Students may not disrupt activities or behave in such a manner that others cannot enjoy them.

Emergency Drills Regular drills will be held for both fire and evacuation procedures. A copy of those procedures is available from the ASMS Program Director

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Social Matters, Discipline & Parent Communications
Social Matters

We are committed to co-operative learning, play and social activities. We encourage all of our participants to be helpful and thoughtful of other students and we work actively to ensure a happy environment in which everyone feels valued and supported. The middle school years are difficult transition years for many children and we want to help them develop a healthy sense of themselves and their special gifts and talents. We encourage parents to keep us informed of any issues that might have an impact on the health and happiness of their child and invite them to make us part of their support network.

Bullying will not be tolerated. Name-calling, physical intimidation or any form of harassment will be grounds for a time-out and a conversation with the Center’s Director. If behavior does not change, a letter will go out to the parents outlining the behavior and the penalties if it continues. A conference with the Director, parents and child may be scheduled if the problem persists. Suspension from special activities, program restrictions and even suspension from the ASMS program as a whole may result if the problems continue.

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Our staff makes every effort to prevent discipline problems before they arise and to use conflict resolution strategies when they do. Should a child continue to experience problems with self-discipline following one-on-one counseling from the program .Director, the following steps will be followed:

1. A conference will be held between the parents of the child, the child and the Program Director and any affected staff during which the problem is outlined and various strategies are developed.

2. If the problem persists after the conference, the child will be suspended from the program pending another conference with the parents that will also include the Executive Director of the Severna Park Community Center. At that time, a determination will be made about the child’s continued attendance at the program. 3. If, in the opinion of the ASMS program Director, a child’s behavior presents a physical danger to themselves or others, immediate suspension or dismissal from the program may result.

Parent Communication

Communication between parents and the ASMS program staff is a key ingredient in the success of this program. We welcome visits from parents and families and encourage you to come early and join us in some of the activities in which your child will be participating. Please feel free to contact the ASMS Director on site if you need to share additional information concerning your child. We value your opinions and suggestions.
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Health and Safety Policies

Health and Safety Overview Students who are ill are not permitted to attend the program. We have no way to safely isolate and/or care for a child who is sick and we cannot take responsibility for their wellbeing. In the event a child becomes ill during the program, every attempt will be made to contact the parents as quickly as possible. If the parents are not available, we will contact the individuals listed at Emergency Contacts on your child’s forms.

Staff Certifications and Medication Management We take the health and well-being of our students very seriously. Our staff is certified in First Aid and CPR and Undergoes regular re-certification. Any medication (whether over the counter or prescribed) must come with written directions from the parents and physician. Medications will be kept on-site in a locked container and will be taken along (as needed) on any field trips or activities away from the Center. If the staff has any doubts about administering the medication it will not be given until parental contact has been made. A medication order form, supplied by the Child Care Administration, may be obtained from the ASMS director.

Injury The staff is required to complete an Accident Report in the event a child is injured. A comprehensive notebook reflecting all incidents resulting in injury is maintained by the ASMS staff. We will contact parents in the event of any injury. In the event of a serious emergency, staff will contact 911.

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Emergency Information It is essential that all emergency work and personal telephone numbers be kept current, as well as any change of address. Parents are responsible for information that is pertinent to the protection of their child. PLEASE be sure to update any changing information as quickly as possible.

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Severna Park Community Center After-School Middle School Program

Certificate of Intent
I hereby state that it is my intention to enroll my child in the ASMS Program for the 2009/2010 School Year. I understand that by submitting this Certificate of Intent, with the required fees and charges, that Severna Park Community Center will reserve a position for my child. I also understand that if my child does not attend the program, any pre-paid fees or charges will not be refunded to me.

Name of Child: ___________________________________ Birth Date:


Address: ___________________________________________________ Zip: _________ Home Phone: ________________________Work Phone: _________________________

Please include a check for the following Non-Refundable fees and charges: Registration Fee Aug.09-June 10 Tuition TOTAL $75.00 $200.00 ------------$275.00

Please make your check payable to: Severna Park Community Center /ASMS I understand, and agree, with the information contained on this form, and desire my child to be enrolled in the ASMS Program for the 2009/20010 school year. I have paid the required fees and charges. Parent/Guardian’s Signature:______________________________________ Date: _____ ASMS Director Signature:________________________________________ Date:_____ This Certificate of Intent MUST be executed prior to or on March 14, 2009 in order to guarantee a space in the 2009/2010 school year. Certificates executed after that date will only be guaranteed a space if there is not a waiting list in effect at that time.

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Severna Park Community Center After-School Middle-School (ASMS) Program Information for Leaders
Name of Child: ______________________________ Birth Date:_______________ Nickname (preferred):_____________________________ Sex:________Grade:______ Address: _____________________________________________ Zip:______________ Name of School:____________________ Home Phone:______________________ Work Phone:_________________________

(Changes to this list must be received from the parent or guardian in writing. This list should include the parent and/or guardian) 1. Name:___________________________________ Relationship:_____________

Home Phone:________________ Work Phone:_________________________ 2. Name:___________________________________ Relationship:_____________

Home Phone:________________ Work Phone:_________________________ 3. Name:___________________________________ Relationship:_____________

Home Phone:________________ Work Phone:_________________________

These are activities my child particularly likes:

These are activities my child particularly dislikes or fears:

I do ___ I do not ___ give permission to have my child’s photograph appear in print or website coverage of ASMS or The Center’ events or activities. Parent/Guardian’s Signature: ___________________________


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Severna Park Community Center After-School Middle-School (ASMS) Program

Please review the information listed below to ensure that you understand your responsibilities in enrolling your child in Severna Park Community Center After-School Middle-School program. 1. I understand that all forms required (Program Registration, emergency Information, Health Inventory, Immunization Certificate, Contract, Information for Leaders) must be completed and on file before my child can attend the program. I understand and agree that late fees will be assessed to cover expenses if I (or my designees) arrive after 6:00 PM. A fee of $5.00 will be charged for every minute after 6:00. I understand that there will be a $25.00 charge for all returned checks. I understand that during school closure days, including days when school is closed because of inclement weather or other unexpected reasons, there will be no program. I understand that if my child is having problems adjusting to the program, a conference will be arranged between me and the staff. I also understand that I may be asked to withdraw my child if their behavior patterns threaten their own health and safety, or that of other children. Refunds will not be made under these circumstances. I understand that a payment schedule will be distributed at the beginning of each school year. Statements will be distributed a week before the next payment period is to begin. Checks must be received by the end of the fifth of the month. A late fee of $10.00 will be charged in addition to the monthly payment, if payment does not meet the due date. I understand that I will give two weeks written notice if I intend to withdraw my child from the program. I understand that in the event of illness, vacation or other extended absences, the ASMS program director must be notified in writing, and that I will remain responsible for the full program payment. I understand that my child will not be released to anyone except custodial parents without specific written permission. I agree to give the center a list of all persons authorized to pick up my child and the circumstances under which my child can be released to these persons. I understand that my child cannot attend the ASMS Program when he/she has any illness that threatens the health of other children and the Health Department regulations concerning periods of infection will be enforced. I also understand that medication will not be administered without written permission from the parents and written instructions from a physician.

2. 3. 4. 5.


7. 8.



I agree to comply with the ASMS Program policies and procedures, and hereby give my child permission to participate fully in this program.

Parent/Guardian’s Signature:_____________________________


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Severna Park Community Center After-School Middle-School (ASMS) Program

Consent and Contact
This form must be completed and signed by the child’s parent or legal guardian:
Child’s Name: (Last, First, MI):____________________________________________________________

Birth Date:_____________

Enrollment Date:____________ School:_______________ Zip:______________

Home Address:_________________________________________

In the event the child named above is injured or ill, I understand that the ASMS Program staff will attempt to contact me, any other parent or the legal guardian at the telephone number provided below: Mother’s Name:____________________________ Work Phone:___________________ Business Address:______________________________________ Zip:______________ Father’s Name:_____________________________ Work Phone:___________________ Business Address:______________________________________ Zip:______________

In the event that I, any other parent or the legal guardian cannot be contacted, I give permission to contact the person or health care provider listed below: Name:____________________________________ Telephone:_____________________ Address:_____________________________________________ Zip:______________ Child’s Physician or Source of Health Care:_____________________________________ Telephone:_____________ Address:_________________________________________

In the event that I or others listed on this form are not available, I give my permission to the ASMS Program Staff to provide first aid for the child named above and to take the appropriate measures including contacting the emergency medical services (EMS) system and arranging for transportation to the nearest emergency medical facility. At no time will the ASMS Program Staff drive an ill or injured child to an emergency medical facility unless accompanied by another adult.

Parent/Guardian Signature:_______________________________


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Severna Park Community Center After School Middle School (ASMS) Program

Parent Permission Slip Bus/Car/Metro/Walking Field Trips
We will be taking trips in either our Center bus, by car, or by walking in this program to various recreational activity sites offering movies, bowling, miniature golf and skating, and other local parks and sites. These visits will always be pre-announced for your convenience and planning. This is a general permission slip giving Severna Park Community Center permission to transport your child on these outings. I hereby agree to waive any and all claims against Severna Park Community Center, its Board of Directors and its staff in the event that my child is injured while being transported to, during or being transported from program outings.

Child’s Name __________________________________________ Parent/Guardian Signature

_________________ Date

Parent Permission Slip
Swimming/Water Activities
We will be visiting and swimming in the indoor pools operated by SPY Aquatics here at Severna Park Community. These visits will always be pre-announced for your convenience and planning. This is a general permission slip giving Severna Park Community Center permission to include your child in all swimming/pool/water activities. I hereby agree to waive any and all claims against SPY Aquatics, Severna Park Community Center, its Board of Directors and its staff in the event that my child is injured in a water-related accident. Child’s Name __________________________________________ Parent/Guardian Signature
Limits for Swimmer: __ Shallow End Only __ No Limit __ Life Jacket Always __ Other ___________________________________

________________ Date

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Severna Park Community Center After-School Middle-School (ASMS) Program INDIVIDUALIZED PLAN CHILD’S NAME: _______________________________________________________ PARENT/GUARDIAN: ___________________________________________________ ADDRESS: _____________________________________________________________ (The information on this form is for Confidential Use only.) Child’s Strengths:

Activities My Child Likes:

Activities My Child Dislikes or Fears:

Child’s Homework Plan:

Special Needs or Restricted Activities:

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