**Registration Packet and full payment are due by Thursday, December 2, 2010.** Student Name__________________________________________ Date_________________ E.L. Haynes Public Charter School 2010-2011 Winter Intersession Student Registration Packet Monday, January 3 through Friday, January 7 Registration Packets & Payments will be accepted during the following hours: Monday – Thursday: 7:30 – 9:00 AM or 3:45 – 6:00 PM Friday: 7:30 – 9:00 AM or 1:15 – 6:00 PM ALL FORMS AND FULL PAYMENT ARE DUE BY THURSDAY, DECEMBER 2 AT 6:00 PM **PACKETS WILL NOT BE ACCEPTED & YOUR STUDENT WILL NOT BE ENROLLED WITHOUT PAYMENT IN FULL** E.L. Haynes Public Charter School 3600 Georgia Avenue, NW Washington, DC 200010 202.667.4446 phone 202.667.8811 fax **Registration Packet and full payment are due by Thursday, December 2, 2010.** Student Name__________________________________________ Date_________________ November 18, 2010 Dear Parents and Guardians of E.L. Haynes Public Charter School Students: It is with great excitement that we present to you our Winter Intersession Program for the 2010-2011 school year! Our staff has been working diligently to come up with fun and exciting learning opportunities for your student to take part in and enjoy. Participation in the Intersession Program is an opportunity that we are happy to provide to all E.L. Haynes students. However, students who do not comply with school rules and expectations may be asked to no longer attend these programs. Enclosed in this packet you will find a number of items helpful in making your child’s enrollment in the Intersession Program successful. Class Offerings: Details on classes being offered each week, including descriptions of what each class will entail. Registration Form: Includes section to indicate your TOP THREE choices to ensure your student gets into a class of their preference, an emergency medical form, a fieldwork permission form, and chaperone information. Your child is not guaranteed to get placed into the class of their top choice. If a second & third choice is not indicated, your child will be placed into a class based on enrollment numbers. Extended Day Program Information: During the Intersession week, EDP will operate Before School from 7:30 – 8:30 AM and After School from 3:30 – 6:00 PM. The cost will be the same as during the regular school session. Your completed Intersession EDP enrollment form will be due with registration. You may contact the school by phone at (202) 667-4446 with any questions you may have regarding EDP enrollment or costs. Intersession classes begin at 8:30 AM and end at 3:30 PM daily, with the Extended Day Program in operation from 7:30 to 8:30 AM and from 3:30 to 6:00 PM. Registration Packets will not be accepted, and your student will not be enrolled in an Intersession class, without full payment. Please refer to the table below. If you have not returned the Registration Packet AND payment, your student will not be guaranteed a spot in Intersession. Lunch Status Fall Intersession fee Free $5.00 Reduced $5.00 Full $150.00* Thank you for taking the time to read through this packet thoroughly. We are looking forward to working with your student during Fall Intersession. Sincerely, Year Round Programs **Registration Packet and full payment are due by Thursday, December 2, 2010.** Student Name__________________________________________ Date_________________ WINTER INTERSESSION CLASS OFFERINGS Monday, January 3 through Friday, January 7 GRADE LEVELS ARE IN ACCORDANCE TO THE 2010-2011 SCHOOL YEAR 3rd-5th Grade Classes: Chris Marr, “Karate Kids” This course will immerse students in the history of martial arts; from its orgins in India, the Phillipines, Thailand and Korea, all the way to its influences in modern America. The students will learn some language from each of the cultures most associated with the martial arts: Chinese, Japanese and Korean. The students will also learn several different myths, fables and legends of the martial arts. Each day, the students will gain a foundational knowledge of a different martial arts style. Monday we will learn the Chinese style Wing Chun. Tuesday we will learn the Japanese style Kyokushin-Kai and the Korean style Tang Soo Do. Wednesday we will learn the Filipino style Kali and western boxing (the Filipino "pinnoy boxers" were a huge early 20th century influence on modern boxing). On Thursday we will learn an American style, Kenpo Karate. As well as traditional martial arts training, students will be exposed to martial arts history and Asian culture through fieldwork and several expert visits from martial arts instructors and black belts! This class has a Health & Fitness, Performance Arts and Social Science focus. R’Kheim Young, “S.T.E.P. Camp: Service Togetherness Equality and Pride” Stepping can be a fun way to stay in shape and develop a sense of unity and pride in your school/community! This course will focus on building strong relationships and leadership skills through exercise, community service and step techniques. Students will learn stepping and its history, while doing several service projects throughout the school and surrounding community. This class will be both fun and intense in a “boot camp” atmosphere. Each day, students will develop friendships and improve their leadership skills through games, group activities and in working as a team to create new steps for our show. This class has a Health & Fitness and Performance Arts focus. Yvette Lynch, “Edible Explorers” The Edible Explorers will take a trip around the world this week! Students will travel to different regions of the world discovering cultures, traditions, people and food. We will travel to Panama, Mexico City, Australia, Lebanon, England and Korea. Students will learn how to read recipes, measure ingredients, learn basic kitchen safety and cook! Come take a trip with Edible Explorers! This class has a Health & Fitness and Mathematics focus. Lonnetta Grant, “Hip Hop with the Stars” Learn to dance Hip Hop in a way that is simple, effective and fun! This class will break down fancy moves into fun & easy-to-learn steps. Hip Hop encompasses movement that has elements of popping and locking, breaking and freestyle movements, allowing the students the opportunity to develop their own sense of style. Students will learn to dance by using a core dance repertoire of drills and repetition. This high-energy class will use the latest sounds in rap, R&B and pop music together with movements influenced by some of today’s most popular video choreographers. Hip Hop is urban, diverse and forever changing. Students will explore personal, social and cultural dynamics of Hip Hop culture in the United States as well as abroad. This class has a Performance Arts and Health & Fitness focus. **Registration Packet and full payment are due by Thursday, December 2, 2010.** Student Name__________________________________________ Date_________________ Francine Rosario, “Girls ROCK” This class will help your female student develop and nurture self-confidence and esteem. We will focus on school- age topics such as bullying, cliques and body image. Students will walk away appreciating their differences as unique characteristics that make them who they are. To do so, we will participate in a combination of music, art and group games. Fieldwork for this class will provide the opportunity for students to learn more about amazing women who have made a contribution to society. This class has a Service Learning and Visual Arts focus. Randy Harper, “Hand Dancing: An Exploration of DC’s Signature Swing Dance!” Did you know that Washington D.C. is home to much more than our President and politics? In this class we will explore and experience the largest and longest dance craze to sweep our city: Hand Dancing! This week, we will learn about where this dance comes from, what dance styles it has influenced and why it has been around for so long. Then, we get into the fun stuff: dancing with our hands! Let’s see how much our hands can dictate how we move our feet. This amazingly fun, energetic and sometimes dizzy-inducing dance (don’t worry, the dizzy part is just for our advanced dancers…is that you?) is still just as fresh, yet classic, as it was when it swept this city more than fifty years ago. Generations of Washingtonians are still Hand Dancing all over the city and even the country! Many people see DC hand dancers and wonder, “Where did they get those smooth moves from?” You can have the moves too! This class has a Performance Arts and Health & Fitness focus. Gerald Mickey, “Art & Me” Students will be able to express their artistic talent through a week-long exploration of art basics. Students will be introduced to artists that are considered "classic" and changed the world of art. They will also be given a glimpse into how those artists eventually helped give rise to modern artists that have appeared in recent years. We will explore the world of art through different art projects, field work and presentations. Students will be able to express their creativity via multiple art forms and styles. This class has a Visual Arts focus. 6th-8th Grade Classes: Steve Gornstein & Mike Cohn “E.L. Haynes Freedom Writers” The E.L. Haynes Freedom Writers will read sections of The Freedom Writers' Diary, written by students in a high school class in California about the struggles they faced in their lives. We will discuss important themes from the book, such as hope and tolerance, and undertake fieldwork to the Holocaust Museum. We will watch portions of several movies, including the film versions of The Freedom Writers Diary and the Diary of Anne Frank. We will also write about ourselves each day and compile our stories into our own Freedom Writers diary. Our week will culminate with a "toast for change," in which we will strive to make positive changes in our lives. While the course will be tailored to middle school students, it will involve the reading, viewing, and discussion of some sensitive subject matter. A permission slip will be available for students who are interested. This class has a Literacy and Activism focus Joseph Mathews, “The F.E.L.L.A.S Project” This course is designed for students interested in leadership roles in the E.L. Haynes community. Building on the need for young males to be leaders and activists for issues that are important to them, The FELLAS Project allows young future leaders to get hands on experience working in communities that they are from. Through services projects at volunteer organizations and classroom work shops around social issues. The FELLAS Project will build a sense of brotherhood, a sense of community and the importance of understanding of service. This class has a Service Learning focus **Registration Packet and full payment are due by Thursday, December 2, 2010.** Student Name__________________________________________ Date_________________ Michelle Tyler & Amber Hinson, “OMG Girls 2” Young Women will experience real life challenges from an adult's point of view. Students are required to choose a career, develop a budget based on their salary, gain money management skills, and experience the challenges of parenting. Each day represents a new challenge that the girls will have to face. Each day the girls will draw two life cards that will that will give them opportunities to experience real-life issues. Each day the girls will write in their journal about how they felt and what were their biggest challenges. We will visit a women’s shelter and have discussion with women who face challenges. This class has a Service Learning focus Casey Rath, “Make Me a Star” In this acting course, students will learn basic acting techniques and develop two- or three-person scenes. Work on the small group scenes (from plays such as A Raisin in the Sun, All My Sons, and several others) will organize the week: students will read their plays as partners and spend much of the week working together to learn and stage their scenes. But students will also spend time as a whole group learning about key dramatic techniques such as the use of space, dramatic tension, taking risks, and knowing a character's motivation. Students will take their scenes through a work-shopping process, performing their scenes for the acting teachers and other students for the purpose of getting constructive criticism and stretching their theatrical imaginations. The drama class will culminate with the final presentation of these acting scenes. The class may include a visit to a DC theatre (a backstage tour), a visit from a theatre professional, and/or attending a professional show one night of the week. This class has a Performance Arts focus Luis Garcia, “Sport Around the World Club” During this course, student will learn about different sports from around the world. While learning about Rugby, Soccer, Lacrosse or Hockey our students will learn about discipline, different cultures, leadership and best of all to how to have fun while engaging in physical activity. The idea of worldwide sports will help the students to realize that the sports world is so much more than football and basketball, which will help students to gain a different perspective This will also teach them to be a good sport since most of these sports are team sports, plus it will reinforce the school motto: Be Kind, Work Hard, Get Smart. This class has a Health & Fitness focus Darnell Almanzar, “Basketball Boot camp” In this course students will learn the fundamentals of basketball. This class will teach students all of the skills that it takes to succeed on and off the court. This class will prepare current and future basketball players what it takes to succeed physically, mentally, and emotionally at basketball. Students will have the opportunity to engage in field work throughout the DC area. This class has a Health & Fitness focus Olivia Toro, “Guide to Fantasy Football” Want to show NFL owners and coaches how it’s done? In this class, we will use player statistics to draft fantasy football teams and play head-to-head games against each other. We will learn about the numbers that inform decisions like starting, benching, and trading players, and we will use numbers from real NFL games to make our own decisions in those areas. We will also spend some time talking about how variables like player health, injuries, and bye weeks impact game outcomes. This class has a Mathematical focus **Registration Packet and full payment are due by Thursday, December 2, 2010.** Student Name__________________________________________ Date_________________ WINTER INTERSESSION: EXTENDED DAY PROGRAM REGISTRATION (***PLEASE COMPLETE ONE PER CHILD***) ***In order for students to attend EDP during Winter Intersession, this form must be completed, regardless of whether or not your student normally attends EDP during the regular school year.*** AGAIN, PLEASE REMEMBER: Extended Day Program Information: EDP will operate Before School from 7:30 – 8:30 AM and After School from 3:30 – 6:00 PM. The cost will be the same as during the regular school session. You may contact the school by phone at (202) 667-4446 with any questions you may have regarding EDP enrollment or costs. Please indicate below what type of Extended Day Program you would like to enroll your student in during Winter Intersession. Student Name: ____________________________________________________________________________ Homeroom Teacher: ______________________________ Grade Level for 2010-11 school year: __________ EMERGENCY CONTACT NUMBERS: Name Number Relation to student I would like my student enrolled in the following program(s) (please check all that apply): □ Before School Program (7:30 – 8:30 AM daily) □ with optional breakfast □ After School Program (3:30 – 6:00 PM daily) □ Neither the Before or After School Program ____________________________________ _________________________________ Parent/Guardian Printed Name Parent/Guardian Signature **Registration Packet and full payment are due by Thursday, December 2, 2010.** Student Name__________________________________________ Date_________________ WINTER INTERSESSION CLASS REGISTRATION FORM (***PLEASE COMPLETE ONE PER CHILD***) Student Name: ____________________________________________________________________________ Homeroom Teacher: ______________________________ Grade Level for 2010-11 school year: __________ *PLEASE INDICATE YOUR STUDENT’S TOP 3 CLASS CHOICES FOR THE WEEK BY MARKING “1”, “2”, & “3” ON THE BLANK NEXT TO THE CLASS NAME IN RANK ORDER* NOTE: STUDENTS CAN ONLY PARTICIPATE IN CLASSES FOR THEIR GRADE LEVEL RANGE! Monday, January 3 through Friday, January 7 GRADE LEVELS ARE IN ACCORDANCE TO THE 2010-2011 SCHOOL YEAR 3rd-5th Grade Classes: _____ Chris Marr, “Karate Kids” _____ R’Kheim Young, “S.T.E.P Camp: Service Togetherness Equality and Pride _____ Yvette Lynch, “Edible Explorers” _____ Lonnetta Grant, “Hip Hop with the Stars” _____ Francine Rosario, “Girls ROCK” _____ Randy Harper, “Hand Dancing: An Exploration of DC’s Signature Swing Dance” _____ Gerald Mickey, “Art & Me” 6th-8th Grade Classes: _____ Steve Gornstein & Mike Cohn “E.L. Haynes Freedom Writers” _____ Joseph Mathews, “The F.E.L.L.A.S Project” _____ Michelle Tyler & Amber Hinson, “OMG Girls 2” _____ Casey Rath, “Make Me a Star” _____ Luis Garcia, “Sport Around the World Club” _____ Darnell Almanzar, “Basketball Boot camp” _____ Olivia Toro, “Guide to Fantasy Football” **Registration Packet and full payment are due by Thursday, December 2, 2010.** Student Name__________________________________________ Date_________________ GOVERNMENT OF THE DISTRICT OF COLUMBIA DEPARTMENT OF HEALTH LICENSING REGULATION ADMINISTRATION AUTHORIZATION FOR CHILD’S EMERGENCY MEDICAL TREATMENT If my child, ____________________________________________________________________________ born on __________________________, becomes ill or involved in an accident and I cannot be contacted, I authorize the following hospital or physician to give the emergency medical treatment required. NOTE: Every effort will be made to notify the parents/guardian in case of an emergency. In the event of an emergency, it would be necessary to have the following information: Preferred Hospital: __________________________________________________________________________ Address: __________________________________________________________________________________ Physician’s Name: ____________________________________ Phone Number: _________________________ I give permission to E.L. Haynes Public Charter School located at 3600 Georgia Ave. NW Washington, DC 20011 to take my child for treatment. I accept responsibility for any necessary expense incurred in the medical treatment of my child, which is not covered by the following: Health Insurance Company: ___________________________________________________________________ Name of Policy Holder: _____________________________ Relationship to Child___________________ Policy Number: ____________________________________ Coverage: ___________________________ DC Medicaid Number: ______________________________________________________________________ Childs known allergies or physical conditions: _____________________________________________________ __________________________________________________________________________________________ Telephone Numbers: (Home) __________________ (Work) __________________ (Cell) __________________ ____________________________________________________________________ __________________ Signature of Parent/Guardian Date **Registration Packet and full payment are due by Thursday, December 2, 2010.** Student Name__________________________________________ Date_________________ FIELDWORK PERMISSION FORM (***MUST BE TURNED IN ALONG WITH REGISTRATION FORM***) I give my child permission to attend trips related to fieldwork in his/her class(es) during Winter Intersession. Specific details about fieldwork will be sent home on the first day of each class. I understand that students will travel by bus or Metro. ____ YES, I give permission for my student to participate in fieldwork during Intersession. ____ NO, I do not wish for my student to participate in fieldwork during Intersession. Please provide contact information for the student’s parent/guardian below: Name (required): _____________________________________________________ Phone (required): _____________________________________________________ Email (optional): _____________________________________________________ EMERGENCY CONTACT NUMBERS: Name Number Relation to student Known Allergies: _____________________________________________________________ ____________________________________ _________________________________ Parent/Guardian Printed Name Parent/Guardian Signature PERMISSION TO VIEW MOVIES I give my child permission to watch G or PG rated movies that relate to my child’s Intersession class. ____ YES, I give permission for my student to view G or PG rated movies during Intersession. ____ NO, I do not wish for my student to view G or PG rated movies during Intersession.
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