2020 CFC 4-H Afterschool Summer Program Registration WAIT LIST

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2020 4-H Afterschool Summer Program Registration

Students in Grades K-6 during 2020-2021 school year
C-FC School
June 8 to August 21, 2020
Monday – Friday
7:00 a.m. – 5:30 p.m.

Students must bring their own sack lunch each day. Morning and afternoon snacks are provided. Families are required to provide some snacks and supplies for the program. 4-H Afterschool summer staff is youth protection certified trained college and high school students. All bus field trips are available to students at NO additional cost. All 4-H Afterschool summer students will also enroll in Buffalo County 4-H and enter exhibits at the Buffalo County Fair – fair fees are included in registration. It may be required that each student have a Scenic Valley Swimming Pool summer pass. Participation in Cochrane-Fountain City Summer School is encouraged.

4-H Afterschool 2020 Summer Program Registration Information

The summer program will be limited to the first 40 full time students who register online and pay the deposit. You will have the opportunity to register until March 1, 2020. Registration will be open to families until registration is full; a waitlist will then be generated. Enrollment information including health form information will be completed via 4HOnline.

Rates Per Child Each Additional Child
Full time (4 or 5 days per week) $100/week $80/week
Part time (3 days per week) $75/week $60/week
Part time (1 or 2 days per week) $30/day $25/day

In order to finalize 4-H Afterschool Summer registration, a deposit per student equal to one week’s fees must be paid by March 1, 2020. This deposit is nonrefundable after March 1, 2020. The deposit will be applied to the last week of participation in 4-H Afterschool Summer Program. A $10 4-H enrollment fee per student for insurance is also required for this summer; include fee with your deposit. Please send checks only made payable to 4-H Afterschool to: 4 H Afterschool, UW Division of Extension Buffalo County, PO Box 276, Alma, WI 54610 or send to school with your child in a sealed envelope marked 4 H Afterschool.

Email *

Parent/Guardian Name *

Contact Phone for Registration Purposes *

Contact Email for Registration Purposes *

Student First and Last Name *

Student Current Grade *

How many days a week will your child participate in 4-H Afterschool this summer? *

4 or 5 Days a Week - $100 per week or $80 per week for additional child

3 Days a Week - $75 per week or $60 per week for additional child

1 or 2 Days a Week - $30 per day or $25 per day for additional child

Check the days of the week your child will attend. *

Monday

Tuesday

Wednesday

Thursday

Friday

Varies - Will provide monthly calendar of dates

Required

Estimated Time of Arrival Each Day *

Time

Estimated Time of Departure Each Day *

Time

Please include any comments or additional information 4-H Afterschool should know about your registration.

If you would like to request a partial scholarship, payment plan or request for reduced rates, please explain your need for financial support in 2-3 brief sentences below. Thank you.

4-H Afterschool Summer Program Contract -- READ THE FINE PRINT PLEASE *

Check each box to signify that you have read each item in the contract.

1. 4-H Afterschool Summer Program will run from June 8, 2020 to August 21, 2020. The program is housed at the C-FC School. Hours are 7:00 a.m. to 5:30 p.m., Monday through Friday. The program will be closed on July 3, 2020.

2. Contracts must be fulfilled for the entire length of the 4-H Afterschool Summer Program. Each student will be allowed five days of vacation within the same calendar week in which no charges will be billed. A written or email notice must be given and approved one week prior for any varied schedule, schedule change or vacation request, otherwise charges will be billed.

3. Any un-contracted days will result in a charge of $30 per day per child. Un-contracted days will be billed in the subsequent week’s invoice. A $10 per half-hour late fee is assessed when a student remains after 5:30p.m. The fee must be paid at the time of the parent/guardian arrival. If a student is not picked up one-half hour after the close of the program the staff will contact the Buffalo County Sheriff’s Department.

4. Parents/Guardians will be billed for summer program based on this contract regardless of attendance. Payment is due in advance of each week’s care on Monday. First payment will be due May 28, 2019. Failure to pay will jeopardize children’s participation in the program. The nonrefundable deposit will be applied to the last week of participation in the 4-H Afterschool Summer program.

5. Students must bring their own lunch each day. Morning and afternoon healthy snacks are provided daily.

6. I understand that I may be required to purchase a pass for my child at the Scenic Valley Swimming Pool in Cochrane.

7. Weekly bus field trips will be available to students during certain days at no additional cost.

I verify that all the information provided above is accurate to the best of my knowledge, and I have read, understood and agree to abide by the above contract and all 4-H Afterschool policies.

Required

Signature *

Please type your full legal name in the text box below. This will certify as your legal signature.

A copy of your responses will be emailed to the address you provided.

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