Grade 5: After School Sports Registration Sessions 3-6

After School Sports provides appropriate organized physical activity to students in grades 3-6 with an equal emphasis on establishing and developing ideal conduct, sportsmanship and teamwork.  It is our hope that students will become leaders amongst their peers in promoting appropriate behavior in all facets of their daily lives.  Mr. Ruisi & Mr. Bayramshian oversee this program under the direction of the Halifax Youth and Recreation Department.

To register your child, fill out this form and then send in payment via check with your child in an envelope marked, After School Sports.  Checks should be  made payable to the Town of Halifax  and delivered to the homeroom teacher.  

1 child - $50/session.  
2 children - $80/session.  
3 children or more - $100/session.  

Payment must be sent in before the session starts in order for your child to attend.

Please note: Scheduled days may change due to enrollment.  There are monthly staff meetings on Wednesdays, early release days and holidays that will impact the schedule, so please follow the session calendar (session calendar can be found at the HES web-page at hes.slrsd.org).

In order for your child to be dismissed to After School Sports, you must put that your child is attending the program into Pick-Up Patrol. Please list all dates that your child will be attending. 

Students will arrive at the library at 2:35-2:40 from their classroom.  Students are encouraged to bring a snack and refillable water bottle.  Snack time will be from 2:40-3:00 in the library.  Students may bring in a change of clothes to wear and sneakers are a must.   At 3:00, students will go to the gym and begin warm-up activities.  All student pickups should be promptly at 4:30 in the gym lobby.
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Student Name *
Sessions: *
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Health Conditions (medications, allergies, etc.)
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Cell Phone
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Emergency Contact Name and Phone Number
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Due to risk of injury from participation in this program or if any other medical emergency takes place at Afterschool Sports and you cannot be reached, you authorize Youth and Recreation to transport your child to Brockton Hospital, South Shore Hospital, Jordan Hospital, or nearest hospital to obtain medical treatment.  You also authorize ambulance and hospital staff to treat your child.  Please type name of the hospital that you give permission for transport to.
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Does your child attend the YMCA program on the day that his/her group meets?
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Parent Carpool:  Please list the names of all individuals that you authorize to pick up your child.  Any individuals not listed will need permission with a note.  (Proper identification will be required.)
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In order for your child to be dismissed to After School Sports, you must put that your child is attending the program into Pick-Up Patrol. Please list all dates that your child will be attending. 
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