Beyond the Bell - MCOZ "Welcome Center" Grades 6th -8th Enrollment Form (Enrollment will remain open until all spaces are filled)

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Beyond the Bell - MCOZ "Welcome Center" Grades 6th -8th Enrollment Form (Enrollment will remain open until all spaces are filled)

The Middletown Child Opportunity (MCOZ) is pleased to work in partnership with Middletown Public Schools to offer after school enrichment programs to students in Kindergarten through grade eight as part of the district Beyond the Bell initiative. The MCOZ is managed by the Newport Family & Child Opportunity Zone (NFCOZ), a program of East Bay Community Action Program. The goal of the After School Programs is to offer fun, safe, and enriching activities to students to allow them to try new activities, meet new friends, and learn new skills to assist them to be successful in school. We expect participants to be engaged, attend regularly, behave safely, and treat all other children and adults with respect and kindness.

The Welcome Center at Gaudet Middle School is a safe space for students grades 6-8 to hang out and just be with their friends after school. While at the Welcome Center, students will be able to work on homework, read, play board games, listen to music, or just hang out and chat. We will have school supplies, snacks, and other essential items to help students to feel comfortable.

Enrollment Process

Enrollment and Welcome Center Policies

The Welcome Center will be open on Monday afternoons from 2:30-4:30 beginning on February 26. Students will sign up to use the Welcome Center as they do for other after school programs and we will cap enrollment at 25 students. Once we have reached our cap, students will be put on a waitlist. The Welcome Center will be staffed with a teacher and a teacher assistant.

Enrolled students will be expected to attend weekly, but we will not chase them if they do not show up. We will simply let parents know that their child did not attend. If students miss two weeks without a valid excuse (i.e. sick or doctor’s appointment), they will be dropped and we will enroll another student from the waitlist.

Once students check in to the Welcome Center, they will be required to stay in the space for at least an hour unless a parent signs them out early. Once they sign out, they will need to have a plan to leave the building. They will not be permitted to roam the halls of the school. This type of behavior will be cause for removal from the enrollment list. Students will be expected to be productive while in the Welcome Center and to respect the space. They will be required to follow the regular school behavior policy - no foul language, bullying, or disrespect to staff or peers at any time. If any of these things happen, students will get one warning and if it happens again, they will be removed from the enrollment list. Participation in the Welcome Center is a privilege and we want it to always remain a “safe zone” for all students.

Please complete a separate enrollment for each child you wish to enroll. Middle School Students in Grades 6-8 Only

You may either complete this online form or submit a completed paper enrollment form to your child’s school administration office. Enrollment will remain open until the program is full and has a manageable waitlist.

Confirmation and waitlist emails will be sent out on the Friday before the following week until full. Once full you will receive a waitlist email. If you do not receive a confirmation or waitlist email, please contact Jamoya Ridgell, MCOZ Manager at (401)261-6773 or jridgell@mpsri.net for details.

There is NO CHARGE to attend this program. There is no bus transportation available for the "Welcome Center".

* The MCOZ and Middletown Public Schools appreciate the generosity of van Beuren Charitable Foundation, the United Way or RI, and the Middletown Civic Appropriations Fund which enables us to offer all enrichment programs free of charge.

BEHAVIOR EXPECTATIONS:
We plan to offer engaging and fun activities for your child. For some children, the day can feel long. Please consider whether this offering is a good fit for your child. Students are expected to follow Middletown Public Schools behavior expectations during all programs. Staff are available to help students get back on track if they are having difficulty. Unsafe, unkind, disrespectful, or inappropriate behavior affects everyone and may result in removal from the program. This will be a consideration for future programs.

Questions: Jamoya Ridgell, MCOZ Manager, jridgell@mpsri.net

Email *

Date *

YYYY

Child's Last Name *

Child's First Name *

Address *

Date of Birth *

YYYY

Gender Identifies With *

Male

Female

Non-Binary

Please choose one

Grade *

Grade 6

Grade 7

Grade 8

Monday "Welcome Center"

Group 2 - Dates: April 22nd, 29th, May 6th, 13th, 20th, June 3rd, & 10th

Gaudet Welcome Center- Group 2 (2:30-4:30)

Required

Health and Medical Needs - check all that apply
*

Food Allergies

Other non-food allergies

My child takes medication during the day?

My child uses an EpiPen?

My child uses an Inhaler?

Other (we will follow up with you)

None of the above, my child doesn't have any health or medical needs.

Required

If checked please list Allergens

Child's Teacher

Parent/Guardian (1) Name, Cell Phone Number, and Email Address *

Parent/Guardian (2) Name, Cell Phone Number, and Email Address

Additional Emergency Contact (1) Name and Cell Phone Number *

Additional Emergency Contact (2) Name and Cell Phone Number

Do your Emergency Contacts have permission to pick up (must be over 18)? *

Yes

Emergency Contact (1)

Emergency Contact (2)

Dismissal Plan *

Will be picked-up by a parent/guardian or emergency contact listed on this form

Has permission to walk home

Optional Question: Tell us about your child so that we may best support him/her/them. We will follow up with you if more information is needed. Check all that apply

Nervous/anxious/shy

Very active

Special needs/IEP

ADHD

Toileting Issues

Other (feel free to share in the next question)

Choose all that apply

If you answered other in the previous question, please feel free to share details below in order to better assist us to support your child.

Primary Language *

Military Family *

Yes (Thank you for your service)

Please choose one

Other information that you would like to share

Other enrichment programs you hope to see us offer in future sessions? *

I authorize the MCOZ to take pictures of my child during program activities for program promotion or reporting. These pictures may be used on the Middletown Public Schools website, the EBCAP website, The United Way Website, or the van Beuren website. *

Yes

Maybe (more information needed)

Please choose one

I have read the dates, times, and behavior expectations for MCOZ Enrichment Programs and wish to apply for my child to attend. *

Yes

I have additional questions and would like someone to contact me

Please choose one

District Assessment Data - I give permission for the MCOZ to receive educational assessment data for my child from Middletown Public Schools for evaluation and program improvement purposes. *

Yes

Maybe

Please use the space below to write questions or to provide any additional information that you wish for us to know

Send me a copy of my responses.

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