21st Century CLC Summer Enrichment Program
Registration Form - for Summer Enrichment Program 2021 (June 01 - Aug 6, 2021, No program July 5-9).
Mondays - Fridays, 10am - 5pm

The 21st CCLC programs are excited to collaborate to provide our students with a Summer Enrichment Program. The program is designed to extend learning into the summer months for the 21st CCLC and students entering grades 1-7. The emphasis is on providing positive, enrichment experiences for our students. We will be offering academic interventions in ELA and Math and enrichment in on physical activity and STEM.

There is no cost for this program and all meals are provided.  
Program will take place at Mountain View Elementary . Anchorage.  
Application deadline is April 29, 2021.
For more information, please contact your school's 21st Century coordinator or contact (907) 742-4410.
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Eligibility...
- Students entering grades 1 - 7 who attended a site with the 21st CCLC Program are eligible to attend. Priority is given to currently enrolled 21st CCLC program attendees.
Student Information...
Name (First) *
Name (Last) *
Date of Birth *
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Grade (Entering in Fall 2021) *
School  (2020/21 school year just completed) *
Parent Name
Parent Email
Parent Phone Number *
Choose which week(s) your child would like to attend (you may check more than one box): *
Required
Transportation... *
Required
PROGRAM POLICIES & REQUIREMENTS - Please check each box to indicate you fully understand and agree to each item. *
Required
Parent/Guardian Signature
I give permission for the above named student to participate in the 21st CCLC Summer Enrichment Program. I understand that by signing this registration form that my child will attend the program Mon-Fri (10am-4pm) for the weeks selected. 21st CCLC staff will provide proper supervision. It is agreed that my child will abide by all rules and regulations of the Anchorage School District and follow all safety guidelines while handling and using tools to complete activities. I understand that if my child, for any reason, fails to abide by all rules and regulations; disciplinary steps will be taken, which may include dismissal. I also grant permission for my child to participate and appear in video or audio recordings, films, photographs, written articles, and on website.  I understand my child may be transported by bus and the schedule will be provided to me in the confirmation packet. I consent to any emergency transportation, medical treatment, care or hospitalization deemed necessary while he/she is participating in the above stated activities. I understand the district will assume no liability or cost for such emergency transportation and medical treatment. I also understand that insurance coverage is my responsibility.
Parent Signature *
Today's Date *
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