2021 MCYC Summer Program Registration

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MCYC 2021 Summer Program Registration Information

Students in Grades K-6 during 2021-2022 school year
Basement of the Mondovi City Building and Central Lutheran Church
June 7 to August 20, 2021
Monday – Friday
7:00 a.m. – 5:30 p.m.

$110/week per student - No part time rates available in summer 2021

Students must bring their own sack lunch each day if lunch is not available at school. Students will participate in school breakfast, if available at school. Morning (if no breakfast) and afternoon snacks are provided. MCYC summer staff is custodial care and mandatory reporter trained college and high school students. All MCYC summer students will also enroll in Buffalo County 4-H and enter exhibits at the Buffalo County Fair – fair fees are included in registration. Field trips to the Mondovi Swimming Pool will be reevaluated as summer approaches. Participation in Mondovi School District Summer School is required.

The summer program will be limited to 40 full time students if all staff positions are able to be filled. Please read the plan below to learn more about student priority. A wait list will be established, if necessary.

READ THE 2021 MCYC SUMMER PLAN at https://buffalo.extension.wisc.edu/4hyd/yd/mcyc/

In order to finalize MCYC Summer registration, a deposit per student equal to one week’s fees must be paid by May 15, 2021. This deposit is nonrefundable after May 15, 2021. The deposit will be applied to the last week of participation in MCYC Summer Program. A $10 4-H enrollment fee per student for insurance is also required; include fee with your deposit. You will receive invoices to your email via QuickBooks. Please send checks only made payable to MCYC to: Candi Bollinger, MCYC Treasurer, 627 Kennedy St., Mondovi, WI 54755 or send to MCYC with your child in a sealed envelope marked MCYC Summer (preferred for current after school families only).

Please complete one registration form per student. Thank you.

Email *

Parent/Guardian Name *

Contact Phone for Registration Purposes *

Contact Email for Registration Purposes *

Student First and Last Name *

Student Current Grade *

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

Monday

Tuesday

Wednesday

Thursday

Friday

Required

Estimated Time of Arrival Each Day (Arrival is limited to 7:00am-8:00am in 2021) *

Time

Estimated Time of Departure Each Day (Departure is limited to 4:00pm - 5:30pm in 2021) *

Time

Please include any comments or additional information MCYC 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.

MCYC Summer Program Contract -- READ THE FINE PRINT PLEASE *

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

MCYC Summer Program will run from June 7, 2021 to August 20, 2021. The program is housed at the Mondovi City Building and the Central Lutheran Church both on Franklin St. Hours are 7:00 a.m. to 5:30 p.m., Monday through Friday.

Contracts must be fulfilled for the entire length of the MCYC Summer Program.

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 June 7, 2020. 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 MCYC Summer program.

Students must bring their own lunch each day unless school lunch is available. Morning and afternoon pre-packaged snacks are provided daily.

My child will wear a face covering, follow physical distancing guidelines, and adhere to other protocol established for the health and safety of students and their families during the COVID-19 pandemic.

I have read the MCYC Summer Program Plan and I understand that UW-Madison Division of Extension faculty, staff and volunteers may require that program participants leave a program, based on health concerns associated with COVID-19.

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 MCYC policies, including those established in the MCYC Summer Plan to comply with COVID-19 protocol.

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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