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POW! Weekly REGISTRATION for SaturdayFUN Program, Tutoring, Grownups Chat & Basketball (pending)
Art/Dance/ Movement/ Obstacles course/Music/ Storytelling/inclusive Soccer/ tutoring/Grownups Chat/ Basketball
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Email
*
Your email
Your input helps us with planning: how can we best support your kid during our programs? Is there a diagnosis/ need we should know about?
Your answer
Phone no. for txt:
*
Your answer
Names
of kid,s,
age,s
:
*
Your answer
Full Name/s of guardian/ parent/s AND address
*
Your answer
Are you attending all programs Saturdays,11 AM - 2:30 PM
*
Yes
Dance/ Playful Movement, 11:00 AM
StoryPower & snack/ lunch, 12:15 PM
Therapeutic Dog visit 12:30
Inclusive soccer/ SuperSoccerStar, 1:30-2:15 PM, one semester (3/4-4/29/23)
Are you attending all programs?
Yes
Dance/ Playful Movement, 11:00 AM
StoryPower & snack/ lunch, 12:15 PM
Therapeutic Dog visit 12:30
Inclusive soccer/ SuperSoccerStar, 1:30-2:15 PM, one semester (3/4-4/29/23)
Are you attending all programs?
Tutoring, Midweek, 1:1, pls send email with tutoring in subject
Grade level K-2
Grade level 3-5
Grade level 6-8
Grade level 9-12
Reading
Writing
Math
Other:
Clear selection
ParentsChat Group…talk, listen, talk,…
In between 12—1:30 PM
Please wear a mask indoors and keep a safe distance outdoors
*
Yes, we will wear a Mask if needed
yes, we bring a ball along
Yes, we will try to attend regularly so our kids can form friendships
Yes, we know this is not a drop-off program & a guardian/parent will be present & engaged
I bring water and snack/lunch - we encourage healthy food choices 🤗
Other:
Required
Basketball clinic, 8 weeks (pending, we are still waiting for space approval)
Interested for ages 5—10
Interested for ages 11—16
Tuesdays, in between 4—7PM
Fridays, in between 4—7 PM
Thursdays, in between 4—7 PM
Other:
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In the last 14 days, has anyone in your household had close contact with someone who has or is suspected to have COVID-19?
*
Yes
No
🤗You are all done! Which dates will you NOT attend:
Your answer
Would like to
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to POW! All programs are free (no obligation, but very helpful)
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