ARAB IC IMMERSION M AGNE T SCHOOL (AIMS )
AFTER SCHOOL PR OGRAM (ASP)
REGISTR ATION GUIDE FALL 2015
Download complete Registration Packet from http://www.houstonisd.org/Domain/1865
Regi str ati on In fo
Date s
Whe re
Note the dates li sted below. In addi tion, all details are listed i n
each of the pages. Thank you.
Ear ly Re gi stra tion
April 7 – Ma y 28
AIM S O ffice
Aft er Ma y 28
AIM S O ffice
*Registration is first come first serve.
*Register Early-$15.00 Registration Fee
Late Re gi stra tion
*Registration is first come first serve.
*Register Late–$25.00 Registration Fee
Add- Dro p D ea dline
Se pte mb er 1 8
AIM S A S P Offic e
Ext en ded Da y Dat e s
Aug ust 2 4-De ce mb er 1 8
On S ite
Enr ich me nt Cla s se s
Se pte mb er 8- De ce mb er 1 8
On S ite
Se pt. 2 2, Oc t. 1 4, 2 8,
No v. 18, De c. 9
On S ite
5 E arl y D is mi s sal Dat e s
12:3 0-3: 00
(If you enroll in Full OR Half Time
Ext Day, this is included.)
9 Bi Weekly Payments (details on Page 5)
At registration, Sept. 4, Sept. 18, Oct. 2, Oct. 16, Oct. 30, Nov. 13, Nov. 30, Dec. 12
OR
4 Monthly Payments (divide your total amount by 4)
At Registration, Oct. 2, Nov. 6, Dec. 4
Make your money order OR check payable to: Arabic Immersion Magnet School
Questions: Contact Sylvia Ponce de Leon, Director: ciasp2@sbcglobal.net OR 713-529-3507
Your registration packet is complete when it includes the following items for each child:
______Extended Day and Enrichment Options (Page 5)
______Contract Agreement/Safety Plan Form - signed] (Page 7-8)
______Authorization Form (Page 9)
______A check or money order payable to: Arabic Immersion Magnet School
Parent Copy
Copyright © 2015 c.h.i.l.d.r.e.n.s. Initiatives After School Programs
Dear Parents,
The Arabic Immersion Magnet School is proud to present a quality After School Program. This
program is designed to provide the needs of the school community in an after school setting. The quality
of our program will thrive with the cooperation of the school community (i.e. administration, staff,
parents, children).
Since this is our first year, together we will expand this program as the year
progresses.
This packet is comprised of several forms. We ask that you review each form and submit only
those that apply to your particular registration.
To better assist you, please note the documents
included in this packet:
Enclosed in this packet are the following forms:
• Page 1 Front Cover Page with Deadlines (PARENT COPY)
• Page 2 Parent Letter (PARENT COPY)
• Page 3-4 Contract Agreement/Safety Plan (PARENT COPY)
• Page 5-6 Extended Day & Enrichment Options (OFFICE COPY)
• Page 7-8 Contract Agreement/Safety Plan (OFFICE COPY)
• Page 9 Authorization/Emergency Form (OFFICE COPY)
IMPORTANT INFORMATION FOR YOU TO KNOW:
1.
•
•
2.
3.
4.
REGISTRATION: Registrations are processed as they are received. The date and/or order of registration
submission will be recorded on your paperwork.
Beginning Aprll 7: Registration forms will be available to be submitted to the School Office by Thursday
May 28.
st
Registrations received after May 28 may be processed for services to begin 2 days after the 1 day
of school (August 26) or 2 days after the day you submit your registration after August 24.
OUTSTANDING BALANCES: For future semesters, registrations will not be accepted from anyone who
has an outstanding balance from any previous semester. Registrations submitted must include a separate
check for their outstanding balance in addition to their first payment. Any accounts with outstanding
balances over $100.00 remaining after December 12 will be assessed a $25.00 collection fee, which
will be rolled over to the Spring 2016 semester. Failure to meet your financial obligations may result in
suspension of services to you. In addition, at the end of the Spring 2015 Semester any account with
outstanding balances over $100.00 will be assessed a $25.00 collection fee, which will be rolled
over to the Fall 2016 semester.
PAYMENT: All checks/money orders are to be made payable to: Arabic Immersion Magnet School
(AIMS). You may either submit your payment of the full amount of your bill at the time of registration OR
you may submit your payments in 4 installments, OR you may submit bi-weekly payments. This is offered
as a convenience to you. Please see the Contract Agreement Safety Plan Form for important details
including deadlines.
RETURNED CHECKS: Checks returned by the bank must be repaid in the form of a money order
for the exact amount. In addition, there is a check return fee of $35.00 that must also be submitted
in a separate money order. Failure to do this within 24 hours of notification may result in
suspension of services.
We are looking forward to a successful Fall 2015 Semester! If you have any other concerns and/or
questions, please do not hesitate to contact us.
Sincerely,
Sylvia Ponce de Leon
Director, After-School Programs
713-529-3507
Email: ciasp2@sbcglobal.net
Parent copy
2
Copyright 2015 © childrens initiatives After School Programs
ARABIC IMMERSION MAGNET SCHOOL (AIMS)
AFTER SCHOOL PROGRAM (ASP)
Contract Agreement/Safety Plan Fall 2015
By initialing and signing below, I understand the contents of this registration packet and agree to the following for
the Fall Semester of 2015. Disregard of this contract and/or the contents in the registration packet will result in
immediate dismissal from AIMS.
1.
REGISTRATION: Registration in any Enrichment Class (Sept. 8-Dec. 18) and/or Extended Day Program
(Aug. 24-Dec. 18) is for the entire Fall Session. Tuition and fees are not prorated after the Add/Drop
deadline of September 18. Only 2 changes are permitted during the Add/Drop. All registered students will
receive confirmation of registration of their enrichment classes during the week of August 10 if you submit
your registration by May 28. No class changes will be made and no refunds or credits will be issued
after Sept. 18. However, any class attended during the weeks of Sept. 7-Sept. 18 will be prorated. I
understand that my registration is ONLY valid if I have paid out all prior balances owed to the
school. Furthermore, I understand that if I submit my registration after May 28, I will be assessed a Late
Registration Fee of $25.00. Also, if I submit my registration after May 28 my registration may be processed
for services to begin within 2 school days after the 1st day of school. Furthermore, I must make other
arrangements for After School until my child’s registration has been processed. In addition, NO refunds
will be assessed in the event of HISD canceling after-school activities for inclement weather or any
other extenuating circumstances.
2.
SIGN OUT: I will sign out my child from an After School Staff Member each day. If my child is enrolled
ONLY in Enrichment Classes, I will sign out my child from an After School Staff Member located in the front
office at the time the Enrichment Class ends. SHOWING PHOTO ID IS MANDATORY UPON REQUEST.
3.
LATE PICK UP:
• If my child is enrolled in Full Time Extended Day and is picked up after 6:00 PM I understand I will be
assessed a late pickup fee of $2.00/ per minute.
• If my child is enrolled ONLY IN AN ENRICHMENT CLASS AND I am late picking up my child by the end
of class time, I understand I may be assessed a
late pick up fee of $2.00/minute. If I am late more than 6 minutes, I have the option of purchasing HalfTime Occ Extended Day of 5-Units which will provide supervision until 6:00 PM. 1 Unit from this card will
be used for the late pick up of the day I purchase this option and I understand that I will have 4 Units
remaining. After 6:00 PM, I will be assessed a fee of $2.00/minute.
• After the 5th late pick-up I may be asked to make other arrangements for After School Services.
• The official time for our after school program will be gauged by the clock located in the school office.
• Please Note: If late pick-up fees are not paid within 24 hours, the fee is automatically doubled
(Check or money order only)
4.
EXT DAY & ENRICHMENT TIMES: I understand that the times of the Enrichment Classes are: 3:30 - 4:30
or 4:35-5:35 OR 3:30-4:00; 4:05-4:35; 4:40-5:10; 5:15-5:45 and the hours of Extended Day are: Full Time
Extended Day 3:00-6:00 p.m.; Half Time Extended Day 3:00-5:00.
5.
Should my child be enrolled ONLY in an ENRICHMENT CLASS AFTER 3:30: I must enroll my child in
either a 3:30 Enrichment Class, Bridge to Enrichment, or Occasional Extended Day.
6.
OCCASIONAL EXTENDED DAYS:
• If I no longer have any Occasional Extended Day Units, I understand another 5-Unit Card will be
AUTOMATICALLY billed to my account.
• I understand that any Occasional Extended Day Unit purchases billed after Nov. 30 MUST BE PAID
WITHININ 24 HOURS OR THERE WILL BE NO
SERVICES PROVIDED.
7.
PICK UP CHANGES/NOTIFICATIONS: I am aware that my child MUST be picked up by an adult and that
my child will never be allowed to walk home without the supervision of an authorized adult I have listed on
the Authorization Contact Form. Furthermore, I will notify in writing via a handwritten note or via email, the
Director (ciasp2@sbcglobal.net) and or Coordinator when my child will not report to Extended Day and/or
Enrichment Classes for any of the following reasons:
A. I will be picking up my child before OR at 3:00 p.m.
B. Someone else, authorized by me, will pick up my child @ 3:00 p.m.
Parent Copy
3
Copyright ! 2015 c.h.i.l.d.r.e.n.s. Initiatives After School Programs
ARABIC IMMERSION MAGNET SCHOOL (AIMS)
AFTER SCHOOL PROGRAM (ASP)
Contract Agreement/Safety Plan Fall 2015
8.
9.
10.
11.
12.
PAYMENTS: MUST BE SUBMITTED BY CHECK OR MONEY ORDER ONLY made out to AIMS. Cash is
not accepted. NOTE:
____If I select to pay biweekly, I will submit my first biweekly payment at the time of
registration. The next due dates are as follows: 9 Bi Weekly Due Dates of XDay: At registration, Sept.
4, Sept. 18, Oct. 2, Oct. 16, Oct. 30, Nov. 13, Nov. 30, Dec. 12
____If I select to pay in 4 installments I will pay at least of 1/4 of my total balance at the time of registration.
The next 3 payments are due as follows: Oct. 2, Nov. 7 & Dec. 4.
____If I do not submit my payments by the due dates, I will be assessed a late fee of $10.00 on the next
day the payment was due.
____I will be assessed a $35.00 charge for each returned check. All returned checks must be repaid to
the school within 24 hours after being notified via a Money Order for the EXACT amount of the
returned check. In addition, there is a $35.00 check return fee assessed by HISD. This payment
must be submitted in a separate money order on the same day you submit the money order for the
returned check. After 1 returned check, all future payments must be made by money order. ***
____I understand that after school services will be suspended if I do not pay my bill on time.
BEHAVIOR EXPECTATIONS: The HISD Code of Student Conduct will serve as the basis for all discipline
expectations to ensure the safety of all students and staff members. Parents will be notified immediately if
their child has violated any portion of the school’s previously communicated Code of Student Conduct.
Services will be suspended should disrespectful or unsafe behavior be directed towards a student or staff
member, either by a parent of a student or a student enrolled in the program. I understand that it is my
responsibility for reading and knowing the expectations of the HISD Code of Conduct. I also understand that
the program reserves the right to deny services on a permanent basis if behavior expectations are not being
met.
SPECIAL NEEDS: We do not provide staff trained to deal with special needs. Please contact the ASP
Coordinator regarding any questions.
Contact Information: I understand that my email address and/or phone number(s) may be given to the
Provider of
any Enrichment class in which I have enrolled my child should the Provider find it necessary to contact me
for After School Activities ONLY.
Technology DEVICES: While students may be permitted to use their technology during the school day
under the supervision of their teacher, no technology devices may be used in the after school program by
any student in grades PK-5. All such devices must be kept in the student’s backpack.
Disregard of any portion of this contract calls for immediate dismissal from the After School Program. By
signing this contract, I am agreeing to all of the above terms and fully understand all information listed on
the Parent Letter AND on any of the forms of this packet.
______________________________/___________________________/_______________/__________________
Name of Parent (please print)
Parent Signature
Date
STUDENT NAME
_____________________________/___________________________/_______________/__________________
Name of Parent (please print)
Parent Signature
Date
STUDENT NAME
Parent Copy
4
Copyright ! 2015 c.h.i.l.d.r.e.n.s. Initiatives After School Programs
ARABIC IMMERSION MAGNET SCHOOL (AIMS)
AFTER SCHOOL PROGRAM (ASP)
EXTENDED DAY AND ENRICHMENT OPTIONS FALL 2015
Full, Half, Occasional & Early Dismissal Extended Day Extended Day Program (" Select One Option)
(Payment due dates are listed on this table.)
Full Time Ext Day 3:00-6:00 /$110/Bi-WEEKLY
Half Time Ext Day 3:00-5:00 /$103/BI-WEEKLY
$957.00
$896.00
"5 Units
$60.00
$55.00
Full Time Occasional Ext Day 3:00-6:00
Half Time Occasional Ext Day 3:00-5:00
Bridge to Enrichment
$60.00
Early Dismissal per Day (12:30-3:00)
$12.00
8 payments of $110 and final payment of $77.00
8 payments of $103 and final payment of $72.00
"10 Units
"15 Units
"20 Units
$120.00
$180.00
$240.00
$110.00
$165.00
$220.00
"25 Units
$300.00
$275.00
Bridge of Time to cover supervision should you enroll ONLY in an
Enrichment Class with a start time of after 3:30.
$24.00
$36.00
$48.00
$60.00
NOTE: There are 5 Early Dismissal Days: Sept. 22, Oct. 14, 28, Nov. 18, Dec. 9ximum of 1 hour of Homework Time Daily.
Full & Half Time Ext Day Payment Due Dates: At registration, Sept. 4, Sept. 18, Oct. 2, Oct. 16, Oct. 30, Nov. 13, Nov. 30, Dec. 12
ENRICHMENT CLASSES – Sept. 14-Dec. 18 (No Enr Classes week of Thanksgiving)
If you choose to register in any class, a minimum of 1/4 of the total amount is due at the time you register. Thank you.
NOTE: If you are enrolled in any portion of Ext Day, your bi-weekly payment is due in addition to ! of the total amount due for Enrichment Classes at the
nd th
time of Registration. In addition, the 2 -4 Payments for Classes are due as follows: Oct. 2, Nov. 6, Dec. 4. You must add the Supply Fee to your total.
Thank you.
Select One !
Min/Max #
Class Name
Time
Day
Grade
Rm #
Tuition
Supply
Teacher
of Students
Fees
5/10
Sculpture Magic
3:30-4:30 Mon
PK-K
TBA
$195.00
$50.00 City ArtWorks
8/15
Camp Einstein
3:30-4:30 Mon
PK-K
TBA
$250.00
$0.00
Camp Einstein
8/12
10/15
10/15
Creative Dance Movement
Soccer
Soccer
4:35-5:35
3:30-4:30
4:30-5:30
Tues
Tues
Tues
PK-K
PK
K
TBA
TBA
TBA
$265.00
$210.00
$210.00
$25.00
$5.00
$5.00
TBA
Mini Stars
Mini Stars
5/15
5/15
1/1
1/1
1/1
1/1
ArtSmart-Early Childhood
ArtSmart-Early Childhood
Private Piano
Private Piano
Private Piano
Private Piano
3:30-4:30
4:35-5:35
3:30-4:00
4:05-4:35
4:40-5:10
5:15-5:45
Wed
Wed
Wed
Wed
Wed
Wed
PK
K
PK-K
PK-K
PK-K
PK-K
TBA
TBA
TBA
TBA
TBA
TBA
$195.00
$195.00
$390.00
$390.00
$390.00
$390.00
$40.00
$40.00
$35.00
$35.00
$35.00
$35.00
City ArtWorks
City ArtWorks
Linda Singer Piano Studio
Linda Singer Piano Studio
Linda Singer Piano Studio
Linda Singer Piano Studio
5/15
7/15
Arabic Language & Crafts Fun
Imagineers “Little Engineers w/Big
Ideas”
3:30-4:30
3:30-4:30
Thur
Thur
PK-K
PK-K
TBA
TBA
$225.00
$225.00
$25.00
$0.00
TBA
American Robotics Academy
NOTE: There must be a minimum number of students enrolled in classes in order for the classes to form. Class Descriptions are found on Page 5. Thank you.
Tuition & Fees
Total Cost
A. Total of Extended Day - Full Time Ext Day ($957)
$ _______________Minimum due: $110.00
Half Time Ext Day ($896)
$ _______________Minimum due: $103.00
Occasional Ext Day
$ _______________# of Units: 5 10 15 20 25 (to be paid in full)
B. Total Tuition for Enrichment Class(es)
$ _______________Total Tuition for Enrichment
C. Total Supply Fees for Enrichment Class(es)
$ _______________Total Supply Fees for Enrichment
D. Total Amount to be paid for Enrichment
$ _______________Min. due: at least ! Enrichment total + Supply Fees
E. Grand Total of A, B, C
$ _______________Ext Day, Enrichment Classes & Supply Fees
F. Payment Enclosed
$ _______________Must be weekly cost of Ext Day and/or 1/4 of Enr Cost)
Initial those that
apply to you
Acceptance of
AIMS ASP
Contract
Please initial
Submitting Full payment
(Grand total – Line E)
Please initial
Total Pymt
Paying 1/4 of GRAND TOTAL
Please initial
$
Total Pymt
Paying Different amount (AT LEAST BI-WEEKLY
COST OF EXT DAY AND/OR 1/4 COST OF
ENRICHMENT AND/OR FULL COST OF OCC)
Please initial
Total Pymt
$
$
Parentʼs Name:_________________________________________Signature_________________________________________________Date______________
Date
Payment At Registration
Amount
For Office Use Only
Check #
Initial
_________________________________________________________________________________
NOTE: When your child is not attending a Homework Class or an Enrichment Class, he/she will be under the supervision of an Extended Day Group Leader
working on different planned activities. Thank you.
Office Copy
5
Copyright ! 2015 c.h.i.l.d.r.e.n.s. Initiatives After School Programs
ARABIC IMMERSION MAGNET SCHOOL (AIMS)
AFTER SCHOOL PROGRAM (ASP)
Enrichment Class Descriptions Fall 2015
Arabic Language & Crafts Fun: This hands-on course is designed for children who love art or want or
need to explore their creativity. At the same time they will be learning and practicing the Arabic language
related to Arts and Crafts. During this course your child will develop his/her fine motor skills as well as
creating their own art pieces. During the “Art Periods” children will be involved in unstructured activities
in which they will explore their imagination. During the “Craft Periods” they will be involved in structured
activities with a specific goal in mind, which will be more intricate and demanding. We will learn to take
care of our materials and to communicate visually through art. Through the process of making our own
creations and noticing other children’s creations we will appreciate other children’s talents strengths and
acceptance of our own abilities.
Children will splash stimulation over creation, imagination,
communication, fine motor skills, interaction and appreciation of other people abilities. Come and join us.
ArtSmart-Early Childhood: Art Smart is an early learning program that introduces young children to art
by letting their natural creative abilities unfold in a fun environment. While students explore color, texture,
shapes, and different types of art materials, they learn to freely express their feeling and ideas through
art projects. ArtSmart is designed to help children develop fine motor skills, perceptual thinking, and
creative problem solving while building an appreciation of art. Students will work with a range of art
materials and techniques tailored to their specific developmental level.
Camp Einstein: In this class, explore topics in Engineering, Science and CSI Investigation. Design
propeller cars and roller coasters. Explore volcanoes and build a rocket to launch into the sky. Become
a CSI Investigator and solve a mystery using blood and DNA analysis. This is the perfect class for the
curious minded student who loves to build, create and see how things work!
Clay Pottery: Explore a wide range of materials and tools for creating sculpture. Construct with wire,
clay, assemblage and much more. Basic sculpting skills and concepts will be introduced allowing
students to create many 3-D wonders during the semester.
Creative Dance Movement: Children’s Combination Dance Classes in ballet, tap, and creative
movement will emphasize balance, rhythm, flexibility, musicality, and spatial awareness for children ages
4 – 6 yrs. old. These weekly sessions will aid a child in exploring movement, gaining self-confidence, and
learning how to follow directions in an environment where children are having fun while learning. Dance
Class Attire: (Girls) Black Leotard, Pink Tights, Pink Ballet Shoes, and Black Tap Shoes. No skirts or
tutus, please. (Boys) T-Shirt, Shorts, Black Ballet Shoes, and Black Tap Shoes. Please send all items
marked with child’s name in a separate bag so we may assist them to get dressed.
Imagineers “Little Engineers w/Big Ideas: “Little engineers with BIG ideas” Children explore the
mechanical use of gears, pulleys, axles, motors and much more, while learning to visually follow and
understand step-by-step construction manuals and basic mechanical properties of how things move and
work. Working in small groups, our young LEGO builders’ dreams come to life. With imaginations going
“wild”, the possibilities are endless.
Private Piano: Offers Beginner to Intermediate private lessons including basic musicianship relating to
Piano, as well as Music Theory pertaining to Piano. Each student will have homework assigned.
Therefore, each student must own their own instrument to practice with at home.
Soccer: This class teaches the students the game of soccer and gives them an understanding of the
rules. It helps them develop fundamental skills needed in the game as well as adding a good form of
exercise to their day. Technique is emphasized more as the student learns to master more difficult
maneuvers. The challenge and excitement of the games keeps learning fun! Soccer will help the
students better their foot skills, balance, coordination, agility, and most importantly, their team work skills.
Main topics in Soccer Clinics (dribbling, passing, footskills, turning, shooting ) confidence on the ball.
Parent Copy
6
Copyright ! 2015 c.h.i.l.d.r.e.n.s. Initiatives After School Programs
ARABIC IMMERSION MAGNET SCHOOL (AIMS)
AFTER SCHOOL PROGRAM (ASP)
Contract Agreement/Safety Plan Fall 2015
By initialing and signing below, I understand the contents of this registration packet and agree to the following for
the Fall Semester of 2015. Disregard of this contract and/or the contents in the registration packet will result in
immediate dismissal from AIMS.
1.
REGISTRATION: Registration in any Enrichment Class (Sept. 8-Dec. 18) and/or Extended Day Program
(Aug. 24-Dec. 18) is for the entire Fall Session. Tuition and fees are not prorated after the Add/Drop
deadline of September 18. Only 2 changes are permitted during the Add/Drop. All registered students will
receive confirmation of registration of their enrichment classes during the week of August 10 if you submit
your registration by May 28. No class changes will be made and no refunds or credits will be issued
after Sept. 18. However, any class attended during the weeks of Sept. 7-Sept. 18 will be prorated. I
understand that my registration is ONLY valid if I have paid out all prior balances owed to the
school. Furthermore, I understand that if I submit my registration after May 28, I will be assessed a Late
Registration Fee of $25.00. Also, if I submit my registration after May 28 my registration may be processed
for services to begin within 2 school days after the 1st day of school. Furthermore, I must make other
arrangements for After School until my child’s registration has been processed. In addition, NO refunds
will be assessed in the event of HISD canceling after-school activities for inclement weather or any
other extenuating circumstances.
2.
SIGN OUT: I will sign out my child from an After School Staff Member each day. If my child is enrolled
ONLY in Enrichment Classes, I will sign out my child from an After School Staff Member located in the front
office at the time the Enrichment Class ends. SHOWING PHOTO ID IS MANDATORY UPON REQUEST.
3.
LATE PICK UP:
• If my child is enrolled in Full Time Extended Day and is picked up after 6:00 PM I understand I will be
assessed a late pickup fee of $2.00/ per minute.
• If my child is enrolled ONLY IN AN ENRICHMENT CLASS AND I am late picking up my child by the end
of class time, I understand I may be assessed a
late pick up fee of $2.00/minute. If I am late more than 6 minutes, I have the option of purchasing HalfTime Occ Extended Day of 5-Units which will provide supervision until 6:00 PM. 1 Unit from this card will
be used for the late pick up of the day I purchase this option and I understand that I will have 4 Units
remaining. After 6:00 PM, I will be assessed a fee of $2.00/minute.
• After the 5th late pick-up I may be asked to make other arrangements for After School Services.
• The official time for our after school program will be gauged by the clock located in the school office.
• Please Note: If late pick-up fees are not paid within 24 hours, the fee is automatically doubled
(Check or money order only)
4.
EXT DAY & ENRICHMENT TIMES: I understand that the times of the Enrichment Classes are: 3:30 - 4:30
or 4:35-5:35 OR 3:30-4:00; 4:05-4:35; 4:40-5:10; 5:15-5:45 and the hours of Extended Day are: Full Time
Extended Day 3:00-6:00 p.m.; Half Time Extended Day 3:00-5:00.
5.
Should my child be enrolled ONLY in an ENRICHMENT CLASS AFTER 3:30: I must enroll my child in
either a 3:30 Enrichment Class, Bridge to Enrichment, or Occasional Extended Day.
6.
OCCASIONAL EXTENDED DAYS:
• If I no longer have any Occasional Extended Day Units, I understand another 5-Unit Card will be
AUTOMATICALLY billed to my account.
• I understand that any Occasional Extended Day Unit purchases billed after Nov. 30 MUST BE PAID
WITHININ 24 HOURS OR THERE WILL BE NO
SERVICES PROVIDED.
7.
PICK UP CHANGES/NOTIFICATIONS: I am aware that my child MUST be picked up by an adult and that
my child will never be allowed to walk home without the supervision of an authorized adult I have listed on
the Authorization Contact Form. Furthermore, I will notify in writing via a handwritten note or via email, the
Director (ciasp2@sbcglobal.net) and or Coordinator when my child will not report to Extended Day and/or
Enrichment Classes for any of the following reasons:
A. I will be picking up my child before OR at 3:00 p.m.
B. Someone else, authorized by me, will pick up my child @ 3:00 p.m.
Office Copy
7
Copyright ! 2015 c.h.i.l.d.r.e.n.s. Initiatives After School Programs
ARABIC IMMERSION MAGNET SCHOOL (AIMS)
AFTER SCHOOL PROGRAM (ASP)
Contract Agreement/Safety Plan Fall 2015
8.
9.
10.
11.
12.
PAYMENTS: MUST BE SUBMITTED BY CHECK OR MONEY ORDER ONLY made out to AIMS. Cash is
not accepted. NOTE:
____If I select to pay biweekly, I will submit my first biweekly payment at the time of
registration. The next due dates are as follows: 9 Bi Weekly Due Dates of XDay: At registration, Sept.
4, Sept. 18, Oct. 2, Oct. 16, Oct. 30, Nov. 13, Nov. 30, Dec. 12
____If I select to pay in 4 installments I will pay at least of 1/4 of my total balance at the time of registration.
The next 3 payments are due as follows: Oct. 2, Nov. 7 & Dec. 4.
____If I do not submit my payments by the due dates, I will be assessed a late fee of $10.00 on the next
day the payment was due.
____I will be assessed a $35.00 charge for each returned check. All returned checks must be repaid to
the school within 24 hours after being notified via a Money Order for the EXACT amount of the
returned check. In addition, there is a $35.00 check return fee assessed by HISD. This payment
must be submitted in a separate money order on the same day you submit the money order for the
returned check. After 1 returned check, all future payments must be made by money order. ***
____I understand that after school services will be suspended if I do not pay my bill on time.
BEHAVIOR EXPECTATIONS: The HISD Code of Student Conduct will serve as the basis for all discipline
expectations to ensure the safety of all students and staff members. Parents will be notified immediately if
their child has violated any portion of the school’s previously communicated Code of Student Conduct.
Services will be suspended should disrespectful or unsafe behavior be directed towards a student or staff
member, either by a parent of a student or a student enrolled in the program. I understand that it is my
responsibility for reading and knowing the expectations of the HISD Code of Conduct. I also understand that
the program reserves the right to deny services on a permanent basis if behavior expectations are not being
met.
SPECIAL NEEDS: We do not provide staff trained to deal with special needs. Please contact the ASP
Coordinator regarding any questions.
Contact Information: I understand that my email address and/or phone number(s) may be given to the
Provider of
any Enrichment class in which I have enrolled my child should the Provider find it necessary to contact me
for After School Activities ONLY.
Technology DEVICES: While students may be permitted to use their technology during the school day
under the supervision of their teacher, no technology devices may be used in the after school program by
any student in grades PK-5. All such devices must be kept in the student’s backpack.
Disregard of any portion of this contract calls for immediate dismissal from the After School Program. By
signing this contract, I am agreeing to all of the above terms and fully understand all information listed on
the Parent Letter AND on any of the forms of this packet.
______________________________/___________________________/_______________/__________________
Name of Parent (please print)
Parent Signature
Date
STUDENT NAME
_____________________________/___________________________/_______________/__________________
Name of Parent (please print)
Parent Signature
Date
STUDENT NAME
Office Copy
8
Copyright ! 2015 c.h.i.l.d.r.e.n.s. Initiatives After School Programs
ARABIC IMMERSION MAGNET SCHOOL (AIMS)
AFTER SCHOOL PROGRAM (ASP)
AUTHORIZATION/EMERGENCY FORM FALL 2015
_______________________________________/_____________________________________
Student’s Name
HR Teacher 2015-2016 (Office Use ONLY)
______________________________/______________________________________________
Parent’s Name
Contact Phone(s) # (i.e. cell, work, etc.) between 2:45-6:30PM
_________________________/___________________________________________________
Parent’s Name
Contact Phone(s) # (i.e. cell, work, etc.) between 2:45-6:30PM
Please list individuals authorized to pick up your child (other than yourself). We need individuals who can
be here quickly in cases of: emergencies, traffic, illness, etc. Consider persons who are near the school
such as neighbors, parents of classmates or the like.
_____________________________________________________________________________
Name
Work Phone #
Home Phone#
Other Phone#
_____________________________________________________________________________
Name
Work Phone#
Home Phone#
Other Phone#
_____________________________________________________________________________
Name
Work Phone#
Home Phone#
Other Phone#
_____________________________________________________________________________
Name
Work Phone#
Home Phone#
Other Phone#
Allergies______________________________________________________________________
Please note the following:
1.
It is important you notify the ASP in writing when you have updated information such as an address change, phone
change, and which individuals you authorize to pick up your child, foods your child may be allergic to, etc.
2.
If you are unable to pick up your child for any reason, The ASP will call an adult you have listed on this form.
3.
DO NOT assume the school's front office relays changes you submit to them to them.
4.
On any given day you are having someone NOT listed on this Authorization/Emergency Form pickup your child,
the ASP must receive notification in writing (no later than 1:00PM) from the parent or the individual registering
the student. You MUST notify the ASP as follows:
A.
Email this notification to: ciasp2@sbcglobal.net.
B.
Fax it to: 713-556-8944 and address the note to the attention of After School Program.
C.
Drop off a note in the ASP Box located in the front school office.
D.
Drop off a note in the ASP Office.
5.
Please be aware that we will NOT release your child to anyone unless we have it in writing. We cannot make any
exceptions. It is your responsibility to update any information you provide on this form. Therefore, it is vital to plan
ahead. In addition, your child WILL NOT be released to anyone who is under the age of 18.
_____________________________________________________________________________
Parent Signature
Date
Office Copy
9
Copyright © 2015 c.h.i.l.d.r.e.n.s. Initiatives After School Programs