Fall 2016 Program Flyer.pub
Danby youth services 2016 Programs Registration Form Pre-registration is REQUIRED! Space is limited, please fill out this form and return it ASAP You will be contacted only if the program or programs you have registered for are full. Please detach this form and return to: Cornell CooperaƟve Extension 615 Willow Ave., Ithaca, NY 14850 , Care of Jack Davison Youth Informa on (Please Print) Youth Name: Grade: Birth date:
M/F: School:
Address:
_______
_______
Parent/Guardian Name:
Danby Youth Programs
Fall - 2016 Programs Managed by Jack Davison
Phone: (Home)____________________________ (Work)______________________ (e‐mail)_________________________________________________________
Emergency Contact Informa on
Name:
Phone: (Home)
(Work)
Medical Condi ons/Restric ons, or special needs? ________________________________________________________________
Allergies?
_____ Yes, I give permission for my child to fully par cipate in Rural Youth Services Summer 2016 programs and to ride in Coopera ve Extension program van if necessary to get to and from ac vi es, field trips and to transport youth home if necessary. _____ Yes, I give permission for program staff and/or other emergency care personnel to administer first aid or medical treatment in the event of an emergency involving my child. _____ Yes, I give permission for my child to par cipate in program evalua on ac vi es for the purpose iden fying the program’s value and ways to strengthen and improve it in the future. Ac vi es may include: skills checklists, informal discussion, surveys, observa on, or group ac vi es. Any feedback or informa on gathered will remain anonymous. ______Yes, I give permission for my child’s photo to be taken during the ac vity and for any photo to be use for documenta on and publicity purposes. ______If my child is unable to a end a scheduled event, I will alert the program manager at © 5925314 or 272-2292 ext. 223 ______ Yes, I understand that my child should bring their own snack, lunch and water for the day. I also understand that they should dress appropriately for the programs that they are a ending. Parent/Guardian Signature:
Date:_______
This program is sup‐ ported by Tompkins County, New York State and your local municipality.
Rural Youth Services Cornell Coopera ve Extension 615 Willow Ave., Ithaca, NY 14850
(607)272‐2292
Please indicate which program(s) your child will be parƟcipaƟng in.
Council strive to bring you the most enriching programs for youth in Elementary and Middle School who reside in the Danby area.
Danby welcomes their new Rural Youth Educator Jack Davison! Though Travis will be missed by many, Jack is excited to con nue Travis’s success with well known programs in addi on to new programs with focus in crea ve construc on, outdoor educa on and theatre! Jack will be at the Danby Harvest Fest on October 16th so come say hello! Email: [email protected] Phone: (607)272-2292
Rethink… Repurpose ———————————————————————————————————————————————————————
Cornell Cooperative Extension, Tompkins County and the Town of Danby and the Danby Community
One person’s trash is another person’s treasure! In this program we will take materials and items that have been thrown away or recycled and give them a new purpose, learning how to make the most of what we already have, and conserve our resources by being crea ve! Program runs from Oct. 3rd to Nov. 14th Will not meet on Oct. 12th (Columbus Day) Where: Danby Community Church When: Mondays, 4:30pm ‐ 6:00pm
Lunch Bunch @ Boynton Middle School We don’t bite! Come hang with us for lunch Tuesdays During your Lunch period @ Boynton Middle School! Wizarding Wednesdays Leading up to the “Wizarding Weekend” (October 27th ‐ 30th), there is much to prepare for! Brooms must be enchanted, House Dormitory's decorated, Uniforms patched and the Bu er-beer prepared! And don’t forget Quidditch prac ce! From Diagon Alley all the way to Hogwarts there is much to do! Program runs from Oct. 5th to Oct. 26th at the Danby Community Church, Wednesdays, 3:30pm ‐ 6:00pm
Primitive Pursuits
Come enjoy the brilliant colors of fall--while learning ancestral living skills such as fric on fires, shelter building, na ve cra s, nature awareness, tracking and more! Par cipants learn about their local environment through the study of earth living skills and nature awareness. This program is for elementary students Program Dates: Oct. 7, 14, 21, 28 Nov. 4, 18 Dec. 2, 9, 16 Where: 43 Hornbrook Road When: Fridays, 3:30pm ‐ 5:30pm
M/F: School:
Address:
_______
_______
Parent/Guardian Name:
Danby Youth Programs
Fall - 2016 Programs Managed by Jack Davison
Phone: (Home)____________________________ (Work)______________________ (e‐mail)_________________________________________________________
Emergency Contact Informa on
Name:
Phone: (Home)
(Work)
Medical Condi ons/Restric ons, or special needs? ________________________________________________________________
Allergies?
_____ Yes, I give permission for my child to fully par cipate in Rural Youth Services Summer 2016 programs and to ride in Coopera ve Extension program van if necessary to get to and from ac vi es, field trips and to transport youth home if necessary. _____ Yes, I give permission for program staff and/or other emergency care personnel to administer first aid or medical treatment in the event of an emergency involving my child. _____ Yes, I give permission for my child to par cipate in program evalua on ac vi es for the purpose iden fying the program’s value and ways to strengthen and improve it in the future. Ac vi es may include: skills checklists, informal discussion, surveys, observa on, or group ac vi es. Any feedback or informa on gathered will remain anonymous. ______Yes, I give permission for my child’s photo to be taken during the ac vity and for any photo to be use for documenta on and publicity purposes. ______If my child is unable to a end a scheduled event, I will alert the program manager at © 5925314 or 272-2292 ext. 223 ______ Yes, I understand that my child should bring their own snack, lunch and water for the day. I also understand that they should dress appropriately for the programs that they are a ending. Parent/Guardian Signature:
Date:_______
This program is sup‐ ported by Tompkins County, New York State and your local municipality.
Rural Youth Services Cornell Coopera ve Extension 615 Willow Ave., Ithaca, NY 14850
(607)272‐2292
Please indicate which program(s) your child will be parƟcipaƟng in.
Council strive to bring you the most enriching programs for youth in Elementary and Middle School who reside in the Danby area.
Danby welcomes their new Rural Youth Educator Jack Davison! Though Travis will be missed by many, Jack is excited to con nue Travis’s success with well known programs in addi on to new programs with focus in crea ve construc on, outdoor educa on and theatre! Jack will be at the Danby Harvest Fest on October 16th so come say hello! Email: [email protected] Phone: (607)272-2292
Rethink… Repurpose ———————————————————————————————————————————————————————
Cornell Cooperative Extension, Tompkins County and the Town of Danby and the Danby Community
One person’s trash is another person’s treasure! In this program we will take materials and items that have been thrown away or recycled and give them a new purpose, learning how to make the most of what we already have, and conserve our resources by being crea ve! Program runs from Oct. 3rd to Nov. 14th Will not meet on Oct. 12th (Columbus Day) Where: Danby Community Church When: Mondays, 4:30pm ‐ 6:00pm
Lunch Bunch @ Boynton Middle School We don’t bite! Come hang with us for lunch Tuesdays During your Lunch period @ Boynton Middle School! Wizarding Wednesdays Leading up to the “Wizarding Weekend” (October 27th ‐ 30th), there is much to prepare for! Brooms must be enchanted, House Dormitory's decorated, Uniforms patched and the Bu er-beer prepared! And don’t forget Quidditch prac ce! From Diagon Alley all the way to Hogwarts there is much to do! Program runs from Oct. 5th to Oct. 26th at the Danby Community Church, Wednesdays, 3:30pm ‐ 6:00pm
Primitive Pursuits
Come enjoy the brilliant colors of fall--while learning ancestral living skills such as fric on fires, shelter building, na ve cra s, nature awareness, tracking and more! Par cipants learn about their local environment through the study of earth living skills and nature awareness. This program is for elementary students Program Dates: Oct. 7, 14, 21, 28 Nov. 4, 18 Dec. 2, 9, 16 Where: 43 Hornbrook Road When: Fridays, 3:30pm ‐ 5:30pm
