Enfield Community Council Youth Programs Fall 2015 Registration Form Name of Participant: _________________________________________________ Address:___________________________________________________________ Date of Birth: __________________ Grade: ________ Parent/Guardian Name_______________________________________________ Home Phone: ____________________ Work Phone: _______________________ E-mail Address: ____________________________________________________ Emergency Contact (other than parent/guardian): Name: ________________________________Phone: ______________________ Relation: _______________________
Enfield Community Council
Fall 2015 Youth Programs
Any allergies, special needs, or medical conditions we should be aware of?
Please Check All That Apply _____Yes, I give permission for my child to participate in Enfield Community Council’s Youth Programs in Fall 2015. _____ Yes, I give permission for the Program Manager to transport my child if necessary. _____ Yes, I understand if my child will be absent from school or from a program session I will notify the Program Manager as soon as possible by email or phone. _____ Yes, I give permission for my child to participate in program evaluations in order to assess the program’s value. Any information gathered will remain anonymous. _____ 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’s photo to be taken during activities and for these photos to be used for documentation and publicity purposes (including on social media like Facebook & Instagram). _____ Yes, I understand that I must pick up my child at the end of each program and that supervision of my child is not provided beyond program time, unless otherwise arranged. _____ Yes, I give permission for the release and exchange of my youth’s records and information (progress reports, etc.) to be shared between the Ithaca City School District Guidance Office at Boynton Middle School and the Enfield Youth Program. Parent Signature: ___________________________________________ Date: __________
Please direct any questions to: Josie Bonham Enfield Youth Program Manager (607) 272-2292 x226
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This Season’s Happenings for Enfield Middle School Youth **No programs when school is not in session.**
Eco-Explorers:* Discover the wonders of the great outdoors! We’ll get our hands and boots dirty as we explore, make discoveries, and gain skills in nature awareness. Make a nature journal and keep track of our adventures! Come enjoy the changing seasons in our community. Meets @ Enfield Elem. School. Some field trips with van transport provided. Mondays, 9/21-12/14 (4-6 PM) Pick-up @ Enfield Elem. School
Awesome Animals: Do you love animals? Join us and see why animals are totally awesome. We’ll visit shelter animals at the SPCA, a few farm animals, and meet some wonderful wildlife from the Cayuga Nature Center. Meets @ Enfield Comm. Bldg. Some field trips with van transport provided. Tuesdays, 9/22-10/27 (4-6 PM) Pick-up @ Enfield Comm. Bldg. **NOTE: Program on 9/29 meets @ Boynton Main Office @ 3:30
Game On!: Stay after school and get your game on! Play Magic the Gathering and/ or LOTS of other games with friends, old and new. Meets @ Boynton Cafeteria. Tuesdays, 11/3-12/15 (3:25-5:00 PM) Pick-up @ Boynton Middle School OR students may take late bus home
Girls’ Circle: Celebrate all your girl glory and join this circle of friends! We will be exploring many topics, including self-expression, connecting to each other, leadership, and respect through fun games, crafts, poetry, and more. Meets @ Enfield Comm. Bldg. Some field trips with van transport provided. Wednesdays, 9/23-12/16 (4-6 PM) Pick-up @ Enfield Comm. Bldg. Lunch Bunch: Hang with us at lunch! This IN-SCHOOL group lets you break away from the normal routine and join other students in crafts, games, snacks, and more. Thursdays, 9/24-12/17 (lunchtime) Meets @ Boynton lunchroom
Harvest Fest Crew: Join this fun & industrious crew to get ready for Enfield’s Annual Harvest Festival! You’ll enjoy a pizza party with your fellow crew members on Friday, 10/9 for all your hard work! Volunteer on 10/10 to see your efforts pay off as our community enjoys this special event. Meets @ Enfield Comm. Bldg. Thursdays & Fridays, 9/24-10/9 (4-6 PM) Pick-up @ Enfield Comm. Bldg. **NOTE: Late pick-up time of 7:30PM on 10/9 due to set-up and pizza party
Enfield Youth Programs—Fall 2015 **A suggested donation of $20/program helps us continue to run incredible youth programs! No one will be turned away due to lack of funds.**
Please check programs that your child will be attending. Eco-Explorers *: Mondays, 9/21-12/14 (4-6PM) Meets @ Enfield Elementary School. Students may take a bus from Boynton.
Awesome Animals: Tuesdays, 9/22-10/27 (4-6PM)
*Program on 9/29 meets @ Boynton Main Office @ 3:30 Meets @ Enfield Community Building. Students may take a bus from Boynton.
Game On!: Tuesdays,
11/3-12/15 (3:25-5:00PM)
Meets @ Boynton Middle School. Students may take late bus or be picked up.
Girls’ Circle:
Wednesdays, 9/23-12/16 (4-6PM)
Meets @ Enfield Community Building. Students may take a bus from Boynton.
Lunch Bunch: Thursdays, 9/24-12/17 (lunchtime) Meets @ Boynton lunchroom during your lunch period.
Harvest Fest Crew: Thursdays & Fridays, 9/24-10/9 (4-6PM) *7:30PM pick-up on 10/9 Meets @ Enfield Community Building. Students may take a bus from Boynton.
Fabulous Fall Food: Thursdays, 10/15-12/17 (4-6PM) Meets @ Enfield Elementary School. Students may take a bus from Boynton.
Finally Fridays!: Fridays, 10/16-12/18 (4-6PM) *No program 10/30
Fabulous Fall Food: Pumpkins and squash and apples, oh my! Let’s make some
Meets @ Enfield Community Building. Students may take a bus from Boynton.
delicious seasonal snacks while learning essential skills in this hands-on cooking program. Put your skills to the test with an “Iron Chef” competition at the end of the program! Meets @ Enfield Elem. School. Thursdays, 10/15-12/17 (4-6 PM) Pick-up @ Enfield Elem. School
Youth must be picked up by a parent or guardian at the program site at the conclusion of each program, unless arranged otherwise.
Finally Fridays!: TGIF! Relax and get ready for the weekends! We’ll do some snack preparation, play games, create crafty projects, and just have fun. Anything can happen! Meets @ Enfield Comm. Bldg. Some field trips with van transport provided. Fridays 10/16-12/18 (4-6 PM) *No program 10/30. Pick-up @ Enfield Comm. Bldg.
Detach this half of form, complete (front & back), and return to: Boynton Middle School Office or Cornell Cooperative Extension, 615 Willow Ave, Ithaca, NY 14850 Attn: Josie Bonham
*Outdoor programs require weather-appropriate clothes that may get dirty.
Space is limited, so register now!