Session 1 After School Program Registration

AFTER SCHOOL PROGRAM REGISTRATION FORM – SESSION 2 CYPRESS PALM MIDDLE SCHOOL 2017-2018 November 13 – Feb. 22

$75.00

Student Name ______Student Number______Grade______Home Room Teacher______

SPORTS Girls’ Soccer – Tuesday and Thursday Girls’ Basketball – Tuesday and Thursday Boys’ Soccer – Monday and Wednesday Boys’ Basketball – Monday and Wednesday Students who are not selected for the basketball or soccer teams will be eligible to join any other club being offered for the remainder of the session providing space is available in that club.

CLUBS Club Success – Monday, Tuesday, Wednesday, and Thursday (circle day/s you will be attending) Cooking Club – Monday, Tuesday, Wednesday, OR Thursday (circle the day you will be attending) Sabrecat Fitness – Monday, Tuesday, Wednesday, and Thursday (circle day/s you will be attending) Debate - Wednesdays Scholar Bowl - Mondays TED Club - Mondays Drama Club – Tuesdays and Thursdays Sabrecat Engineers - Tuesdays Computer Club - Mondays City Engineers - Thursdays Club Animate - Wednesdays Jazz Band - Wednesdays SabreSharks – Tuesdays The Roar Newspaper Club - Mondays Builders’ Club – Thursdays Cheerleading - Mondays Sabrecat Masters – Wednesdays Scenic Prep Crew - Wednesdays

THE REGISTRATION FEE WILL COVER CLUBS AS WELL AS SPORTS. Parent Signature______Date ______Full Address______Home Phone ______Cell Phone ______Emergency Contact Name ______Emergency Phone: ______Paid by: Cash______Check#______Transportation (CIRCLE ONE): CAR BUS IF A STUDENT IS A CAR RIDER THE STUDENT IS REQUIRED TO BE PICKED UP BY 5:30. If a student is picked up later than 5:30 three times within a session the student will need to start riding the bus instead of being a car rider. Please notify the school if there is an address change affecting student’s transportation. If you are changing your student’s transportation please make sure your student knows how he/she is getting home. REGISTRATION FEE IS $75.00 FOR SESSION 2. THE $75.00 REGISTRATION FEE COVERS BOTH SPORTS AND CLUBS – ONE FEE COVERS ALL THE SPORTS/CLUBS A STUDENT WISHES TO PARTICIPATE IN AS WELL AS BUS TRANSPORTATION HOME. THERE IS NO REFUND OF REGISTRATION FEES. REGISTRATION FORMS ALONG WITH $75.00 CAN BE TURNED IN TO STUDENT SERVICES. I, the signed parent or legal guardian of (name of student) ______grant permission for my child or ward to participate in the registered After School Program sponsored by Cypress Palm Middle School. This permission form covers the 2017-2018 school year. The School Board of Collier County, Florida will provide for reasonable supervision of specialty classes assuming inherit risk of those activities. These risks are accepted by me, and I release and hold harmless the School Board of Collier County from all liability other than its failure to reasonably supervise my in the new club.