Ridot Emergency Contact Form

Pierce After-School Suncrest Tutoring Permission Form

Student’s Name ______Parent’s Name ______

Teacher Tutoring ______Date of Tutoring ______

Concept needing extra help ______

I give my permission for my child to stay after-school for tutoring on Tuesday’s and Wednesday’s from 3:00- 5:30pm. I understand transportation will not be provided and that my child will need to be picked up by 5:30 PM. Starting on Tuesday-3 November 2015 through 27 January 2016. No Tutoring on 18 Nov, 25 Nov, and the week of 15 December 2015.

Parent Signature ______

Phone Number ______Emergency Number______

All tutoring permission slips are due the week before tutoring. If your child cannot be picked up by 5:30, or if permission slip is not returned, they are not permitted to stay. C O N T A C T I N F O R M A T I O N F O R M

Child’s Name:______

Parents Name(s): ______

Home Phone: ______Cell Phone: ______Other Phone: ______

PRINCIPAL PURPOSE(S) for which emergency contact information is intended to be used: (1) Person(s) to be notified in case of emergency (2) Provides several means of contacting parents for emergency or pick up from tutoring.

Person(s) to be notified in case of an emergency or pickup:

Name(s): ______Relationship: Relative □ Friend □ Other ______

Secondary person to be notified in case of emergency:

Name(s): ______Relationship: Relative □ Friend □ Other ______

Additional friends/family who have permission to pick up my child from camp. Please include babysitters or other child care providers that may pick up/drop off your child(ren). Name: ______Phone: ______Name: ______Phone: ______Name: ______Phone: ______

Parent’s Signature ______Date: ______Pierce After-School Suncrest Tutoring

October 22, 2015 Dear Parents:

Your child has been selected to participate in free afterschool tutoring through the Suncrest Church program. Tutoring will begin November 3, 2015 and end January 27, 2016 (no tutoring Nov. 18th, Nov. 25th and the week of December 15th). Tutoring will be offered during the following times:

3:00-5:30 PM Tuesday and Wednesday (2.5 hours per day) Students need to be picked up promptly at 5:30pm.

The goal of the program is to increase learning opportunities for your child. Students will work in small groups to build basic skills. Extra practice in either English Language Arts or Math will lead to improved test scores. Please note that participation in tutoring takes precedence over sports, after school clubs or other extracurricular activities.

This is a homework helping session. It is important for you to help your child with classroom homework. Good behavior and regular attendance are required. Poor behavior will cause your child to be dismissed from the program. Two unexcused absences will lead to removal from tutoring. Students who are not picked up before 6:00pm will be removed from the program.

Please complete the form attached to acknowledge you have received this letter and to provide transportation information. Tutoring forms are due no later than November 1st and spots will be filled on a first come, first served basis. If you have any questions, please contact us at 650-5308.

Sincerely, Mrs. Christine Wheeler, Principal Mr. Nicholas Petralia, Assistant Principal Clifford Pierce Middle School