Communities Improvement Association

COMMUNITIES IMPROVEMENT ASSOCIATION

P. O. Box 263 {3180 Sandtown Road} - Millbrook, AL 36054

-Phone: (334) 285-3227 – (334) 467-3541

https://www.cia1.org

STUDENT CONTRACT

The Communities Improvement Association addresses community needs in many ways; we make our Kids Journey (KJ) programs available as well as affordable to all kids.

Our KJ Summer program is set to begin on Monday, June 1, 2015. Over the summer KJ will provide help to children in reading, math, and writing who may be functioning below grade level. Our goal is to bridge the gap in learning and assist struggling students within the Tri-Community area with achieving grade level mastery prior to the conclusion of the summer. Enrolled students will attend an eight-week summer program that operates during the hours of 6:00 a.m. and 5:00 p.m., five days a week, Monday – Friday (see summer class schedules). KJ will provide a hot breakfast and a hot lunch, with additional healthy snacks with juice or milk.

We are not fully funded; however, along with fees, we look toward grants and the community for funds. We accept donations and gifts, which are tax deductible. We believe in our mission to help make education affordable; the strength of our program is our teachers who dedicate time and energy to be here to teach your child.

It is important to us to make this program available as well as affordable to all those who want to further the study or just want it for personal enhancement. Also, if we can help maximize opportunities for your child, this is just why this program was designed.

BESSIE JONES, Program Director
CATHERINE JAMES, Treasurer

The CIA, a 501(c)(3) corporation, is required to have an annual independent financial audit? We are considered a nonprofit organization and operate in accordance with federal tax rules for public charities subject to the IRS.

CIA MISSION AND VISION

The mission of the organization is to promote the welfare of the children and youth in the home, school, church, and communities. To provide wholesome recreational activities, raising the standard of living and instituting education and training programs. To institute educational programs through training, conferences, committees and projects.

The vision is to create a healthy community by nurturing the mind, body, and spirit. To empower others for the future by pooling our resources and expanding our strength. Striving to improve the communities by fostering unity and support.

Physical Development

We have designated times to go outside to strengthen their large muscles such as running, walking, skipping, balancing and changing positions. Dress your child in appropriate clothing for outdoor play. Our playground is designed for the different age groups for play. In the event of inclement weather, we will plan inside activities that

strengthen physical development.

Discipline

There will be no form of corporal punishment at KJ. When needed, time-out will be enforced or time alone from the group. If any further discipline occurs and needs to be handled, the parent will be notified. The parent will also receive a conduct note.

Withdrawals or Dismissals

KJ asks that if you are planning to leave the program that you give us a 2 week notice. There will be a form clearing you of all fees that may be due. If by chance you leave and do not give the center appropriate notice, you will still be responsible for any fees.

Fees

Upon enrollment of your child to KJ, I agree to pay the following fees per week for Kids Journey Summer or Afterschool Programs (circle program):

FEE SCHEDULE
1 Child per week $ / $
1 Child per month / $
2 Children per week / $
2 Children per month / $
3 or more Children per week / $
3 or more Children per month / $

These rates are due regardless of how many days your child attends the program. All fees are due on Monday. If the fees are not paid by Tuesday at the close of business, a $10.00 fee will be assessed. If your child will be absent a week, please inform KJ staff.

Registration Fee

There is a $30.00 registration fee for your child/children. Registration will be based upon number of children registered. This fee is due upon enrollment. This is an annual fee that is due each session (summer/afterschool) your child is enrolled.

Summer ______| Afterschool ______

These fees help to cover administrative costs. There is a discount for families with multiple children. There is also discount of $10.00 if parents are a member of the Communities Improvement Association (CIA). There will be a $30.00 check fee for each returned check. KJ reserves the right to refuse any other payments by check.

Operating Hours

The program will operate the following hours:

Kids Journey Summer hours are 6:30am until 5:30pm

Kids Journey Afterschool hours are 3pm until 5:30pm

There will be an assessment of $1.00 per hour that you are late pickup.

The program will be closed (prior notice will be given regarding changes):

Christmas Day

Christmas Eve

Thanksgiving Day

Day after Thanksgiving

Memorial Day

Martin Luther King Day

Fourth of July

Labor Day

New Year’s Day (dependent upon the day of the week)

The parent must bring the child into the facility each day and sign the child in according to state law. The child will be taken to the proper class and left under the supervision of KJ staff. Your child will be signed in and signed out at the end of the day.

The parent must list each person that is authorized to pick the child up. If someone is to pick up your child other than yourself, the person will need to bring in a valid driver’s license for I.D. purposely. We understand that emergencies do happen that may result in someone that may not be listed. Please call KJ and give us the name of the person that will be picking up the child

Our Day

Your child’s day will start with breakfast and innovative play, meet and greet and so much more. There are so many aspects in planning an interactive day such as safety, nutrition, proper supervision, weekly lesson plans, transportation, physical, cognitive social, emotional and development as well as the health of your child and others.

As a part of your child’s day, your child will be encouraged to have rest periods. We realize that all children will not rest. In the event that your child doesn’t rest, he or she will be asked to remain on his or her class with a book.

Safety

Safety is a must. According to state law, Kids Journey will operate under the regulations and guidelines of the Communities Improvement Association (CIA).

Transportation

Field trips will be scheduled in connection with our lesson plans some Fridays. You will always know in advance where, what time and what method of transportation will be taken. You will be asked to sign a parental consent form for all planned trips away from the center. All transportation will be inspected by a licensed mechanic yearly as per state law. All vehicles are to be licensed and insured.

Immunization

Parents should provide KJ with a current immunization as well as medical forms upon enrollment. This is a policy that must be adhered. These medical records should be up-dated each year and a new one submitted.

Staffing

KJ tries to operate according to the ratio designed by the states. Proper supervision is important to provide care. KJ is staffed by volunteers and certified instructors, which helps keep fees low. KJ encourages parents to volunteer an hours to assist with tutoring students whenever feasible.

Medication

If there is a need for your child to take medication while in the care KJ, we encourage that no medicine be left in the care of KJ office staff. All medicine should be signed in at the front desk.

Allergies

Please bring in a doctor’s note if your child has any food allergies. This information will be kept confidential and provided to kitchen staff, Center Directors, and Teachers. This will help us to care for your child and provide a nutritional meal for them.

Belongings

Often times we have water play day, bring a buddy day, etc. It is important that parents check the lost and found box periodically for any items your child may have left behind. Items should be labeled with your child’s name. KJ will not be responsible for lost items but every attempt will be made to secure and return your child’s belongings.

Child Development

The development of your child is important. All children grow and learn differently; therefore, we shall have explored cognitive, physical, language, emotional-social development and fine motor skills.

Nutrition

The menu for the week will be posted on the parent board. If feasible, your child will be served two meals and a snack each day.

Daily Schedule

Kids Journey Summer Schedule (*Program dates: June 1, 2015 through July 24, 2015.)

6:30 – 7:00 Early Drop Off

7:00 – 7:45 Breakfast

8:00 – 8:45 Reading Adventures

9:00 – 9:45 Health & Nutrition (Alabama Cooperative Center)/Physical Fitness

10:00–10:45 Math Adventures

11:00–12:00 Lunch - Physical Fitness-2

12:00 –12:45 Health & Nutrition (Alabama Cooperative Center)

1:00 – 1:45 Science Adventures, 4H Club (Elmore County Cooperative Center)

2:00 – 2:45 Chess/ Snack/ Art/ Sewing

3:00 -3:45 Life Skills/ Computer Room

4:00 – 5:00 Recreation Room/ Movie/ Free Play

4:00 – 5:30 Pickup

Fridays Field Trip/Fun and Educational

The CIA, a 501(c)(3) corporation, is required to have an annual independent financial audit? We are considered a nonprofit organization and operate in accordance with federal tax rules for public charities subject to the IRS.

COMMUNITIES IMPROVEMENT ASSOCIATION

P. O. Box 263 {3180 Sandtown Road} - Millbrook, AL 36054

-Phone: (334) 285-3227 – (334) 467-3541

APPLICATION CONTRACT

Parent/Guardian: ______

ADDRESS ______

Telephone ______

For your child’s well-being, the information you provide must be complete and accurate. This information is necessary to maintain funding, compliance and records for Kids Journey.. Please check off each box below as you complete each section. An additional $1.00 provides membership for your child for 1 year to the Communities improvement Association. Note that parents must provide all information when registration is received

Are you or any member of your household on active military duty? (check one

Yes____ No ____

ETHNICITY (check one)

_____ American Indian/Alaska Native Asian

____ Black/African American Hispanic/Latino

____Multi-Racial Native Hawaiian/Pacific Islander

____White/Caucasian Other______

ANNUAL HOUSEHOLD INCOME (check one)

Less than 9,999___ 10,000-14,999___ 15,000-22,999 ___ 23,000-33,999 ___ 34,000-49,999 ___ 50,000-above ___

SCHOOL LUNCH PROGRAM ELIGIBILITY (check one)
_____Free ____Reduced _____Not Eligible Unknown

Emergency Care

Name of Doctor/Medical Facility______

Special Medical instructions ______

MEMBER LIVES WITH (check one)

___Both Parents ___ Mother Only ___Father Only ___Guardian ___Foster Care ___Group Home Other______

You may contact me through the following methods:

Phone: ______

e-Mail: ______

Mail ( ) same, add address if different ______

I understand that it is my responsibility to monitor my child’s participation in Club activities based on any physical or medical limitations that my child has that would inhibit his/her participation. I understand that BGCGM operates under an open door policy; therefore, it is my responsibility to monitor and provide transportation for my child to and from the program. In the event of injury or should emergency care be required, I authorize the staff to arrange for emergency medical attention for my child, only if I can’t be reached immediately.

I give permission for my child to participate in surveys, discussion groups or other activities that help determine the success of programs. I authorize the staff to obtain or share data related to my child for the purpose of program assessment. I authorize release of information from school about my child to KJ so the program can best serve its members. I grant per-mission for photographs, audiotapes and records of my child to be used by the KJ and its agents for public relations and/or pro-gram evaluation purposes on behalf of the CIA/KJ has permission to receive and share information (for use of identifying program and opportunity needs) with agencies serving our members such as: Health Department, Health Agencies or other agencies deemed by Kids Journey, Millbrook, AL.

Parent/Guardian Signature:

______

Signed Date

Program Director/Advisor/Teacher

______

Signed Date

CHILD NAME ______

Date of birth ______Current Grade ______Student Gender: M___ F___

School ______

CHILD NAME ______

Date of birth ______Current Grade ______Student Gender: M___ F___

School ______

CHILD NAME ______

Date of birth ______Current Grade ______Student Gender: M___ F___

School ______

Persons authorized to pick up child/children

1. Name

Address

2. Name

Address

3. Name

Address

The CIA, a 501(c)(3) corporation, is required to have an annual independent financial audit? We are considered a nonprofit organization and operate in accordance with federal tax rules for public charities subject to the IRS.