AFTER SCHOOL PROGRAM REGISTRATION FORM – SESSION 1

CYPRESS PALM MIDDLE SCHOOL

2017-2018

August 28 (sports) – November 2

September 5 (clubs and sports) – November 2

$75.00

Student Name ______Student Number______

Grade______Home Room Teacher______

SPORTS (SPORTS WILL BEGIN MONDAY, AUGUST 28.

Girls’ Volleyball –Tuesday and Thursday

Boys’ Volleyball –Monday and Wednesday

Boys’/Girls’ Cross Country –Tuesday and Thursday

Students who are not selected for the volleyball teams will be eligible to join any other club being offered for the remainder of the session providing space is available in that club. Also, intramural volleyball will be offered for those who did not make the volleyball team.

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)

Sabrecat Athletic Conditioning - Thursdays

Debate - Mondays

Scholar Bowl - MondaysTED Club - Mondays

Drama Club – Tuesdays and ThursdaysSabrecat Engineers - Tuesdays

Computer Club - ThursdaysCity Engineers - Thursdays

Club Animate - WednesdaysJazz Band - Wednesdays

Color My World– WednesdaysSabreSharks - Tuesdays

Builders’ Club - ThursdaysSabrecat Masters - Wednesdays

What’s News@CPM – Tuesdays and Thursdays

THE REGISTRATION FEE WILL COVER CLUBS AS WELL AS SPORTS. STUDENTS WHO SIGN UP FOR SPORTS WILL NOT PAY ANY ADDITIONAL FEE FOR CLUBS. CLUBS BEGIN TUESDAY, SEPTEMBER 5.

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 1. THE $75.00REGISTRATION 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 2017-2018school 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.