CLINTON PUBLIC SCHOOL - 2022 Summer Enrichment Program - Clinton Public Schools
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CLINTON PUBLIC SCHOOL
2022 Summer Enrichment Program
The Clinton Public School District’s Summer Enrichment Program
welcomes students, both in and out of the district in
grades PreK-12 to participate in our engaging developmentally
appropriate interactive summer programs.
Join us this summer, and give your child the opportunity to interact with
friends, new and old, while participating in a variety of activities with our
talented and committed instructors.
Deadline to register is June 10, 2022
Please return completed registration forms along with payment to:
Clinton Elementary School
100 Church Street
Clinton, MA 01510
Attention: Kelli Peete and Laura Sullivan
Information about class offerings can also be found on the Clinton
Public School’s website at www.clinton.k12.ma.us
The Clinton Public School District is an Equal Opportunity/Affirmative Action Employer and is in
compliance with Federal regulations prohibiting discrimination in employment on the basis of race, color,
religion, national origin, age, gender, gender identity, sexual orientation, homelessness, or disability.
Dear families,
Summer is right around the corner! Browse through our
enrichment programs offered this summer. If you have any
questions or concerns regarding any of the programs, you can
contact us at sullivanl@clinton.k12.ma.us and
peetek@clinton.k12.ma.us .
We look forward to working with you this summer.
Early registration is recommended as classes do fill quickly.
When registering:
● Please read the parent responsibilities/policies page thoroughly
● Complete, sign, and return the double-sided registration/media
release page (one registration per child)
● Payment can be made in cash or check made out to
Clinton Public Schools
● Registrations can be mailed in, or returned to your child’s
teacher.
● You will receive confirmation when your registration and
payment have been received.
Thank you in advance for participating in the Clinton Public School
District’s Summer Enrichment Program. We are sure your child will
enjoy his/her experiences with these talented and creative
instructors. Again, if you have any questions please feel free to reach
out to:
Kelli Peete: peetek@clinton.k12.ma.us or
Laura Sullivan: sullivanl@clinton.k12.ma.us
Thank you,
Kelli & Laura
The Clinton Public School District is an Equal Opportunity/Affirmative Action Employer and is in
compliance with Federal regulations prohibiting discrimination in employment on the basis of race, color,
religion, national origin, age, gender, gender identity, sexual orientation, homelessness, or disability.
What is Summer Enrichment?
A social and academic experience
Each year, the Clinton Public School District offers a variety of Summer Enrichment
Programs to students both in and out of the district in grades Pre-K thru 12. Instructors
take time and consideration in preparing programs that are engaging and
developmentally appropriate for all grade levels. All programs promote social
interactions between peers and adults and offer engaging experiences whether the
students are practicing, improving, or learning new skills or activities. An academic
component is embedded within each of the programs.
Who are the Instructors?
Instructors are current Clinton Public School staff, alumni, or community members who
all have an updated CORI on file with the Clinton Public Schools. Each instructor has
written a summary describing some of the activities your child will be participating in
throughout the week. They’ve determined a minimum and maximum number of
students for their classes to run effectively and safely therefore, enrollment is based on a
first come first serve basis. It is at the discretion of the instructor to cancel their program if
enrollment is low. You will be contacted no later than 10 days prior to the start of class if
a class will be canceled. At that time, you will have the opportunity to register for
another class, request a refund for tuition and supply fee.
Where are the classes located?
Classes can be held at Elementary, Middle, High School, or Administration Building
Instructors will notify you at least a week before the start of class with more detailed
information on location and logistics of pick up and drop off.
When/Where are the classes scheduled?
Our programs will run for 4 weeks this summer and will be held at any of the 3
schools, and the administration building.
• Session 1: June 27-July 1
• Session 2: July 11-15
• Session 3: July 18-22
• Session 4: July 25-29
What is the cost of each program? Are there refunds?
▪ Tuition for all full day programs is $60 per student, plus a $10 non-refundable
registration fee and a possible supply fee (noted in class description) ▪ Tuition for all
half day programs is $50 per student, plus a $10 non-refundable registration fee
and a possible supply fee (noted in class description) ▪ If classes are canceled by
the instructor due to low enrollment, a refund of the tuition and supply fee will be
given. (the $10 registration fee is non-refundable)How Do I register? When is the Deadline?
The deadline to register is June 10th. Limited space available. Registrations are based
on a first come first serve basis. Late registrations will be accepted depending on the
class and enrollment.
1. Complete the 2-sided registration/media release forms
2. Return the form and full payment to your child’s teacher or mail it to: Clinton
Elementary School, Attention: Laura Sullivan and Kelli Peete, 100 Church Street,
Clinton, MA 01510
What Happens after I register?
You will receive an email confirming your registration when payment and registration
papers are received. Instructors will then contact you prior to the start of class as a
reminder and to provide more information on logistics of the class.
CPS Summer Enrichment Policies
Your signature on the registration/emergency contact form indicates that you have
read and agreed to the policies and expectations listed below.
You do not need to return this page. --please keep this for your records
* Students are encouraged and expected to use respectable, responsible, and safe
behaviors at all times while participating in the programs. Parents will be contacted if
the above expectations are not adhered to.
* Students are encouraged and expected to follow all CDC guidelines as outlined.
*Drop off for classes is no earlier than 8:50 and pick up no later than 2:10pm Instructors
will let you know which doors students will be using for drop off and pick up.
* Please confirm that the phone numbers and email addresses are accurate on the
registration form for emergency purposes. Instructors will contact you if your child feels
ill or is injured.
*Please list any allergies or health concerns on the registration form and discuss any
important concerns with the instructor.
*Attendance will be taken each day. If your child will not be attending, please let the
instructor know.
*Please let the instructor know if someone other than the parent/guardian or names
listed on the registration form will be picking up your child.OVERVIEW OF CLASSES BEING OFFERED
Session 1 June 27-July 1
Green and Gold Basketball Camp- Students entering grades 1-7
Fun-A-Palooza- Students entering grades 1-6
Homemade Chefs- Students entering grades 3-8
Winter in July- Students entering grades K-4
DIY Pinterest Class- Students entering grades 1-4
Sports and Games- Students entering grades 1-6
Creative Hands- Students entering grades K-4
Basketball Skills Camp- Students entering grades 7-12
CNC Sign Design- Students entering grades 6-12
Board Games- Students entering grades 1-4
Soccer Summer Extravaganza- Students entering grades K-12
Session 2 July 11-15
Green and Gold Basketball Camp- Students entering grades 1-7
Craft Club- Students entering grades 4-5
Sportsmania- Students entering grades 3-6
DIY Pinterest Class- Students entering grades 1-4
Clinton Girls Basketball Camp: Students entering grades 3-9
All Around The World- Students entering grades K-3
CNC Sign Design- Students entering grades 6-12
Board Games- Students entering grades 5-8
Soccer Summer Extravaganza- Students entering grades K-12
Fun-A-Palooza- Students entering grades 1-6
Session 3 July 18-22
Green and Gold Basketball Camp- Students entering grades 1-7
Field Hockey Fundamentals- Students entering grades 4-8
DIY Pinterest Class- Students entering grades 1-4
SteamXPLOSION!- Students entering grades PreK-K
Encanto Extravaganza- Students entering grades K-4
Mad Scientist Camp- Students entering grades 4-5
CNC Sign Design- Students entering grades 6-12
Soccer Summer Extravaganza- Students entering grades K-12
Speed Demons- Students entering grades 2-5
Session 4 July 25-29
Green and Gold Basketball Camp- Students entering grades 1-7
Harry Potter Wizard Camp- Students entering grades 3-5
Spreading Kindness- Students entering grades 2-6
Homemade Chefs- Students entering grades 3-8
Sportsmania- Students entering grades 3-6
CNC Sign Design- Students entering grades 6-12
Soccer Summer Extravaganza- Students entering grades K-12
Basketball Skills Camp- Students entering grades 7-12CAMP DESCRIPTIONS
All Around the World
Students entering grades K-2
Instructor: Stephanie Florio
Session: 2 July 11-15
Time: Full Day 9am-2pm
Cost: $60.00
Reg. fee: $10.00
Supply fee: $ 10.00
Total Cost: $80.00
Join us for a week of fun and excitement while we travel and explore different countries from around the
globe! Each day is an exciting new adventure where your child can explore a different country each day.
We will be exploring each country by reading stories, making crafts, learning new games, and tasking
yummy foods from each country. At the end of each day we will stamp our passports from the country we
explored and then move on to a new adventure!
Basketball Skills Camp
Students entering grades 7-12
Instructor: Steve Manguso (varsity basketball coach)
Session 1: June 27- July 1
Time: Full day, 9am-2pm
Cost: $60.00
Reg. fee: $10.00
Supply fee: $0.00
Total Cost: $70.00
The program will focus on the development of basketball skills; shooting, ball handling, passing, and all
offensive concepts. This will be done through perfect practice and repetition. There will be competition in
all skill categories and three on three and five on five competition.
Also offered:
Session 4: July 25-29
Time/Location: Half day, 9am-12pm
Cost: $50.00
Reg. fee: $10.00
Supply fee: $0.00
Total Cost: $60.00
Field Hockey Fundamentals
Students entering grades 4-8
Instructor: Lauren Russell
Session 3: July 18-22
Time: Half day, 9am-12pm
Cost: $50.00
Reg. fee: $10.00
Supply fee: $0.00
Total cost: $60.00
Field hockey fundamentals is for anyone looking to try out a new sport. Come learn the basics of
the fantastic sport of field hockey. We will run, stretch, play games, and learn good sportsmanship
and teamwork! We will finish each day with a cool down stretch and short journaling piece about
our take away from each day!SteamXPLOSION!
For 4yr old’s entering PreK and students entering Kindergarten
Instructor: Regina Rondina
Session 3: July 18-22
Time: Half day 9-noon
Cost: $50.00
Reg. fee: $10.00
Supply fee: $12.00
Total Cost: $72.00
The goal of the class is to provide opportunities to experience important concepts in science, technology,
engineering, arts, and math. Each day will be filled with activities that will encourage the children to 1. ask
questions and be curious as they experiment with bubbles and shadows;.2. build compare, create and
design by using mega blocks, large Legos, and using tools to make things work. 3. Explore and experiment
with magnetic properties through play 4. think creatively and differently as they work on their project –
building ramps, supplementing building blocks with small cars, trucks, animals, and other recycled items. 5.
and use their problem-solving skills by allowing their imaginations to soar and have fun using their abilities to
hear, see, smell, touch, and taste. All these can help children learn about themselves and the world. Daily
activities of the children are provided in a Preschool room and in a BIG SPACIOUS GYM!
DIY Pinterest Crafts for Kids
Students entering grades 1-4
Instructor: Kayla Donoghue
Session 1,2, & 3: June 27- July 1, July 11-15, & July 18-22
Time: Full day, 9am-2pm
Cost: $60.00
Reg. fee: $10.00
Supply fee: $15.00
Total Cost: $85.00
Get ready to craft, paint and create new treasures from Pinterest! Each week we
will have a new and fun summer theme. Week 1 will be Fourth of July, Week 2 will be
dolphins, mermaids and sharks and the third week will be Seashells, sand and
surfing. For our big projects, we will be designing our own beach towels and tote bags.
Perfect accessories to take with you on a trip to the beach! Come join in on all these
FUN and FABULOUS projects. Let’s get crafty!
Spreading Kindness
Students entering grades 2-6
Instructor: Nicole Parker
Session 4: July 25-29
Time: Half day, 9am-12pm
Cost: $50.00
Reg. fee: $10.00
Supply fee: $15.00
Total Cost: $75.00
Kindness is Contagious
Help your child have fun creating and learning the feelings of giving and sharing kindness. We
will read a book daily about being kind. Kids will paint rocks with inspirational messages to
leave around town. We will make key chains or lanyards to bring to the police/fire stations.
Making ‘goody bags’, cards, bookmarks to bring to Corcoran House, to send to Veterans, to
leave for your postal worker, for children in the hospital, or homeless in Worcester. (Field trips to
deliver kindness in community if allowable)Clinton Girls Basketball Camp
Students entering grades 3-9
Instructor: Alison Alvarado
Session 2: July 11-15
Time: Half Day, 9am-12pm
Cost: $50.00
Reg. Fee: $10.00
Supply Fee: $15.00
Total Cost: $75.00
Calling all future girls basketball stars! Join us in learning/working on the game of basketball. This camp will
start with the basics. Each day we will work on the fundamentals; dribbling, passing, shooting, and defense.
There will be competitions and games throughout the week to improve skills and have FUN! We will also learn
how to be part of a team and learn to work together to reach a goal! Special guest appearances from
coaches, current and former players will be a highlight of the week. Whether you are just playing basketball
for the first time or have been playing for years, this camp is for you!
Fun-A-Palooza
Students entering grades K-4
Instructor: Kelli Peete & Helen Kerrigan
Session 1: June 27-July 1
Time: Full day, 9am-2pm
Cost: $60.00
Reg. fee: $10.00
Supply fee: $15.00
Total Cost: $85.00
If you love having fun, this camp is for you! We will spend our days playing board games, doing a variety of
activities and crafts, playing sports and group games, water activities, and science experiments both in the
classroom and outdoors. Each day we will incorporate a relaxing reading time where we will do read aloud
and have book clubs discussing different themes and discuss the stories we read. So, get ready gamers,
crafters, scientists, and readers! We can’t wait to see you.
Fun-A-Palooza ALSO OFFERED:
Instructor: Kelli Peete & Helen Kerrigan
Session 2: July 11-15
Time: HALF day, 9am-12pm
Cost: $50.00
Reg. fee: $10.00
Supply fee: $15.00
Total Cost: $75.00
Speed Demons Camp
Instructor: Jeremy Frisch
Session 2: July 18-22
Time: Half Day, 9am-12pm
Cost: $50.00
Reg. Fee: $10.00
Supply Fee: $15.00
Total Cost: $75.00
"Speed Demons" is an athletic development program designed for children to have fun, get faster and
improve athleticism. Come and run, jump and play for the day. We’ll play lots of backyard games, ninja
warrior obstacle courses, relay races and parkour. This class is guaranteed the kids will be active and have
the most fun all summer.Green and Gold Basketball Camp
Students entering grades 1-7
Instructor: Matt Kobus
Session 1,2,3, & 4: June 27- July 1, July 11-15, July 18-22, & July 25-29
Time: Half day, 9am-12pm
Cost: $50.00
Reg. fee: $10.00
Supply fee: $15.00
Total Cost: $75.00
“The clock is ticking down 3… the pass! 2… the shot! 1… BUZZZZ...
The shot is good!! CLINTON WINS! CLINTON WINS!”
Green and Gold basketball camp will focus on developing some serious basketball skills while
fostering “a love for the game”. On the court we will work to build on the ability to shoot, pass,
dribble, and move around. We will also learn about teamwork and what it means to work
together.
Off the court, we will mix engaging games that build gross-motor skills with some favorite sports
and games, such as soccer, kickball, capture- the-flag and more! Kids need to get outside in the
summer and our sports program ensures that that is the priority!
Our camp will incorporate comprehensive health education based upon the MA
Comprehensive Health Frameworks. The strands of Physical Health and social & Emotional
Health will be the pillars for the program by ingraining the standards of Physical Activity and
Fitness as well as Interpersonal Relationships throughout all aspects of this summer program.
Soccer Summer Extravaganza
Students entering grades K-12
Instructor: Jim Gooding
Session 1, 2, 3, &4: June 27-July 1, July 11-15, July 18-22. & July 25-29
Time: Half Day, 9am-12pm
Cost: $50.00
Reg. Fee: $10.00
Supply Fee: $3.00
Total Cost: $63.00
Participants will generally be divided by age and ability. New skills will be learned and existing skills
and moves will be developed further. My goal is to make the week challenging, engaging, and
FUN for students of all ages.
We will incorporate individual soccer related fitness and agility drills and small group games and
competitions. To bring daily: sunscreen (to be applied by parent/student before each session),
water, big snack, sneakers and cleats, SHIN GUARDS, soccer ball labeled with child’s name, and
appropriate athletic clothing. A small journal/notebook and pen will be provided where we will
track our progress (hint, for instance - juggling).Harry Potter Wizard Camp
Students entering grades 3-6
Instructor: Valerie Andrade
Session 4: July 25-29
Time: Half Day 9am -12pm
Cost: $50.00
Reg. fee: $10.00
Supply fee: $10.00
Total Cost: $70.00
Accio fun! Come join us at our own version of Hogwarts for a very magical week. You will be sorted into
houses in our sorting ceremony, join the group for a beginning of the year banquet, make your own wand at
Ollivanders, play some “quidditch”, brew some potions, create some magical crafts, and much, much more!
If you think that you need a little more magic in your life, this camp is for you!
Craft Club
Students entering grades 4-5
Instructor: Valerie Andrade
Session 2: July 11-15
Time: Half day 9am-12pm
Cost: $50.00
Reg. fee: $10.00
Supply fee: $15.00
Total Cost: $75.00
Calling all Crafters! Do you love making things and getting messy? Well, this camp is for you! Every day we’ll
complete a craft, learn a little about the artists that inspire us, and have fun! Crafts will include things like
paper mache, painting, yarn-work, jewelry making, sculpting, paper crafts, and much more!! Come join us
and let your inner artist show!
Winter in July
Students entering grades K-5
Instructor: Sarah Haemer
Session 1: June 27- July 1
Time: Full day, 9am-2pm.
Cost: $60.00
Reg. fee: $10.00
Supply fee: $15.00
Total Cost: $85.00
Calling all cold weather lovers!! We will be exploring all animals, holidays and sensory things
related to WINTER! We will make snow globes, indoor snow, get a jump on winter and holiday
decorations, cards, crafts and have LOTS of FUN!! We will do some cool science experiments,
have relay races, and make some cute seasonal snacks! If you love the winter as much as I do,
come have fun and cool off with me this summer!!Sportsmania
Students entering grades 3-6
Instructor: Ashley Forgues & Kayleigh Force (fourth session)
Session 2 &4: July 11-15, & July 25-29
Time: Full Day, 9am-2pm
Cost: $60.00
Reg. Fee: $10.00
Supply Fee: $ 5.00
Total Cost: $75.00
Calling all sport maniacs! Have some great summer fun with a variety of sports and fun games
played each day! We will be playing sports such as touch football, wiffle ball, soccer, kick ball to name a few!
As well as some gym time classics such as dodgeball, capture the flag, drip drip drop and even a few water
days! Work on your PE skills, make some friends and have some fun all while being outside!
Homemade Chefs
Students entering grades 3-8
Instructor: Donna Curtin
Session 1 & 4: June 27-July 1 & July 25-29
Time: Half Day, 9am-12pm
Cost: $50.00
Reg. Fee: $10.00
Supply Fee: $15.00
Total Cost: $75.00
This class is a perfect recipe for aspiring chefs and cracking summer boredom while gaining kitchen
confidence, learning essential cooking skills and making new friends! Each day something savory and sweet
will be made. Collaborative chef teams will work together using the talents and abilities of all chefs. Each day
chef campers will dine on their creations for lunch and will take home any left overs. This is not a sandwich
club, we are kicking it up a notch! You will be sautéing, brining, and baking. Bring your enthusiasm and your
appetite! (Food allergy forms will need to be completed to participate in this offering).
Creative Hands
Students entering grades K-4
Instructors: Nora Renzi and Kiley Middleton
Session 1: June 27-July 1
Time: Full Day, 9am-2pm
Cost: $60.00
Reg. Fee: $10.00
Supply Fee: $10.00
Total Cost: $80.00
Who is ready to get their creative juices flowing? We are looking for those interested in allowing their inner
artist to be free. We will be exploring different types of art forms from paper mache to tie dye. We will dive
into our senses by making oobleck and slime, as well as an edible craft.Sports and Games
Students entering grades 1-6
Instructor: Harold Ogilvie
Session 1: June 27-July 1
Time: Full Day, 9am-2pm
Cost: $60.00
Reg. Fee: $10.00
Supply Fee: $0.00
Total Cost: $70.00
Sports and Games: This is a fun start to the summer. The students will take part in a variety of outdoor games
such as wiffle ball, kickball, capture the flag, freeze tag, dodgeball, and a variety of other indoor and outdoor
games. Students will all begin with a stretching program to loosen up. The students will work on different skills to
collaboratively problem solve as well as learning good sportsmanship.
Mad Scientist Camp
Students entering grades 4-5
Instructors: Valerie Andrade and Ashley Forgues
Session 3: July 18-22
Time: Full Day, 9am-2pm
Cost: $60.00
Reg. Fee: $10.00
Supply Fee: $15.00
Total Cost: $85.00
Attention Mad Scientists! Do you love experimenting, discovering new ideas, and learning how things in the
world around you work? In Mad About Science we will learn science concepts through hands-on
experiences. Come learn how to make predictions, solve problems, and make a mess with us!
CNC Sign Design
Students entering grades 6-12
Instructor: Dave Hilton
Session 1, 2, 3, & 4: June 27-July 1, July 11-15, July 18-22, & July 25-29
Time: Half Day, 9am- 12pm
Cost: $50.00
Reg. Fee: $10.00
Supply Fee: $10
Total Cost: $70.00
Want to learn what it is like to be an engineer!? Join the CNC Sign Design camp where you will use industry
standard programs and machines to create a sign of your choice! You will be learning skills such as
woodworking, engineering design, and machining to create a personalized wooden sign for yourself or a
loved one! (They make great gifts!) Show off your creative side with spray painting, designing, and carving
your sign throughout the week. See what it’s like to be a creative engineer with the CNC Sign Design camp!Encanto Extravaganza
Students entering grades K-4
Instructors: Melanie Chaves and Rachel Sharon
Session 3: July 18-22
Time: Full Day, 9am-2pm
Cost: $60.00
Reg. Fee: $10.00
Supply Fee: $15.00
Total Cost: $85.00
Calling all Mirabels, Isabelas, and Brunos! Oh wait, we don’t talk about Bruno! Join us for a fantastical and
magical fiesta as we explore all things Encanto. You’ll make crafts, dance and sing along to Encantos’
award winning music! You’ll even explore Columbian art, culture and create typical dishes from the movie. If
Encanto taught us anything, it’s that there’s a little magic in all of us and you won’t want to miss it!
Board Games
Students entering grades 1-4
Instructor: Jim Duffy
Session 1: June 27- July 1
Time: Full Day, 9am-2pm
Cost: $60.00
Reg. Fee: $10.00
Supply Fee: $0.00
Total Cost: $70.00
If you like planning and building a strategy to get something done, we have a summer club for you "Board
Games”. This club will enhance your skills in a fun, challenging manner. We are going to bring back some
older board games that will tap into certain skills that you may not know you have. These board games are
the following: checkers, chess, dominoes, and scrabble. While Chess and Checkers are games played
individually, both Scrabble and Dominoes can be played individually or in teams. While each of these games
has a level of complexity to it, they all have some common beneficial components to them. Whether you are
a novice or already know how to play the games, everyone is welcome. Come join us for this club, as we
unlock that part of your brain that is responsible for your deeper cognitive functioning and critical thinking.
You will all be amazed.
Board Games
Students entering grades 5-8
Instructor: Jim Duffy
Session 2: July 11-15
Time: Full Day, 9am-2pm
Cost: $60.00
Reg. Fee: $10.00
Supply Fee: $0.00
Total Cost: $70.00
If you like planning and building a strategy to get something done, we have a summer club for you "Board
Games”. This club will enhance your skills in a fun, challenging manner. We are going to bring back some
older board games that will tap into certain skills that you may not know you have. These board games are
the following: checkers, chess, dominoes, and scrabble. While Chess and Checkers are games played
individually, both Scrabble and Dominoes can be played individually or in teams. While each of these games
has a level of complexity to it, they all have some common beneficial components to them. Whether you are
a novice or already know how to play the games, everyone is welcome. Come join us for this club, as we
unlock that part of your brain that is responsible for your deeper cognitive functioning and critical thinking.
You will all be amazed.2022 Summer Enrichment
Registration/Emergency Contact
Please complete a separate registration form for each child registering
Student’s Name: Parent/Guardian Name:
(Male or Female)
Grade student is entering in Sept 2022: Address:
Any known allergies: Home #:
Cell #:
Other information about my child: Email:
Payment: (circle one) Emergency contact:
Check # Cash Name:
Checks made out to: Clinton Public Schools Phone #:
Relationship to student:
Please put a check mark next to each one below to show an understanding of all policies
______My child has permission and is physically fit to participate in the program(s) below.
______ I understand that transportation is my responsibility.
______ I understand that no refunds will be given unless the instructor cancels the class, or the parent cancels
14 days prior to the start of class.
______ Registration fees are non-refundable
______ I have read all parent responsibility policies and agree
Entering +10.00
+Supply Total
Title of Class Session Date Grade level Half Day Full Day Reg.
of student
Fee Paid
Fee
(example) Soccer Camp 2 July 3rd $60 $10.00 $15.00 $85
19-23
$10.00
$10.00
$10.00
$10.00
$10.00
$10.00
Total
Checks made out to Clinton Public Schools. Return this 2-sided registration/media release
form & full payment to: Laura Sullivan and Kelli Peete at CES by June 3rd, 2022
Parent signature_____________________________________________ Date______________________2022 Summer Enrichment Media Release Form
Our Summer Enrichment programs may develop, participate in, or be the subject of
media-based presentations and events which highlight various educational,
instructional and promotional activities that take place during the course of the
programs.
Presentations may include but are not limited to:
▪ video tapes
▪ computer generated presentations which may include
scanned/digital photographs and video clips
▪ computer-based productions transmitted via telecommunications
▪ Photographs, student work (art, writing etc.)
▪ slide/tape presentations
▪ web pages
▪ newspapers (pictures with names)
Media based presentations may be used in:
▪ Faculty presentations, in-service conferences
▪ Student take home DVD/CD
▪ Summer enrichment web pages/newsletters
▪ Summer class projects, lessons, activities
▪ Publicity (newspaper articles, Clinton Public School Website, Teacher
website, TV presentations, local cable etc...)
Media Release Permission Form
I hereby give permission to the Clinton Summer Enrichment Program in Clinton MA, to
use my child name/ voice, photograph, likeness, art, writing, and any or all of the audio,
video or computer-generated products (as listed above) in any of the Clinton Summer
Enrichment programs during the 2022 session.
___________I do give the Clinton Public Schools’ Summer Enrichment Program media
release for my child
___________I do not give the Clinton Public Schools’ Summer Enrichment Program
media release for my child.
Date Child’s Name Parent’s signature
The Clinton Public School District is an Equal Opportunity/Affirmative Action Employer and is in compliance
with Federal regulations prohibiting discrimination in employment on the basis of race, color, religion,
national origin, age, gender, gender identity, sexual orientation, homelessness, or disabilityOn behalf of the Clinton Public Schools Dept.,
and the instructors, we would like to THANK YOU
for participating in our 2022
Summer Enrichment Program!
If you have any questions, concerns, or
would like to give feedback on our programs
please feel free to contact us at:
peetek@clinton.k12.ma.us
or
sullivanl@clinton.k12.ma.us
THANK YOU!You can also read
