Columbia Montessori School 2021 Summer Program
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Columbia Montessori School 2021 Summer Program June 7 - August 20, 2021 Columbia Montessori School’s 2021 Summer Program for kids ages 6-10 brings us back to nature. Join us as we dive deeper into some of our favorite topics and explore the natural world around us! Overview: We believe spending time with nature may reduce stress, difficulty with attention, depression, and anxiety, while also increasing creativity, cognitive functioning, physical activity, and respect and responsibility for the earth. We also believe learning can be fun! Throughout the 2021 Summer Program, kids will not only develop a deeper connection and respect for nature, but we will have fun doing it by exploring materials to use as “beaks,” creating their own habitats, identifying animal tracks, and returning to a favorite activity of cooking with solar power! Approach: Using Project and Place Based methods, we will activity explore the natural phenomena occurring here in Mid-Missouri and some of the challenges our planet currently faces. Guided by their own interests and applying their knowledge and skills to nature that we can see and experience firsthand, we aim to foster empathy for the natural world and instill an appreciation for all its wonders. Activities: Kids in the Summer Program will enjoy a variety of activities including eco-experiments, field trips, guest speakers, art and science explorations, and nature walks. There will also be plenty of time to play games and enjoy being a kid! Each of the 11 weekly sessions will then focus on a different topic of nature, with various activities to ensure there is something for everyone! Weekly Program: Week Dates Theme* Week 1 June 7-11 Habitats Week 2 June 14-18 Life Cycles Week 3 June 21-25 Birds & Beaks Week 4 June 28-July 2 Water Forms & Cycles Week 5 July 6-9 Water Systems & Pollution Week 6 July 12-16 Sun & Light Week 7 July 19-23 Pollination & Photosynthesis Week 8 July 26-30 Reptiles & Amphibians Week 9 August 2-6 Rock & Roll (Geology) Week 10 August 9-13 The Marks We Leave Week 11 August 16-20 Wilderness Survival & Foraging *With a project led approach to learning, the weekly themes are subject to change. Themes may be extended into an additional week or cut short based on the interest level of students.
Daily Schedule: The daily schedule is an estimate only and is subject to change based on engagement, weather, field trip times, etc. 7:15-8:45 Welcoming and Work Time in Outdoor Classroom 8:45-9:00 Set up Breakfast 9:00-10:00 Breakfast and Cleanup 10:00-11:00 Morning Meeting and Nature Walk 11:00-12:15 Exploration and Activities of Weekly Topic 12:15-12:30 Lunch Setup 12:30-1:30 Lunch and Cleanup 1:30-2:00 Yoga, Rest, or Quiet Work Time 2:00-3:15 Exploration and Activities of Weekly Topic 3:15 Snack, Jobs, and Pack OR Aftercare 3:15-3:30 Snack and Clean up 3:30-5:00 Work, Outside Play, Outdoor Classroom 5:00-5:45 Jobs and Pack as getting picked up Cost: ● $30 Enrollment Fee ● $185 weekly rate (8:00am - 3:15pm, drop off begins at 7:15am) ● $25 weekly rate for after care (3:15pm - 5:45 pm) Price includes: Breakfast – Lunch – Snack – All Supplies and Materials - Field Trip Costs *CMS is an equal opportunity provider.* Admissions: Due to construction in our building this summer, space for the 2021 Summer Program is limited. With the limited space, this year’s program will be capped at age 10 in order to better accommodate the group of friends in attendance. Priority will be given to those able to enroll for the entire program. Please note that completing an enrollment form does not guarantee a spot. We will be reviewing applications and let you know whether or not you have been accepted. At that point, payment will be due to reserve your spot. Please see the payment policy for additional info on payments. Email office@columbiamontessori.org to enroll! 3 Anderson Ave. Columbia, MO 65203 | P: 573-449-5418 | F: 573-442-6421 | E: office@columbiamontessori.org www.columbiamontessori.org
2021 Summer Program Enrollment Form Child’s Name: ________________________________________ Sex: _______ DOB: _____________ Address: ____________________________________________________________________________ City: ________________________ State: ________ Zip: ______________ Previous CMS Student? yes no Date(s) of previous attendance: _____________________ Grade entering fall 2021: __________ School attending fall 2021:_________________________ Parent/Guardian Information Please list below all legal guardians and contact information. Name: _____________________________________________ Relationship: ____________________ Address (if different): __________________________________________________________________ City: ____________________________ State: ________ Zip: ________________ Phone: Cell/Home _____________________________ Work ____________________________ Email Address: _______________________________________________________________________ Employer/Occupation or School Attend: ____________________________________________________ Employer or School Address: ____________________________________________________________ Work/School Schedule: ________________________________________________________________ Name: _____________________________________________ Relationship: ____________________ Address (if different): __________________________________________________________________ City: ____________________________ State: ________ Zip: ________________ Phone: Cell/Home _____________________________ Work ____________________________ Email Address: _______________________________________________________________________ Employer/Occupation or School Attend: ____________________________________________________ Employer or School Address: ____________________________________________________________ Work/School Schedule: ________________________________________________________________
Child’s Name: ___________________________________________ Emergency Contacts Please list at least 2 additional people CMS may contact and who can pick up your child if necessary. Your child will not be allowed to leave with anyone not on the list below, unless a written note signed by a parent/legal guardian listed on this application is received by the front office or program teachers. Name: _________________________________ Relationship to child: _____________________ Phone: Cell/Home #: _________________________ Work/Other #: __________________________ Address: ____________________________________________________________________________ (street, city, state, zip) Authorized pickup? yes no Emergency contact? yes no Name: _________________________________ Relationship to child: _____________________ Phone: Cell/Home #: _________________________ Work/Other #: __________________________ Address: ____________________________________________________________________________ (street, city, state, zip) Authorized pickup? yes no Emergency contact? yes no Name: _________________________________ Relationship to child: _____________________ Phone: Cell/Home #: _________________________ Work/Other #: __________________________ Address: ____________________________________________________________________________ (street, city, state, zip) Authorized pickup? yes no Emergency contact? yes no Emergency Medical Care I understand that I will be notified at once in case of an emergency with my child, and I will make arrangements for medical care of my child with the physician or hospital of my choice. If I cannot be reached to make necessary arrangements, or in a critical emergency requiring medical care, I authorize Columbia Montessori School to obtain emergency medical treatment for my child. I understand that I will assume all financial responsibility for any treatment or injuries sustained by my child while he/she is in the care of Columbia Montessori School. Preferred Hospital: ______________________________________ Phone: _______________________ Prefered Physician/Clinic: ________________________________ Phone: _______________________ ___________________________________________________________ _____________________ Signature of parent or guardian Date
Child’s Name: ___________________________________________ Health Information Allergies Please list any known allergies and reactions. Please note that certain allergies may require an additional form due to the severity of the allergy and/or treatment plan. ____________________________________________________________________________________ Medication Please list any medications that your child will be taking while at CMS. An additional form may be needed to ensure the safety and proper administration. ____________________________________________________________________________________ Comments on Child’s Development Please list any personal development, behavior, patterns, habits, and individual needs that might help us care for your child. ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Photo & Video Release I grant or deny CMS the right to use the image of my child in the following ways: Type of Use Check ✓ to grant permission Classroom Use Cubbies, bulletin boards, etc. CMS Use Monthly email newsletter, CMS events, etc. CMS Private Online Groups & Private Social Media Pages Private CMS Facebook group, private classroom pages, etc. Educational Materials Teacher training, college student course projects, etc. Printed Promotional Materials Brochures, fliers, ads, etc. Digital Promotional Materials Public Social Media, CMS Website, etc. External Sources Local newspapers, news stations, etc. By signing below, I understand that it is my responsibility to update this form in the event that I no longer wish to authorize one or more of the above uses. I agree that this form will remain in effect during the term of my child’s enrollment. _____________________________________________________________ _____________________ Signature of parent or guardian Date
Child’s Name: ___________________________________________ Non-Medication Topical Application Permission Renewed Annually I give permission for the following non-prescription topical treatments to be applied to my child on an as-needed basis in accordance with the directions listed on the packaging. ❏ Sunscreen:___________________________________________________________________ (must indicate brand) NOTE: Lotions or manual pump spray bottles ONLY, no aerosol spray cans permitted. ❏ Insect Repellent: _____________________________________________________________ (must indicate brand) NOTE: No DEET products permitted. Lotions or manual pump spray bottles ONLY, no aerosol spray cans permitted. ❏ Other: _______________________________________________________________________ (must indicate brand) By signing below, I understand that it is my responsibility to update this form in the event that I have changed my preference on topical applications. I understand that only products I have provided and indicated on this form will be applied to my child and that CMS will not be applying products if I have not provided them. _____________________________________________________________ _____________________ Signature of parent or guardian Date
Child’s Name: ___________________________________________ 2021 Summer Program Selection Please check which week(s) your child will be attending. If unsure, you may enroll in weeks at a later date. However, we cannot guarantee a spot if the program becomes full unless the week has been paid for. Weekly fees are refundable if notice of cancellation is given at least 7 days in advance. Preference will be given to those able to commit to the whole or majority of the summer. Program After Care Week Dates Theme Fee ✓ to enroll ✓ to enroll Week 1 June 7-11 Habitats $185 Week 2 June 14-18 Life Cycles $185 Week 3 June 21-25 Birds & Beaks $185 Week 4 June 28-July 2 Water Forms & Cycles $185 Week 5 July 6-9* Water Systems & Pollution $165 Week 6 July 12-16 Sun & Light $185 Week 7 July 19-23 Pollination & Photosynthesis $185 Week 8 July 26-30 Reptiles & Amphibians $185 Week 9 August 2-6 Rock & Roll (Geology) $185 Week 10 August 9-13 The Marks We Leave $185 Week 11 August 16-20 Wilderness Survival & Foraging $185 *No Summer Program on July 5 Price includes: Breakfast – Lunch – Snack – All Supplies and Materials Amount Due _____________ x $185 = _______________ (Number of weeks) _____________ x $165 = _______________ (Number of weeks) _____________ x $25 = _______________ (Number of weeks) (After Care) Enrolment Fee $30 = $30 ______________________________________________ Total: ________________ _____________________________________________________________ _____________________ Signature of parent or guardian Date
Child’s Name: ___________________________________________ Acknowledgements & Receipt of Materials Initials I have received a copy of this facility’s policies pertaining to the admission, care, 1 and discharge of children. I have been informed that a copy of the licensing rules that govern child care 2 centers is available at this facility to review. The provider and I have agreed on a plan for continuing communication regarding 3 my child’s development, behavior, and individual needs. 4 I have received a copy of CMS’ Emergency Handbook. When my child is ill, I understand and agree that they may not be accepted for care 5 or remain in care. I understand that, before the first day of attendance by my child, I will provide proof 6 of completed age appropriate immunizations or exemption from immunizations. I have been notified that I may request notice at initial enrollment or any time 7 thereafter whether there are children currently enrolled in or attending the facility for whom an immunization exemption has been filed. 8 I ☐ do ☐ do not give permission for this facility to transport my child. I understand I will be notified in advance when field trips are planned and I 9 ☐ do ☐ do not give permission for my child to participate in field trips/excursions. I understand payment for Summer Program is due in advance, and my child may 10 not be accepted into care if payment has not been made. I understand that upon enrolling the $30 enrollment fee is non-refundable and 11 weekly tuition is refundable only upon at least 7 days advance notice. _____________________________________________________________ _____________________ Signature of parent or guardian Date …………………………………………………………………………………………………………………………………………………………. Office Use Only Admission Date: Discharge Date: Door Code: Notes:
Summer Program Payment Policy Agreement Columbia Montessori Summer Program is a weekly program where students may enroll for as few or many weeks as they desire, pending available spots and approval of the Executive Director. Cost is based on the number of enrolled weeks. Should limited spots be available, priority may be given to students who need care for more than 6 weeks. Rates & Fees ● $30 Enrollment Fee, due at time of application ● $185 weekly rate, $165 for 4 day weeks (day ending at 3:15pm) ● $25 weekly rate for after care (3:15pm - 5:45 pm) Deposit Summer Program does fill up. To guarantee a spot, a $25 non-refundable deposit is required for each week. Your spot cannot be guaranteed without the deposit. The $25 will be subtracted from your balance due for each week. Payment Policy The remaining balance for each week must be made prior to the start of that week. If payment is not received your child will not be able to attend. Payment Options ● Check, Cash, or Money Order ○ Families paying by check, cash, or money order may do so by paying in full or on a monthly or weekly basis. Each week must be paid prior to the start of the week. ● ACH ○ Current and continuing CMS families may add their Summer Program payments to their regular monthly ACH payments. Cancellation Policy If your child is unable to attend for any reason, please provide as much notice as possible so we can give the spot to the next family. In order to receive a refund, please provide no less than 7 days’ notice of cancellation. Partial refunds are not available for unexpected absences, like illness. If Columbia Montessori School cancels a week of Summer Program through no fault of your own, you will be fully refunded for the canceled weeks. ________________________________________ _________________________________________ Printed Name Child’s Name ___________________________________________________________ ______________________ Signature Date 3 Anderson Ave. Columbia, MO 65203 | P: 573-449-5418 | F: 573-442-6421 | E: office@columbiamontessori.org www.columbiamontessori.org
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