Spring 2020 CAMBRIDGEPORT COMMUNITY SCHOOL - the City of Cambridge

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Spring 2020 CAMBRIDGEPORT COMMUNITY SCHOOL - the City of Cambridge
DEPARTMENT OF HUMAN SERVICE PROGRAMS
           COMMUNITY SCHOOLS DIVISION

CAMBRIDGEPORT COMMUNITY SCHOOL

       Spring 2020

            Wade Lindhorst – Director
                  617/349-6307
                  617/233-9137
              Cambridgeport School
       89 Elm Street, Cambridge, MA 02140
        www.cambridgema.gov/dhsp/elm
            wlindhorst@cambridgema.gov
Spring 2020 CAMBRIDGEPORT COMMUNITY SCHOOL - the City of Cambridge
Neighborhood Council
Diane Griggs
Renee Pittman - Williams

Administrative Staff
Wade Lindhorst - Community School Director
Liz Lewis – Program Manager
Roslyn Shoy – Division Head Community Schools

Enrichment Program Staff
Jafar Manselle       Larry Wynn        Alden Griggs       Valerie Chrisphonte
Alanna Saunders      Angelique Smith   Chris Belloste     Nik Taylor
Riley Curda          Arianna Diggs     Luqiang Fu         Arti Pandy
       Sebastian Stranahan                    Mary Teuschner
       Christina Kostopoulos                  Michayla MacGlashing

Drop in Office Hours
Tuesday           Wednesday                  Thursday           Friday
9:00 - 12:00 a.m. 1:00 - 5:30 p.m.           1 - 5:30 p.m.      9:00 - 12:00
Spring 2020 CAMBRIDGEPORT COMMUNITY SCHOOL - the City of Cambridge
SPRING SESSION IMPORTANT DATES
01/21/20 – 01/23/20     Tuesday -        Spring Priority Registration for current Fall 2019
                        Wednesday        participants only
01/23/20                 Thursday        1st ever Cambridgeport Community School Space Derby
                                         Open Registration for classes with openings for New
02/03/20              Monday – Friday
                                         Families
02/07/20                   Friday        Family Trip to Harvard’s Women Basketball

02/18/20 – 02/21/20   Tuesday – Friday   February Vacation @ the King Open Community School

02/24/20                  Monday         Spring Session Begins
                                         Early Release Day – No regularly Scheduled Classes
03/18/20                Wednesday
                                         TRIP – New England Aquarium & IMAX
04/10/20                   Friday        No School – Good Friday

04/15/20                Wednesday        Boston Celtics Family Trip

04/16/20                 Thursday        18th Annual Grand Prix Derby Kit & Rules Registration

04/20/20                  Monday         No School – Patriots Day

04/21/20 – 04/24/20   Tuesday – Friday   April Vacation

05/08/20                   Friday        Massachusetts Pirates Family Trip
                                         Early Release Day – No regularly Scheduled Classes
5/13/20                 Wednesday
                                         TRIP – Animal Adventures , Bolton, Ma.
05/25/20                  Monday         No School – Memorial Day
                                         Early Release Day – No regularly Scheduled Classes
06/03/20                Wednesday
                                         TRIP – All Citywide Community School Fair
06/04/20                 Thursday        Spring Showcase
Spring 2020 CAMBRIDGEPORT COMMUNITY SCHOOL - the City of Cambridge
Cambridgeport Community School
                             Spring 2020 Early Release Day Activities
                                   DATE           ACTIVITY/TRIP   WHERE                                      TIME
                                      WEDNESDAY,             NEW
                                                                                                             12:30 TO
                                      MARCH                  ENGLAND                 BOSTON, MA
                                                                                                             5:30
                                      18TH                   AQUARIUM
                                      WEDNESDAY,             ANIMAL                  BOLTON, MA
                                                                                                             12:30 TO
                                      MAY                    ADVENTURES
                                                                                                             5:30
                                      13TH
                                      WEDNESDAY, END OF      RINDGE FIELD                                    12:30 TO
                                      JUNE       SCHOOL YEAR BEHIND THE                                      5:30
                                      3RD
                                                 FAIR        PEABODY
  This Photo by Unknown
                                                             SCHOOL
**EARLY RELEASE DAY AND TRIPS AND ACTIVITIES ARE FOR CURRENT REGISTERED COMMUNITY SCHOOL PARTICIPANTS ONLY AND A PART
OF OUR REGULAR PROGRAMMING. EACH ACTIVITY AND TRIP ARE $40 EACH.   SEE REGISTRATION FORM TO PICK OUT THE DATES YOU NEED.

                                 Cambridgeport Community School
                                   April Vacation Week Activities
                                  DATE            ACTIVITY/TRIP   WHERE                                  TIME /
                                                                                                         PRICE
                                   TUESDAY,               MAD SCIENCE ON SITE       8 TO 3:30
                                   APRIL                  & SILLY     CPORT SCHOOL $175 WK
                                                                      89 ELM STREET 8–5
                                   21ST                   SCIENCE
                                                                                                         $200 WK
                                   WEDNESDAY,             DISCOVERY
                                   APRIL                  MUSEUM                   ACTON, MA
                                   22ND
                                   THURSDAY,              MOOSEHILL                SHARON,
                                   APRIL                  WILDLIFE                 MA
                                   23RD                   SANCTUARY
                                   FRIDAY,                DAVIS                    HARVARD,
                                   APRIL                  FARMLAND                 MA
                                   24TH
Spring 2020 CAMBRIDGEPORT COMMUNITY SCHOOL - the City of Cambridge
GENERAL PROGRAM INFORMATION & POLICIES

The Elm Street Community School is a community-based program that focuses on
programs/activities and special community events for school-age children to active older adults.
We welcome community involvement and suggestions to help provide services to the
neighborhood in our efforts to develop a strong community based program. Council meetings
will be held regularly for neighborhood residents to attend. For additional information about
these meetings contact the Director.
Registration Procedure
Our Spring Session will begin on Monday, February 24th and will end on Friday, June 12th.
Registration – For Current Program Participants, will begin Tuesday, January 21st from 5:00
P.M. - 6:30 P.M. in the school’s Cafeteria. When your name is called you will simply drop off
the registration forms with payment and you can leave. Registration continues on Tuesday
from 7:30 - 9 A.M and it will be on a First come - First serve basis. Non Participant Registration
will begin on Tuesday, February 4th . After these dates please drop off your child’s registration
form in the Community Schools Mail Box in the main office. Class selection will be based on
available spaces. For more information call 617/349-6307. If you cannot come to register at the
times listed above because of a prior commitment, please contact the Community School
Director at 617-349-6307. Our classes must have a minimum of 6 participants or the class will
be cancelled.
Please Note: An Annual Application Fee of $25.00 per child is required at registration. (This
fee is applicable for the School Year only).

PAYMENTS
Full payment is due at time of registration, however a payment plan can be arranged with the
director. Checks or Money Orders (NO CASH) should be made payable to: Elm Street
Community School. If you have an outstanding balance with any Department of Human Service
Program, your child’s registration will not be accepted until all payments are made. Class fees
are based on the number of weeks a class meets. Returned checks will be charged an
additional $25.00. Full payment must be made within 48 hours to avoid disruption in your
child’s schedule.

REFUNDS
If a class is not fully enrolled, the class may be cancelled. You will be notified and given a
refund, or an alternative class may be chosen. We understand that there may be times when a
class is not what your child expected. A full refund will be given if we are notified within 24
hours after the first class. Partial refunds will only be given if a child is no longer able to
participate due to medical reasons. Refunds are not issued for missed classes.

EARLY RELEASE DAYS
Regular scheduled classes are not held on early release days. A special activity or field trip will
be planned. Children must be registered in advance to attend any early release day trips.
Spring 2020 CAMBRIDGEPORT COMMUNITY SCHOOL - the City of Cambridge
PROGRAM CLOSINGS
Classes are not held on city holidays, snow days or on days the Cambridge Public Schools are
closed.
FINANCIAL ASSISTANCE
Partial scholarships are available to families who qualify. Please request a financial aid form
from the director. Income verification in the form of W – 2 or 4 current pay stubs must be
submitted with the application. All information provided will be kept confidential. Deadline for
financial assistance is Friday, February 7th.
CHILD PICK UP & ABSENCES
Children will only be released to those you have authorized on your child’s registration /
emergency card. If there is any change in pick up arrangements the director must be notified in
advance. Only children ages 9 & up will be allowed to walk home with parent/guardian
permission. Please notify us by phone or email if your child will be absent from the program.

LATE FEE POLICY
Instructors are not responsible for children after the class ending time. All children must be
promptly picked up at the end of class. There will be a late fee of $1.00 per minute for each
minute you are late after the scheduled pick up time. Late fees must be paid within 48 hours to
avoid disrupting your child’s participation in the program. Chronic lateness may result in
suspension of your child’s participation in the program.

SCHOLARSHIP DRIVE
We welcome your contribution to assist us with providing scholarships to families in financial
need. You may choose to support a particular program or contribute to our general scholarship
fund. We thank you for your support.

EQUAL ACCESS
The City of Cambridge, Department of Human Service Programs / Community Schools Division
does not discriminate in providing services on the basis of race, religion, national origin, cultural
heritage, political beliefs, sexual preferences, marital status, or disability. The Department of
Human Services will provide auxiliary aids and services, written materials in alternative formats,
and reasonable modifications in policies and procedures to qualified individuals with disabilities
upon request. For more information call
617-349-2000 (voice) or 617-492-0235.

INCLUSION POLICY
Department of Human Service Programs welcomes individuals with disabilities in all of its Out
of School Time Programs. DHSP will provide reasonable accommodations to individuals with
disabilities who meet the basic eligibility requirements of the OST Programs or who with the
provision of reasonable accommodations will be able to the basic eligibility requirements to
facilitate equal participation for those individuals in existing OST Programs.
Spring 2020 CAMBRIDGEPORT COMMUNITY SCHOOL - the City of Cambridge
Community Schools Bus Policy
      The Community School Programs offer afterschool enrichment classes in every elementary
      school in Cambridge. Most children attend the classes at the Community School located in their
      school building. Some families prefer to have their children attend classes in the school
      building located in their neighborhood. If an established bus route exists from a child’s school
      to the preferred Community School, very often the Cambridge Public Schools are able to
      transport children to that Community School. Parents/guardians need to make transportation
      arrangements with the Cambridge Public Schools.
      In an effort to support families, beginning this year a staff person from Community Schools will
      be available in front of the school to greet children under the age of 9 arriving by bus and will
      escort them into the school. Children age 9 and older who have parental permission may enter
      the school on their own.
      To avoid disrupting ongoing classes and to support children’s full participation in the
      enrichment classes, children must arrive no earlier than 15 minutes prior to the start of
      Community School Program and no later than 1 hour past the program start time. For a
      breakdown by school of the times that children may arrive for programs, please refer to the
      schedule below:

Cambridge Public Schools       Dismissal Times    Community Schools               Community Schools
                                                                                  Approved Arrival Times

Amigos                         2:55 pm            Amigos/Cambridgeport CS         2:45 – 4:00 pm
Cambridgeport                  2:25 pm            Elm Street CS                   2:15 – 3:30 pm
Peabody                        2:55 pm            Fitzgerald CS                   2:45 – 4:00 pm
Haggerty                       1:55 pm            Haggerty CS                     2:00 – 3:00 pm
King Open                      2:55 pm            Harrington CS                   2:45 – 4:00 pm
Graham and Parks               2:25 pm            Linnaean CS                     2:15 – 3:30 pm
Kennedy-Longfellow             1:55 pm            Kennedy CS                      2:00 – 3:00 pm
Morse                          2:25 pm            Morse CS                        2:15 – 3:30 pm
Tobin                          1:55 pm            Tobin CS                        2:00 – 3:00 pm

      Please note: bus schedule does not apply to Fletcher Maynard and M.L. King Schools due to 4
      pm dismissal.
Summer Camp
      Night
 When: March 4th, 2020
  Time: 6:30 – 8:30 p.m.
Where: CRLS School Cafeteria

  Community & Family Events
                 18th Annual Grand Prix Derby
                        Thursday, April 16th
    Registration and Pick up rules & Kits at 5:30 in the Cafeteria
                   18th Annual Grand Prix Derby
               Thursday, May 21st in the Gymnasium
Family Trip To The Boston Celtics
                 Wednesday, April 15th

                 See the Celtics Face the Chicago Bulls
                 Sign up for our annual family trip to the Boston Celtics.

                       Buses will be made available for transportation.
Before the game our own Cambridgeport Community School Purple Panda’s Basketball team
            will play on the historic parquet court. Come and support our team.

     Family Trip To The Massachusetts Pirates
         OF THE PROFESSIONAL NATIONAL INDOOR FOOTBALL LEAGUE
                              Friday, May 8th

                    See the Pirates Face the Carolina Cobras
    Buses to the DCU CENTER in Worchester will be made available for transportation.
Monday Enrichment                                         VEXModel
                                                                IQ Magic
                                                          Grades: 3 –JK5& K
                                                             Grades                               3:45 – 4:45
Programs                                                     3:45
                                                          Fee:     – 4:45
                                                                $ 85
                                                             $120 Sebastian Strananhan
                                                          Instructor:
14 Weeks                                                  VEXInstructor:
                                                               IQ is a snap-together robotics system designed from
February 24th – June 8th                                  theModel
                                                              ground  magic
                                                                         up toisprovide
                                                                                 a superthis
                                                                                           fun opportunity
                                                                                               molding claytothat  can be
                                                                                                                future
No Classes on 04/20/20, 05/25/20                             made into     just about    anything.  We willadvanced
                                                                                                            make masks,
                                                          engineers    of all skill levels. By packaging
                                                             vases, cars,
                                                          concepts   into anjewelry    and more.
                                                                               accessible    package, the system also
Kindergarten Explorers                                    naturally encourages teamwork, problem solving, and
                                                             Cut-Paste
                                                          leadership    for&students.
                                                                              Imagination
Grades: JK-K                      2:30 – 5:30                Grades JK - 2
Cost: $125 per hour                                          3:45 with
                                                                   – 4:45Tina
                                                          Baking
Instructor: Arianna Diggs                                    $120
                                                          Grades: 3 – 5                           3:45 – 4:45
A well rounded nurturing program for our younger             Instructor:
                                                          Fee:  $ $140
children. They will have the opportunity to                  This is a hands
                                                          Instructor:           on class where the child can create
                                                                        Tina Kostopoulos
participate in daily teacher planned activities such         things Can
                                                          MMM….      like you
                                                                           collage
                                                                                smellmaking   and more.aroma
                                                                                        the wonderful     Their of freshly
as structured centers that foster experiential            baked good in the air? Students will in this create.
                                                             imagination     can   take  off with what  they  class that will
learning as well as self-directed choice time that will   teach   themRotation
                                                              Station    ways to bake simple recipes.
include math and science concepts, sensory                    Grades JK & K
experiences, literacy activities and outdoor time.        PE 4:45
                                                              2 The– Max
                                                                      5:30
Monday Specialist Classes -                               Grades:
                                                              $120 & 2
                                                                     1                         3:45 – 4:45
Puddlestompers                                            Cost:   $ 100
                                                              Instructor:
                                                          Instructor:
                                                              This is anAlanna  Saunders
                                                                         open session    with a variety of simple
Let’s Build It                                            Thiscrafts,
                                                                is a class
                                                                      games, Lego’s K’Nexconcepts,
                                                                           of basic fitness  and more. movement   skills,
                                                                                                         A great way
Grades: 1 & 2              2:45 – 3:45                    andtogames    that  emphasize   creative thinking
                                                                 end the day with low key activities.        and
Cost: $85                                                 cooperation.
Instructor: Luqiang Fu                                        Structures
Lego’s, K’nex, Lincoln Logs, Magna-tiles, ROK Blocks,         Grades JK - K
KEVA Planks, Zoobs and more. This class will offer            2:45 – 3:45
stations that the students will rotate to. Great way          Grades 1 – 5
for a child to try all types of “Hands On” fun.               3:45 – 4:45
                                                              $85
African Drumming with Jafar                                   Instructors:
Grades: 2 – 5                     2:45 – 3:45                 Why is building structures amazing STEM play? To
Cost: $ 140                                                   build a solid structure you need a good design, the
Instructor: Jafar Manselle                                    right amount of pieces, a solid base, and basic
In this class we will learn some African style                engineering skills. Also, fine motor skills and
drumming and students will express themselves             Parkour Generations
                                                              patience included. We have materials you can use to
through dance.                                            Grades: 3 – 5                        3:45 – 4:45
                                                              build amazing structures such as Legos, K’nex, KEVA
                                                          Grades: 1 - 2                        4:45 – 5:30
                                                              Planks and more in this class
Parts & Crafts                                            Cost: $170
Grades: 1 & 2                     2:45 – 3:45             Instructors: Parkour Staff
Cost: $ 115                                               All kids love to run, jump and climb! If you want your child
Instructor: Tina Kostopoulos                              to discover how to move and explore their potential in a
Students will get to integrate throw away parts           safe environment, then sign them up for Parkour, run by
from anything from old games, old electronic parts        the team of experienced coaches from Parkour
and more. Using spare parts and craft supplies            Generations
students will make their own creations.
Fuse Beads
                                                        Grades 1st – 5th                 4:45 – 5:30
MONDAY CONT…..                                          Cost: $ 85
                                                        Instructor: Alanna Saunders
                                                        These colorful beads are arranged on plastic
Scratch                                                 pegboards to form patterns and then fused together
Grades: 3 – 5                    3:45 – 4:45            with a clothes iron. They can also be strung into
Cost: $120                                              necklaces, woven into keychains and more
Instructor: Sebastian Stranahan
Explore programming with Scratch. Create
interactive games, stories, and animations              Tuesday Enrichment
while learning about fundamental topics in
computer science. Scratch is a graphical                Programs
programming language designed to be a fun and           15 Weeks
friendly way to begin programming, but still deep
enough to provide challenges and problem                February 25th – June 9th
solving opportunities to experienced users.             No Classes 4/21/20, 5/3/20 and 6/3/20

Let’s Build It EXTREME
Grades: 3 - 5             3:45 – 4:45                   Kindergarten Explorers
Cost: $85                                               Grades: JK-K                      2:30 – 5:30
Instructor: Luqiang Fu
                                                        Cost: $125 per hour
Snap Circuits, Engino, IQ Builders, Kre-O
                                                        Instructors: Arianna Diggs
Transformers, Bionicals, ROK Blocks, Zoobs and
more. This class will offer stations that the           A well rounded nurturing program for our younger
students will rotate to. Great way for a child to try   children. They will have the opportunity to
all types of “Hands On” fun.                            participate in daily teacher planned activities such as
                                                        structured centers that foster experiential learning as
Pop, Jazz & Sass                                        well as self-directed choice time that will include
Dance Class                                             math and science concepts, sensory experiences,
Grades: 1 & 2            3:45 – 4:45                    literacy activities and outdoor time.
Cost: $140
                                                        Tuesday Specialist Classes;
Instructor: Alanna Saunders
                                                        Art w/ Mr. Wynn 2:45
A fun dance class with simple moves to learn
while enjoying the most popular songs and               Knucklebones Lil Ninja’s 4:45
artists.
                                                        Chinese Calligraphy
Hex Bugs, Battle Bots and VEX Robotics                  Grades: 3rd – 5th                  2:45 – 3:45
Grades: 1 -5             4:45 – 5:30                    Cost: $120
Cost: $100                                              Instructor: Luqiang Fu
Instructor: Sebastian Stranahan                         Chinese calligraphy is a type of pleasing writing, as
HEXBUG, Battlebots and VEX Robotics helps               well as a kind of sport, embodying the artistic
children to create engaging and fun toys that           expression of human language in a tangible form. In
immerse children STEM through the excitement            this class, students will use the Four-treasures of
of the TV series BattleBots. Build your own             Chinese calligraphy, which includes ink brush,
version of these robots, with easy snap-together        inkstick, paper and inkstone as they learn to write
pieces that teach hands-on problem solving skills       basic Chinese characters, short phrases, and poems.
and result in these Bots coming to life.
This Lil House
  TUESDAY CONT…..                                         Grades 3rd – 5th                 2:45 – 3:45
                                                          Cost: $120
                                                          Instructor: Michayla Macglashing
Jordan Jammers Spring League                              Each week the students will be interior designers as
Grades: 1 - 2                                             they will decorate by putting up wall paper, wood
Cost: $105                2:45 – 3:45                     floors and more in a Victorian Doll House. Students will
Instructor: Alden Griggs                                  even get to paint the siding and trim on the outside of
We will encourage teamwork and sportsmanship              the house.
while introducing them the basics skills in this sport.
The class will be structured with a focus on a            Cross-Curricular Game Play
different skill                                           Knucklebones of Boston
each week before having a time to play an informal        Grades: 1st & 2nd                   2:45 – 3:45
game.                                                     Cost: $160
                                                          Instructor(s): Mackenzie Brown
Chess Wizards                                             Taking traditional educational curriculum into the
Grades: 1 - 2                       2:45 – 3:45           "yard" (adding physical stimulation) allows students
Grades: 3 – 5                       3:45 – 4:45           to acquire knowledge in a fun, healthy and physically
Cost: $180                                                active way. Utilizing athletically inspired activities and
Instructor: Chess Wizards Staff                           games, participants will be engaged in a program of
Chess Wizards offers fun, intellectual and challenging    creative play that teaches aspects of art, math,
chess education and tournament experiences to             nature, science, and social studies. You’ve never had
children of all abilities and ages. We believe learning   so much fun learning so much! Proper athletic attire
should be fun! Our students learn chess is fun on         and sneakers are required.
Day 1! In addition to traditional gameplay, we
incorporate variations of chess games that foster         LEGO - Mindstorm
teamwork.                                                 Grades: 3 – 5                       3:45 – 4:45
                                                          Fee: $ 90
The World of Mad Science                                  Instructor: Sebastian Strananhan
Mad Science of Greater Boston                             LEGO MINDSTORMS Education EV3 Core Set is a
Grades: 3 - 5                    2:45 – 3:45              hands-on, cross-curricular STEM solution that
Cost: $210                                                engages students by providing the resources to
Instructors: Mad Science Staff                            design, build and program their creations while
Ever wonder how bridges stand over water? Or how          helping them develop essential skills such as
gravity works? Kids explore a variety of introductory     creativity, critical thinking, collaboration, and
topics in engineering, physics, and chemistry, as they    communication.
learn how science can impact our everyday lives.
                                                          Arts with Mr. Wynn
Floor Hockey                                              Grades: 1st & 2nd              3:45 – 4:45
Grades: 1-2                      3:45-4:45                Cost: $120
Cost: $105                                                Instructor: Larry Wynn
Instructor: Alden Griggs                                  Explore many mediums in the world of art. Students
We will encourage teamwork and sportsmanship              will learn about many forms and types of art in this
while introducing them the basics skills in this sport.   class.
The class will be structured with a focus on a
different skill each week before having a time to play
a game.
TUESDAY CONT…..                                    Wednesday Enrichment
                                                     Programs
Athletics
Knucklebones of Boston
                                                     12 Weeks
Grades: 3rd – 5th                  3:45 – 4:45       February 26th – June 10th
Cost: $ 160                                          No Classes on 3/ 18/20, 4/22/20, 5/13/20 & 6/3/20
Instructor: Mackenzie Brown
This class is not your average sports class!
Knucklebones Athletics focuses on strategy,          Kindergarten Explorers
fitness, and fun, allowing everyone to get           Grades: JK-K                      2:30 – 5:30
involved and have a good time. Bringing all our      Cost: $125 per hour
own unique equipment, we’ll play traditional         Instructor: Arianna Diggs
games such as hockey, soccer and basketball          A well rounded nurturing program for our younger
and add some outside the box games like              children. They will have the opportunity to participate in
Poison, Gaga, and Castle ball. Ever tried to score
                                                     daily teacher planned activities such as structured centers
points using a 4’ ball on a 6’inflatable tube?
                                                     that foster experiential learning as well as self-directed
Welcome to Powerball! Everyone will be
challenged, learn new skills and have a blast!       choice time that will include math and science concepts,
Proper clothing and sneakers are required.           sensory experiences, literacy activities and outdoor time.
                                                     Wednesday Specialist Classes;
Snap Circuits                                        Vegetable Circus 3:45
Grades: 2 – 5                    4:45 – 5:30         Yoga 4:45
Cost: $ 100
Instructor: Sebastian Strananhan                     Circus Skills
Elenco's Snap Circuits® makes learning               Vegetable Circus
electronics easy and fun! Just follow the colorful   Grades: 1 - 2                    2:45 – 3:45
pictures in our manual and build exciting            Fee: $ 120
projects such as FM radios, digital voice            Instructor: Brian Walden
recorders, AM radios, burglar alarms, doorbells,     Circus Skills introduces children to a wide array of
and much more! You can even play electronic          complimentary fitness activities and performance skills
games with your friends. All parts are mounted       including juggling, hula hooping, contact juggling, yoga
on plastic modules and snap together with ease.      and more! Circus Skills helps children refine their
Enjoy hours of educational fun while learning        attention, learning to calm themselves and build focus,
about electronics.                                   developing patience, balance, coordination, and motor
Board games
                                                     skills. Through exploring these activities, children
Grades: 1 – 5                   4:45 – 5:30          engage in positive risk taking in a safe, supportive
Cost: $190                                           environment which develops self-confidence, social
Instructor: Luqiang Fu & Alanna Saunders             connectedness, teamwork, and leadership.
Everyone's favorite games ... when you need
them! Games to be played includes Connect
Four, Combo Chess/Checkers/Backgammon
games, Playing Cards etc.
WEDNESDAY CONT…..                                       Arts with Mr. Wynn
                                                        Grades: 3rd – 5th               2:45 – 3:45
Yoga with a Story                                       Cost: $100
Grades: 1 - 2                      2:45 - 3:45          Instructor: Larry Wynn
Grades 3 – 5                       3:45 – 4:45          Explore many mediums in the world of art.
Cost: $100                                              Students will learn about many forms and types of
Instructor: Arti Pandey                                 art in this class.
Come join us as we learn how to yoke our breath to
our body through the age-old practice of yoga. This     Cambridgeport Community School Sports League
class will endeavor to guide the students through a     Grades 3 – 5                        2:45 – 4:45
series of poses (also known as 'asanas') with a         Cost: $170
conscious focus on the breath. Yoga serves many         Coaches: Val Chrisphonte & Alden Griggs
purposes: building flexibility, stamina and strength;   This league is designed to have 30 participants on
calming the mind; de-stressing the individual; and      4 different teams. This Spring each team will play
                                                        each other in different sports. Instructors will
above all, bringing the body-mind experience into
                                                        continue with fundamentals skill building, focus,
one wholesome healthful unity. For children this
                                                        enjoyment, accomplishment, respect and fair
translates into a calmer, more settled frame of mind
                                                        play. Then the coaches will select the four teams
which allows them to take the tumbles of a              so there will be a competitive and level playing
constantly changing, moving day with greater ease.      field. Then the league will begin and each week
Over time, it gives them the ability to find balance    there will be two games going on at each end of
within themselves.                                      the court. In April the participants will play on the
                                                        famous parquet floor of the Boston Garden to
Lego Play                                               play prior to a Celtic game. Each player will have
Grades: 1 & 2                   2:45 – 3:45             t-shirts for league play at all traveling games.
Cost: $ 75
Instructor: Luqiang Fu                                  Jewelry Making
Play with an abundance of Legos. Create, play and       Grades: 1st – 2nd                3:45 – 4:45
hang with your friends and let your imagination be      Cost: $100
the guide in this class.                                Instructor: Alanna Saunders & Tina Kostopoulos
                                                        Make unique pieces of jewelry and learn skills
Lego Boost                                              used for putting it together. Some projects
Grades: 3rd – 5th                2:45 – 3:45            include; braiding friendship bracelets, tiaras,
Cost: $75                                               macaroni necklaces, new design for beads and
Instructor: Tina Kostopoulos                            recondition old damaged jewelry.
LEGO® BOOST lets children create models with
motors and sensors, and then bring their creations      Lil Bits
to life through simple, icon-based coding               Grades: 1 & 2                      3:45 – 4:45
commands. Using the Chrome books LEGO BOOST             Cost: $110
tablet app includes easy step-by-step building          Instructor: Sebastian Stranahan
instructions for creating and coding multifunctional    littleBits is the easiest and most versatile STEAM
models.                                                 solution for hands-on creative learning.
                                                        Engineering Skills. Fun & Engaging. Coding Skills.
WEDNESDAY CONT…..                                     Thursday Enrichment
Magic The Gathering                                   Programs
Grades: 3rd – 5th
Cost: $150
                                3:45 – 5:30
                                                      15 Weeks
Instructor: Sebastian Stranahan                       February 27th to June 11th
Defeat opponents and show off your skill with epic    No Classes on 4/23/20
creatures and powerful enchantments. We will
provide the cards and we discourage participants      Kindergarten Explorers
to bring their own.                                   Grades: JK-K                      2:30 – 5:30
                                                      Cost: $125 per hour
Pokemon                                               Instructor: Arianna Diggs
Grades 1 & 2                     4:45 – 5:30          A well rounded nurturing program for our younger
Instructor: Luqiang Fu                                children. They will have the opportunity to
Cost: $80                                             participate in daily teacher planned activities such as
“Gotta catch ‘em all!” Enter the arena, Pokémon       structured centers that foster experiential learning
cards and all, and play your friends for an all-out   as well as self-directed choice time that will include
battle. Cards and battle mats will be provided as     math and science concepts, sensory experiences,
well as instructions on how to play.                  literacy activities and outdoor time.
                                                      Thursday Specialist Class;
ZOOB Builders                                         ABC Spanish in Motion ½ class 2:45
Grades: 1 - 5                    4:45 – 5:30          ABC Spanish in Motion ½ class 3:45
Fee: $80
Instructor: Alanna Saunders                           Cooking in the Kitchen
Kids can either build their own creations or follow   “Kids Test Kitchen”
the challenges. The best part about playing with      Grades: 1 - 2                     2:45 – 3:45
ZOOB is exploring, discovering and using              Grades: 3 - 5                     3:45 – 4:45
imagination to create any design that comes to        Cost: $ 210
mind.                                                 Instructor: Jay
                                                      Each week we’ll explore new or familiar foods in
                                                      their raw, unmanipulated state. Then, working as a
                                                      team, we’ll slice, dice, peel, measure, and cook until
                                                      we’ve prepared the finished dish. This winter, we are
                                                      heating things up with a batch of fresh comfort
                                                      foods, and a little something for your sweet tooth!
                                                      Each week will highlight ingredients known to be
                                                      really good for us, and at the end of class your
                                                      aspiring chef will receive the main ingredient, or a
                                                      sample of the finished dish, and the recipe so that
                                                      they can show off what they’ve learned!
DIGITABLE ANIMATION & STORYTELLING
THURSDAY CONT…..                                            Empow
                                                            Grades 3 – 5                       2:45 – 3:45
                                                            Cost: $280
                                                            Instructors: Enpow Staff
Dodgeball                                                   Students start with storyboarding – a perfect way to
Grades: 3 - 5                    2:45 - 3:45                capitalize on kids’ natural storytelling skills. A great
Cost: $105                                                  class for the younger age groups, students start by
Instructor: Valerie Christphonte & Alden Griggs             creating their characters, scenes, and stories by
Dodgeball is a game in which players on two teams try       drawing, writing, and digitally creating their movie
to throw balls at each other while avoiding being hit       scripts. Students then will learn to use digital
themselves. Soft Gator Balls are used in this class that    animation software, such as Stykz, to create their
also focuses on safety and teamwork.                        own short animated films. Stykz makes it easy for
                                                            beginners by incorporating pre-made figures to bring
LEGO Simple Machines                                        their ideas to life. This class shows students how to
Grades: 1 & 2                      2:45 - 3:45              animate step-by-step, allowing them to explore their
Cost: $ 120                                                 creativity while learning about story-telling, time-
                                                            management, and some principles of animation.
Instructor: Luqiang Fu
In this class students will work from a set that contains   ELECTRONIC MUSIC PRODUCTION
a brick assortment that includes gears, wheels and          Empow
axles, levers, and pulleys. This set will engage students   Grades 3 – 5                      3:45 – 4:45
in investigating and understanding the operation of         Cost: $280
simple and compound machines found in everyday              Instructors: Enpow Staff
life.                                                       If you were to design your own home, what would it
Hobby Adventures                                            look like? How about a huge TV and gaming room, 4
Grades: 1 - 5                    2:45 - 3:45                car garage, or perhaps a playroom just for your pet
Cost: $120                                                  dog! It’s up to you how you want to make your
Instructor: Michayla MacGlashing                            dream home, but it’s important to know some of the
Students will get a chance in exploring many different      basics when it comes to architecture, that way your
hobbies such as Model Airplanes, Jewelry, Wood              home is not only stable, but also convenient and
Crafts, Sewing, Crochet, Outdoor Hobbies and more.          functional. By learning Digital Architectural Design,
What a great adventure to try new things.                   you’ll walk through the design process of creating a
                                                            floor plan, modeling rooms within a home, and
Happy Feet (Soccer)                                         creating your first home in which you can tour in 3D.
                                                            Once you get the grasp of creating the necessities of
Grades: 1 - 2                     3:45 – 4:45
                                                            a home, you’ll explore styles and construct
Cost: $105
                                                            commercial buildings that follow standard
Instructor: Alden Griggs
                                                            regulations like fire safety and wheelchair
Children will learn the basic fundamentals of soccer
                                                            accessibility.
through station work. Our goals for this program are
to have fun, learn character through sport, and             Model Magic
increase soccer skills.                                     Grades: 1 – 5                  4:45 – 5:30
                                                            Cost: $120
                                                            Instructor: Alanna Saunders
                                                            Model Magic modeling compound is an easy
                                                            manipulated clay that can form and shaped to
                                                            anything the imagination dreams up.
THURSDAY CONT…..                                              Friday Enrichment
Structure w/ KEVA Planks
                                                              Programs
Grades: 1 - 5
Cost: $90
                                 4:45 – 5:30                  14 Weeks
                                                              February 28th – June 12th
Instructor: Sebastian Stranahan
                                                              No Classes on 4/10/20 & 4/24/20
Children discover the joy of creating original works of
art or cleverly designed contraptions. Future architects
and engineers come discover discovering the world of          Kindergarten Explorers
building. Young KEVA builders today will be building our
                                                              Grades: JK-K                      2:30 – 5:30
world in a few years.
                                                              Cost: $125 per hour
                                                              Instructors: Arianna Diggs
PE 2 The Max
Grades: 3rd – 5th                   4:45 – 5:30               A well rounded nurturing program for our
Cost: $90                                                     younger children. They will have the opportunity
Instructor: Luqiang Fu                                        to participate in daily teacher planned activities
This is a class of basic fitness concepts, movement skills,   such as structured centers that foster experiential
and games that emphasize creative thinking and                learning as well as self-directed choice time that
cooperation.                                                  will include math and science concepts, sensory
                                                              experiences, literacy activities and outdoor time.
                                                              Friday Specialist Classes;
                                                              Creative Ballet 3:45
                                                              Gymnastics 4:45

                                                              Hip Hop & Double Dutch
                                                              Grades: 3 – 5                    2:45 – 3:45
                                                              Cost: $140
                                                              Instructor: Angelique Smith
Lego Fun                                                      Hip-hop dance refers to street dance styles
Grades: 1 & 2                    4:45 – 5:30                  primarily performed to hip-hop music or that have
Cost: $90                                                     evolved as part of hip-hop culture. Double Dutch
Instructor: Luqiang Fu                                        is a game in which two long jump ropes turning in
Play with an abundance of Legos. Create, play and hang        opposite directions are jumped by one or more
with your friends and let your imagination be the guide       players jumping simultaneously.
in this class.
                                                              Lil Bits
                                                              Grades: 3rd – 5th                  2:45 – 3:45
                                                              Cost: $125
                                                              Instructor:
                                                              littleBits is the easiest and most versatile STEAM
                                                              solution for hands-on creative learning.
                                                              Engineering Skills. Fun & Engaging. Coding Skills.
Arts with Mr. Wynn
FRIDAY CONTINUE…….                                         Grades: 1st & 2nd             2:45 – 4:45
                                                                      rd   th
                                                           Grades: 3 – 5                 3:45 – 4:45
Gymnastics                                                 Cost: $115
Grades JK – 2                                              Instructor: Larry Wynn
3:45 – 4:45                                                Explore many mediums in the world of art. Students will
$140                                                       learn about many forms and types of art in this class.
Instructors: Angelique Smith
Build coordination, strength and balance. Learn safe       The HIVE @ the Library
stretching exercises, gymnastic routines and how to        Grades: 3rd – 5th                 2:45 –:45
use traditional gymnastic equipment.                       Cost: $170
                                                           Instructor:
Basic Hot Wheels                                           The Hive is a new STEAM creativity zone being built in the
Grades: 1 – 5                     3:45-4:45                lower level of the Cambridge Main Public Library.
Cost: $90                                                  Each Friday students will walk to the Library with
Instructor: Sebastian Strananhan                           community school staff. The Hive consist of a hands-on
Basic Hot Wheels® is a fun and engaging way to learn       workshop (aka “makerspace”) stocked with digital and
about concepts such as energy, force, and motion. In       traditional fabrication tools, multimedia recording studios
this class the child can have fun exploring how far        for creating audio and video content, and an Extended
they can have their car jump from a ramp, how an           Reality Lab for experiencing and experimenting with
incline can develop speed and socially learn how to        virtual and alternate reality.
play with others. A lot can be learned from Hot
Wheel play.                                                Advanced & Strategic Board & Tabletop Games
Creative Movement
                                                           Grades: 3 - 5                      4:45 – 5:30
Grades: 1 & 2                        2:45 – 3:45           Cost: $ 85
Cost: $140                                                 Instructor: Sebastian Strananhan
Instructor: Mary Teusher                                   Kalacka Ball, Nok Hockey, Tabletop Hockey, Shuffleboard,
In this class students will explore techniques and         Ping Pong and other classic wooden table top games will
individual choreography games.                             be featured in this class. Along with strategic games like
                                                           “Ticket to Ride”, “The Settlers of Catan” and more.
K’Nex Ultimate Builders
Grades: 1 & 2                      2:45 – 3:45             Groovy Gimp
Cost: $85                                                  Grades: 3 - 5                       3:45 – 4:45
Instructor: Luqiang Fu                                     Cost: $110
In this class builders create awesome constructions        Instructor: Alanna Saunders
ranging from simple buildings to grand structures.         In this class students will learn essential stitches and skills
Your child can build a fire truck, an aircraft, and much   they need to master the art of plastic lacing. Simple but
more. Children can bring their imagination to life with    fun projects making cool zipper pulls, key chains,
the creation of three-dimensional models. Whether          bracelets, decorations and more.
their constructing a unique vehicle or depicting a
pirate ship, this class allows a multitude of 3D           Beyblade
configurations to help them bring their dream design       Grades: 1 – 5                    4:45-5:30
to life.                                                   Cost: $85
                                                           Instructor: Luqiang Fu & Sebastian Stranahan
                                                           Beyblade is customizable spinning battle top with a spin
                                                           blade base, spin gear, weight disk, attack ring, and more.
                                                           We will provide the Beyblades and Bayblade Stadiums.
                                                           Students are encouraged to leave their own beyblades at
                                                           home.
KINDERGARTEN EXPLORERS CLASS SELECTION

        Childs Name ________________________________ Grade _____ Teacher ______________ Room # ____

                                             (Please circle fee of class choice)

          Monday       Fee      Tuesday          Fee     Wednesday          Fee        Thursday          Fee       Friday         Fee
2:45      Kindergarten $125     Kindergarten     $125    Kindergarten       $125       Kindergarten      $125      Kindergarten   $125
          Explorers             Explorers                Explorers                     Explorers                   Explorers
to
3:45

$125      Kindergarten   $125   Kindergarten     $125    Kindergarten       $125       Kindergarten      $125      Kindergarten   $125
          Explorers             Explorers                Explorers                     Explorers                   Explorers

$125      Kindergarten   $125   Kindergarten     $125    Kindergarten       $125       Kindergarten      $125      Kindergarten   $125
          Explorers             Explorers                Explorers                     Explorers                   Explorers

$125      TOTAL

Please Register My Child for the Following Additional Programs
Early Release Day
Wed. March 18th             $50___________                              Application Fee $25.00
New England Aqurium                                                     Not applicable if it was paid in the Fall

Early Release Day
Wed. May 13th              $50 ____________                             Total Amount Due for Classes $____________
Animal Adventures                                                       (The above Chart)
Early Release Day                                                       Total Amount Due For Additional Classes ________
Wed. June 3rd              $50 ___________                              (This includes the total from other side chart)
Community School
Fun Day Fair

                                                                        TOTAL AMOUNT DUE $____________________
April Vacation Camp        8:00 – 3:30 / $200 ______________            Make checks or money orders out to the
April 21st – 24th          8:00 – 5:30 / $225 ______________            Cambridgeport Community School
                                                                        NO CASH ACCEPTED

        Parents Signature ______________________________________________ Date: _______________________
1st and 2nd GRADE CLASS SELECTION
          Childs Name _______________________________ Grade _______ Teacher ______________ Room # _______
            (PLEASE CIRCLE FEE OF CLASS CHOICE, THEN WRITE THE NUMBER 2 FOR YOUR SECOND CHOICE)

           Monday           Fee    Tuesday          Fee    Wednesday          Fee         Thursday       Fee       Friday       Fee
           (14 Weeks)              (15 Weeks)              (12 Weeks)                     (15 Weeks)               (14 Weeks)
2:45 to    Drumming         $140   Jordan           $105   Vegetable          $120        Kids           $210      Creative     $140
3:45       with Jafar              Jammers                 Circus;                        Test                     Movement
           2nd Grade only                                  Circus Skills                  Kitchen
           Let’s            $85    Cross Circular   $160   Yoga with a        $100        LEGO           $120      K’nex        $85
           Build it                Game Play               Story                          Simple                   Ultimate
                                   (Knucklebones)                                         Machines                 Builders
           Parts &          $115   Chess            $180   LEGO               $75         Hobby          $120      Art with     $115
           Crafts                  Wizards                 Play                           Adventure                Mister
                                                                                                                   Wynn
3:45 to    PE 2             $100   Art with         $120   Jewelry            $100        Model          $120      Gymnastics   $140
4:45       The Max                 Mister Wynn             Making                         Magic

           Pop              $140   Floor            $105   Lil                $110        Happy          $105      Hot Wheels   $90
           Jazz &                  Hockey                  Bits                           Feet
           Sass
4:45 to    Hex Bugs,        $85    Board            $90    ZOOB               $80         LEGO           $90       Beyblades    $85
5:30       Battle Bots &           Games                   Builders                       Fun
           VEX Robotics
           Parkour          $170   Snap             $100   Pokemon            $80         KEVA           $90       Groovy       $110
                                   Circuits                                               Planks                   Gimp

           TOTALS

Please Register My Child for the Following Additional Programs
Early Release Day
Wed. March 18th             $50___________                            Application Fee $25.00
New England Aquarium                                                  Not applicable if it was paid in the Fall

Early Release Day
Wed. May 13th               $50 ____________                          Total Amount Due for Classes $____________
Animal Adventures                                                     (The above Chart)
Early Release Day                                                     Total Amount Due For Additional Classes ________
Wed. June 3rd               $50 ___________                           (This includes the total from other side chart)
Community School
Fun Day Fair
April Vacation
                                                                      TOTAL AMOUNT DUE $____________________

          Parents Signature ______________________________________________ Date: _______________________
3rd – 5th GRADE CLASS SELECTION
          Childs Name ____________________________ Grade ______ Teacher ________________ Room # ________

            (PLEASE CIRCLE FEE OF CLASS CHOICE, THEN WRITE THE NUMBER 2 FOR YOUR SECOND CHOICE)

           Monday           Fee    Tuesday          Fee    Wednesday        Fee           Thursday       Fee        Friday         Fee
           (14 Weeks)              (15 Weeks)              (12 Weeks)                     (15 Weeks)                (14 Weeks)
2:45 to    Drumming         $140   Mad Science      $210   LEGO             $75           Dodgeball      $105       Hip Hop &      $140
3:45       with Jafar                                      Boost                                                    Doubledutch
           VEX              $85    Chinese          $120   Art With         $100          Hobby          $120       Lil Bits       $125
           IQ                      Calligraphy             Mister Wynn                    Adventures
           Baking           $140   This             $120                    $170          Digital        $280                      $170
           With                    Lil                                                    Animation
           Tina                    Hose                     Elm Street                    &                             The HIVE
                                                               Sport                      Storytelling                   @ main
                                                                                          EMPOW
                                                              League                                                     library
3:45 to    Let’s Build It   $85    Athletes         $160                                  Electronic     $280
4:45       EXTREME                 (Knucklebones)             2 hours                     Music                          2 hours
                                                                                          Production
                                                                                          EMPOW
           Parkour          $170   Chess            $180   Yoga with a      $100          Kids           $210       Art with       $115
           Generations             Wizards                 Story                          Test                      Mister
                                                                                          Kitchen                   Wynn
           Scratch          $125   Lego             $90       Magic         $150
                                   Mindstorms
                                                               The
4:45 to    Hex Bugs,     $100      Snap             $100                                  KEVA           $90        Groovy         $110
5:30       Battle Bots &           Circuits                 Gathering                     Planks                    Gimp
           VEX                                               2 hours
           Robotics
           Fuse          $85       Board            $90    Zoob             $80           PE 2 the       $90        Table Top      $85
           Beads                   Games                   Builders                       MAX                       Games
           TOTALS
Please Register My Child for the Following Additional Programs
Early Release Day
Wed. March 18th             $50___________                            Application Fee $25.00
New England Aquarium                                                  Not applicable if it was paid in the Fall
Early Release Day
Wed. May 13th               $50 ____________                          Total Amount Due for Classes $____________
Animal Adventures                                                     (The above Chart)

Early Release Day                                                     Total Amount Due For Additional Classes ________
Wed. June 3rd               $50 ___________                           (This includes the total from other side chart)
Community School
Fun Day Fair
April Vacation
4/21 – 4/24/20              $?___________                             TOTAL AMOUNT DUE $____________________

            Parents Signature ______________________________________________ Date: ____________________
CAMBRIDGEPORT COMMUNITY SCHOOL
                         SCHOOL YEAR 2020 SPRING REGISTRATION FORM

Child’s Name ______________________________ DOB ______________ Age ____ Gender _______
Teacher ______________________________________ Grade _____________ Room #_________
Address______________________________________________________________________________
Ethnicity:
Black ______ Latino ______ Haitian _______ White______ Asian _______ Other _______

Parent/Guardian Name (1) _______________________ Relationship___________________________
Home Number__________________ Cell Number____________________ Work Number ____________
Email Address __________________________________________ (please print clearly)

Parent/Guardian Name (2) __________________________Relationship___________________________
Home Number___________________ Cell Number____________________ Work Number ___________
Email Address __________________________________________

Emergency Contact Name
(1)________________________________________Relationship________________________
Home Number____________________ Cell Number____________________ Work Number __________

Emergency Contact Name (2)___________________________Relationship________________________
Home Number___________________ Cell Number_____________________ Work Number __________

Does your child have an IEP (Individual Ed Plan) Yes_____ No_____

Does your child have any allergies or medical conditions that we should be aware of?
Yes______ No_______ If yes, please describe: _____________________________________________

Does your child have an Epi Pen? Yes______ No______ Does your child have an inhaler?
Yes______ No______

I hereby give permission for my child to participate in all Community School activities and trips.

Parent/Guardian Signature ________________________________________ Date: _________________

I hereby give permission for my child to walk home when class is dismissed (Age 9+ only).

Parent/Guardian Signature ________________________________________ Date: _________________

I give my permission to the City of Cambridge/Community Schools to use photographic and video
images of my child and family for publicity purposes. I acknowledge that publicity could include the use
of our names and images in any slide shows, websites, social media, or articles submitted for publication
and distribution.

Parent/Guardian Signature ________________________________________ Date: ________________
City of Cambridge
                         Department of Human Service Programs
                               Information Release Form

_______________________________                          ____________________________________
      (Child’s Name)                                           (Name of School)

Please circle one:      NEW STUDENT                      RETURNING STUDENT

I am applying for: (Please circle your program choice.)

Youth Center               Community                  Afterschool Licensed Preschool Licensed
Licensed Programs          Schools (CS)               Childcare            Childcare

Area IV                    Elm Street CS              Fletcher Maynard K-3       East Cambridge
Frisoli                    Fitzgerald CS              King K-2                   Preschool
Gately                     Fletcher Maynard CS        King 2-4                   Haggerty Preschool
Moore                      Haggerty CS                Morse K-2                  King Open Preschool
MSP @ Frisoli              Harrington CS              Morse 3-5                  M. L. King Preschool
MSP @ Gately               Kennedy CS                 Peabody K-2                Morse Preschool
West Cambridge             King CS                    Peabody 2-5                Peabody Preschool
                           Linnaean CS
(MSP=Middle                Morse CS                   King Open
School Partnership)        Tobin CS                   Extended Day
                           Longfellow CS              (KOED)
                           Amigos CS

I hereby authorize the Department of Human Services (DHSP) to observe my child in his/her school day
classroom or program and to discuss my child’s educational, physical, medical, psychological and/or
other needs with his/her teachers, specialists, therapists, medical providers and other caregivers for the
purpose of evaluating his/her participation in DHSP’s out of school time (OST) and preschool programs.

Parent/Guardian Name (Please Print): __________________________________

Parent/Guardian Signature: ______________________ Date: ______________

                      PERMISSION TO OBTAIN STUDENT RECORDS
                             (IEP, 504 Plan, behavior plans)

I hereby authorize my child’s school/program to release my child’s records including his/her
Individualized Education Program (IEP), Behavioral Intervention Plan and/or Section 504 Plan. DHSP
will not disclose the content of any such records to any other party without my written consent, except as
DHSP may be required by law to do so. All records will be used for the purpose of evaluating my child’s
participation in DHSP’s out of school time (OST) programs.

Parent/Guardian Signature: ______________________ Date: ______________
                                                                                               Revised 3/09
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