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Summer Program Registration

RCMS is inviting students to participate in the optional Summer (5th Block) Program for three weeks in July from 9:00 am to 11:30 am. A snack will be provided daily. Transportation is available upon request.

July 11-13

July 18-20

July 25-27 

Please complete the following form:

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Email *
Child's First Name  *
Child's Last Name *
Current Grade (2022-2023) *
My child will participate in the following week(s)
Select all that apply: 
 *
Required
Address *
Home Phone *
Cell Phone *
Parent/Guardian Name #1 *
Parent/Guardian Name #2 *
Work Phone
Alternate Contact if Parent can not be reached *
Does your child have any medical conditions or allergies that we need to be aware of? (Please list any food allergies) *
Persons authorized to pick up your children (Name / Relationship / Phone Number)
*
My Child Will: *

Address for drop-off/pick-up (only 1 address allowed) Students will be dropped off at bus stops. An adult guardian is required to be at the bus stop for elementary aged students

On occasion students visit places of interest or attend activities off campus.  Students will be taken by an approved school vehicle or will walk a short distance.  Children will always be supervised.  

May we have permission for your child to accompany a group on short visits during his/her program attendance? 

*

We are proud of our summer program and the activities provided to students and families.  We are asking for your support in our efforts to publicize our successes.  Please review the “Student Information Release Form” provided by the Richland County School District.

May we have permission to allow your child to participate in videotaping, newspaper articles, district website and publications, TV coverage, or any use of media for the summer program?

*

Please review the “Technology Acceptable Use Policy” provided by the Richland County School District.

The District has the right to, and does monitor use of the technology system. 

*
May we have permission to access information and data concerning your child’s school performance (certified staff) to best assist school day performance?  
 *

A copy of the RCES/RCMS Handbook and behavior expectations is available electronically on the RCCU website and in paper form in school offices.  

 *
A copy of the RCES/RCMS Handbook and behavior expectations is available electronically on the RCCU website and in paper form in school offices. 
*
Student Signature (for 3rd Grade and Older):  *
Current Grade *
Parent/Guardian Signature *
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