Night Hawk: Herndon MS After-School Program

Registration Consent Form for this School Year

Please read and complete this form prior to attending any Middle School After-School Activities.

FCPS Middle Schools offer a free After-School Program every regular school day (with some exceptions).  This program is staffed by FCPS teachers and staff, NCS staff, and approved contractors and volunteers. After-School Programs include a variety of activities such as homework assistance, school clubs, fine arts, leadership, sports, and other activities. 

The Middle School After-School Program is jointly sponsored by Fairfax County Neighborhood and Community Services and Fairfax County Public Schools and is exempt from licensure as per §22.1-289.030 of the Code of Virginia with no direct oversight by the Virginia Department of Education.  

Specific Information is available at the school and on the school’s website.

Email *
Untitled Title
Consent
I understand that participation in the After-School Program is a privilege and contingent upon student behavior as outlined in the FCPS Student Rights and Responsibilities, as well as School, After-School and FCPS Bus Rules.  Violation of these rules could result in disciplinary action from both the School Day and After-School Programs. 
I understand that participation is completely voluntary, and that some of the planned physical activities may expose my child to some potential injury.  I agree that, to my knowledge, my child is physically and medically able to participate in these activities.  If any injuries do occur to my child, I understand that school and county personnel will respond in the same manner that occurs during regular school hours.  I understand that participation may be denied if my child is consistently picked up late.  I understand that in case of early closing due to inclement weather or emergency conditions, all after-school activities will be canceled.
I understand and hereby grant permission for my child to participate in the Middle School After-School Program for this school year.

Parent/Guardian Name (first and last)

 *
Student Agreement
I (student) understand that participation in the After-School Program is a privilege and contingent upon my behavior as outlined in the FCPS Student Rights and Responsibilities, as well as School, After-School and FCPS Bus Rules.  Violation of these rules could result in disciplinary action from both the School Day and After-School Programs. 

Student Initials *
Student ID Number *
Student Grade Level *
Student's FIRST Name (legal name) *
Student's LAST Name  *
Student's MIDDLE INITIAL (if applicable)
A copy of your responses will be emailed to the address you provided.
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