2024-2025 Extended Learning Application- Mary Rowlandson Elementary School
Welcome to the Extended Learning Program's 2024-2025 school year registration for Center School students.
Please fill out this application form to apply for a spot in our growing program. Registration closes on July 1st, 2023, or when the program is full.

Following the submission of this form you will receive a Google Receipt, please note that this does not confirm your registration in the program. We will contact you on Wednesday, May 8th, 2024, to either confirm your student's enrollment or to provide information about our waitlist. Enrollment is determined for families on a first-come first-served basis.

We appreciate your patience as we assess our staffing and space capacities for the upcoming year. Our aim is always to accommodate as many families as possible while ensuring the safety and well-being of all students!

If you have any questions in the meantime, please visit our Extended Learning Program website or contact us directly at bhannigan@nrsd.net. We are here to help!

Please fill out a separate form for each child, we offer a 10% discount for each sibling, this will automatically be applied when your invoice is uploaded.
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Email *
Program Hours
Program Hours
The Extended Learning Program is open on all scheduled school days. The Extended Learning Program is not open on weekends, holidays, full conference days, and school vacations. In the case of a delayed start the AM Extended Learning Program will not run. In the case of a half day due to inclement weather the PM Extended Learning Program will not run.

AM Program: 7:25am-8:25am
PM Program: 3:05-6:00pm
Early Release Days: 12:15pm-6:00pm

Student's First name *
Student's Last name *
School *
Select the grade that your student will be in during the 2024/2025 school year *
Student DOB *
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/
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Student Gender *
Attendance
Children thrive socially and academically in an environment that provides familiarity and routine. The Extended Learning program takes pride in providing this familiarity for our students. To maintain our students' routines and schedules, we encourage regular attendance.

Please let us know if your child will be absent via email by 2:00pm for PM program.
 
*Failure to inform us of an absence from the program will result in a $10.00 fee.*

To request an extra day,  please fill out our Change of Schedule Form, found on our Extended Learning Program website. We do not allow rotating schedules.

Schedule changes can be done at any time. However, monthly costs are not prorated. In order for invoice amounts to be updated all schedule changes must be made no later than the 27th of the month prior. Any schedules changes made after the payment date will not be refunded. Please plan your schedule changes accordingly.

All long-term schedule change requests after AUGUST 1ST will be assessed a $15.00 fee. Add a days are not be assessed a $15.00 fee. 
AM program days per week *
PM program days per week *
AM program days of attendance  *
Required
PM program days of attendance  *
Required
Guardian and other contact information
Please provide the best way to reach you or other emergency contacts.
Guardian First Name *
Guardian Last Name *
Guardian email *
Guardian address *
Best phone number to reach guardian in case of emergency *
Second best phone number to reach guardian *
Alternative contact FIRST AND LAST NAME *
Alternative contact phone number *
Alternative contact relationship to student *
Alternative contact email (if they would like to receive communications). Please list all emails that you would like to receive communications regarding the Extended Learning Program.
Emergency contact FIRST AND LAST NAME *
Emergency contact phone number *
Student's relationship to emergency contact *
Please list all individuals approved for student pick up (must be over 18 and have valid ID) *
Medical Information
Provide us with a detailed account of student medical information. Please note that there is NO NURSE ON DUTY during these hours. Our staff cannot administer medications, sun tan lotions, bug sprays, or any other over-the-counter products.
Does your student have a life threatening allergy? *
If so, please describe below
Does your student use an Epi-Pen? *
Does your student have a non-life threatening allergy? *
If yes, please describe
Does your student have any other medical conditions? (Check as many as apply) *
Required
Does your student take any medication that you would like staff to be aware of?
More About Your Student
Please provide us with any information about your child's social emotional well-being so we may best attend to their individual needs. We have an open communication policy with the schools which allows us to maintain effective, positive behaviors and learning strategies.
Is there any social/emotional information about your student that you would like for us to have?
Does your student have an IEP, 504 or other special considerations?
Clear selection
Is there anything else you would like for us to know about your student? 
Guardian Permission Acknowledgments
Please initial below to sign off on each statement.
Please indicate if you would like your student participate in home work time *
Please initial to approve student's participation in Friday movie day (Rated G or PG) *
Please initial to acknowledge that personal devices and other items from home (i.e. cellphones, iPod touches, switches, etc.) are not allowed at the Extended Learning Program.  *
Please initial to approve student's participation in walking trips *
Please initial to approve student's participation in photographs (used for our website, district live feed, and local newspapers) *
Please initial that you understand our billing is done through MySchoolBucks.com. You will need to create an account for your student through the site. All bills will be sent electronically to your email. Payment is due on the 28th of each month August-May. You can waive all program fees for 12 months by signing up for a OnePay Membership, found under My User Profile. *
Please initial to acknowledge that there is no nurse on duty. Medications, sun screen, bug sprays etc. cannot be administered by Extended Learning staff. *
Please initial to acknowledge that the program will be running under CDC COVID-19 guidelines. Increases in cases or clusters may cause the program to close temporarily or long term. *
A copy of your responses will be emailed to the address you provided.
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