Enrichment Registration - Winter 2019
Registration Deadline: I-JUMP: Friday, January 11, 2019. All other classes: Friday, January 18, 2019
Student last name *
Your answer
Student first name *
Your answer
Grade *
Teacher *
Your answer
Email address
Most enrichment communication is done by email. If you do not have access to email or prefer phone, please indicate below.
Your answer
Parent/guardian name(s) *
Your answer
Address *
Your answer
Phone 1 (Preferred) *
Your answer
Phone 2
Your answer
Emergency contact #1 name and phone (aside from guardians listed above) *
Your answer
Emergency contact #2 name and phone
Your answer
Severe Allergies
Your answer
Pickup after class *
There is no bussing for enrichment but rides can be arranged. Please contact Kathy Duell at kduell@icsd.k12.ny.us or call the office. Please select if you child will go to CASP after class or be picked up.
Required
Name and phone of guardian who will pick up student
Please plan to arrive 5 minutes early to ensure smooth pickup, in the front entrance vestibule.
Your answer
Other people who may pick up this student
If you have any concerns about an unauthorized person picking your child-up from enrichment please contact enrichment coordinators at ces.enrichment@gmail.com or Karen Rachetta at karen.rachetta@icsd.k12.ny.us 539-7155.
Your answer
Class choice 1 *
Class choice 2 *
Class choice 3 *
Program(s) cost *
Payment or Scholarship Application is due within 3 school days of registration. Please turn in promptly to reserve your child's spot!
Your answer
Donation to scholarship fund?
Please consider donating and extra $5, $10 even $40+ to the Enrichment Scholarship Fund. Please write a separate check labeled “scholarship” in the memo. Thank you!
Your answer
Scholarship Application? *
Financial assistance is available. Please talk to Tracy in the main office or visit the PTA website for an application. You may call to have an application sent home with your child. Applications must be turned in within 3 days of registering for enrichment.
Total payment & check number
Checks are to be made payable to CAROLINE PTA and submitted within 3 school days of registering. Please write a separate check for each class (this makes refunds easier if a class is full or cancelled), write the class name in the memo, and send into school with your child in an envelope labeled ENRICHMENT. If cancellation occurs due to insufficient enrollment or other circumstances, your payment payment will be returned. No refunds will be made once the class has begun. Please include check number(s) below.
Your answer
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