FCE Green Paw Garden Club - Round Rock ISD
Parental Permission for Participation in Elementary Extracurricular Club/Activity

PLEASE Submit TO Cindy Loftis BY October 15, 2018

SCHOOL USE ONLY SECTION:
Sponsor’s Name: Cindy Loftis
Sponsor’s Contact Information: cindy_loftis@roundrockisd.org
Sponsor a Staff Member: Yes

Grade Level(s) Participating: 1st, 2nd, 3rd, 4th, 5th grades (club is limited to 30 students)

Meeting Dates/Times: every other Thursday beginning on 10/18/18 from 2:55 pm -3:45 pm

Meeting Location:meet in the gym, then go to the classroom or garden with teacher

*Pick-up Location and Time: in garden or in front of school at 3:45 pm
(NOTE: Any child picked up late three times or more than 15 minutes late twice will not be allowed to continue participation in the activity.)

All Round Rock ISD extracurricular clubs and organizations have an adult sponsor who will be present at all meetings. Although these sponsors are often a Round Rock ISD staff member, due to the volume of extracurricular clubs and activities offered by the District, some of our groups are led by a parent or volunteer sponsor with no staff member present. Each of these lead sponsors are required to undergo a full background check, including a fingerprint check, just as is required of our school district employees. Additionally, the majority of our extracurricular clubs and activities meet in the school building. For groups with parent/volunteer sponsors, while there will not be a staff member in the room during the meeting, there will always be a staff member present on campus while meetings are taking place.
Although most extracurricular activities and clubs meet on school property, a few of our groups with parent/volunteer sponsors meet away from the campus in places such as private homes, due to the nature of the group and the size of the materials being used. If your child is participating in meetings that take place away from the school district, we want to be sure you are aware that no Round Rock ISD staff member will be present during meetings and activities. The sponsors of these groups, however, will undergo the same thorough background check as all other sponsors, as described above.

Email address *
Application
I give my permission for my child to participate in the FCE Green Paw Garden Club, an extracurricular program of the Round Rock Independent School District at Forest Creek Elementary for the 2018-2019 school year. *
Student's Information
Student's Name
Your answer
GRADE *
Required
Student's Homeroom Teacher *
Your answer
How my child will usually get home: *
Required
Medical Information
My child has the following special medical conditions or issues (Check all that apply): *
Required
If yes to any above, list the conditions and/or allergies:
Your answer
Parent Information
Please fill in below:
Parent Email *
Your answer
PARENT CONTACT INFORMATION (Name & Phone number) *
Your answer
I acknowledge that I have read and understand all of the information provided on this permission form. I understand that if I am late to pick up my child three times or more than 15 minutes late twice my child will not be allowed to continue participation in the club or activity. I agree to assume responsibility for any and all liability arising out of my child’s participation in any extracurricular club or activity sponsored by the District. *
Student Response
Please have student respond to the following question:
*
MM
/
DD
/
YYYY
Please describe why you want to be in the Forest Creek Garden Club. Students should fill this out. *
Your answer
Were you in garden club last year? *
Information for Junior Master Gardener Registration
Are you a military family? *
What is your race/ethnicity?
2 Teacher Recommendations are required.
After submitting your application, drop by Mrs. Loftis' classroom (room 409) and pick up the Teacher Recommendtation form. Find 2 teachers to fill out and return to Mrs. Loftis by October 15th.
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