2020-2021 Middle School After-School Program Application
Hayfield's Middle School After-School Program (MSASP), Hawks Stay After, is designed to offer our middle school students a safe, fun-filled and structured environment to participate in after our normal school day ends. MSASP provides academic support, social skill enhancement, student club participation and various activities.

The program will begin VIRTUALLY on Monday, September 28, 2020, and it is absolutely FREE to all participants. MSASP runs daily from 3:30–5:30. The MSASP schedule and list of activities/clubs will be released by Thursday, September 24, 2020. Please note that the MSASP covers everything after school (e.g. academic support, MSASP activities, and performing arts practices and auditions). With that being said, it is very important that you complete the registration form for your student(s).

Registration (Below) is necessary in order participate in an activity, club, or any teacher-led academic support. Parents/guardians must complete a separate registration form for each student participating. The various teacher-sponsored clubs/activities list will be available on our home page and Schoology. The list is subject to change throughout the year as student participation varies and as new clubs/activities are added.

This program is a school-sponsored activity and, as such, will follow all Fairfax County Public School Student Rules and Responsibilities. Please discuss with your child the importance of abiding by all school rules and expectations while participating in MSASP activities. This is critical to ensure the success of the program and to provide a safe and secure environment for all involved.

If you have questions, concerns, or suggestions please feel free to contact the After-School Specialist by email at amfitzgeral1@fcps.edu or call directly at 703-924-7609.
Email address *
Parent/Guardian Email Address *
This is our primary mode of communication. Please double-check for accuracy.
FCPS Student ID Number *
Please enter your student's 7-digit FCPS student ID number. To ensure that FCPS students are properly enrolled, IT IS IMPORTANT THAT YOU ENTER A CORRECT STUDENT ID.
Student's LAST Name *
Student's FIRST Name *
Student's grade level in Fall of 2020-2021 *
Gender *
Date of Birth *
Student's Address - Please complete each entry below as asked. YOU MUST PROVIDE A COMPLETE AND ACCURATE ADDRESS or risk being dropped due to an incomplete application.
House #, Street Name, and Apt # if applicable *
City *
Zip Code *
#1 Parent/Guardian to Contact *
Please list the parent or guardian to contact FIRST in case of an emergency or to discuss after-school activities
#1 Parent/Guardian Name *
#1 Cell Phone Number *
Parent/Guardian cell phone number
#1 Work/Daytime Phone Number *
#1 Email Address *
Email address for parent/guardian. This is our primary mode of communication. Please double-check for accuracy.
#2 Emergency Contact *
Please list the second adult to contact to in case of an emergency or to discuss after-school activities.
#2 Emergency Contact Name *
#2 Cell Phone Number *
#2 Work/Daytime Phone Number *
#2 Email Address *
Emergency contact email. This is our primary mode of communication. Please double-check for accuracy.
Other Parent/Guardian's Name
If you wish, provide an additional parent or guardian's name and information.
Other Parent/Guardian's Daytime Phone
Other Parent/Guardian's Email
Army Youth Programs in your Neighborhood
Fairfax County Public Schools partners with the Department of the Army for funding for the after-school programs for multiple middle schools in the county. For Hayfield to qualify for this funding we have to know how many Army-affiliated students we have in our building and are participating after-school.
Is either parent/guardian a member of the U.S. Army or works for the U.S. Army? *
Student Allergies? *
Please check all that apply and enter any other allergies or food restrictions under "Other."
Is there any other information you would like to share about your child?
Student Code of Conduct
Although our environment is virtual (online), the standards of behavior remain significantly important to maintain. In other words, our virtual classrooms are real classrooms with real After-School Specialists, teachers and other support staff; therefore, appropriate student behavior is expected. To ensure that all students understand how to behave in an online environment, we have developed a code of conduct that all students are required to follow. This code of conduct addresses student interaction with FCPS staff and other students, as well as their individual actions and is expected to be followed. If there are specific strategies for working with your child that you feel would be helpful to share, please reach out to Mr. Fitzgerald before the start of the after-school programs so they can be integrated into the planning.
• Follow the same guidelines provided by the FCPS Student Rights & Responsibilities document.
• Show respect for others in what you do and say.
• Attend regularly.
• Be involved in your activities each day and encourage others to do so as well.
• Listen to the all staff and follow directions carefully.
• Maintain your self-control. The ASP staff members will listen.
• Have fun!
• Support the MSASP staff and work with them to resolve disciplinary problems.
• Understand that monitoring your child’s online activity is a parent’s responsibility.
Termination of Service/Ineligible for Services
• If the participant’s actions cause injury to self, peers, and/or staff.
• If the child exhibits inappropriate behavior which may inhibit participation in activities.
• If the child engages in repetitive, aggressive, harmful, and/or disruptive behavior.
• If the participant fails to follow the general rules of conduct.
• If the participant engages in any drug related activity (ATOD).
• If the participant is involved with the destruction of school property.
• If the child does not meet the eligibility criteria for the program.
• If the child participates in inappropriate online activity (See Code of Conduct)
Behavior Guidance and Management
From time to time the After-School Program staff must take actions to resolve a problem that is disruptive to the virtual program and other participants. Behavior guidance requires very specialized skills. We appreciate your support as staff try to find a solution that promotes non-disruptive behavior and allows your child to participate without incident in the activities. Staff members use a proactive approach to meet the needs of the children by planning age and ability appropriate activities, discussing the needs of the children with their parents, and evaluating the entire environment. The safety of the participants and staff is of paramount concern.
Permission: I hereby grant permission for my child to participate in any or all of the virtual programs. I understand that participation by my child 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 also understand that school and County personnel will respond in the same manner that occurs during distance learning activities. *
I give permission for my child to be photographed and/or videotaped for use in publicizing FCPS programs and services. *
In accordance with the Virginia Privacy Protection Act of 1976, the requested information will be used to coordinate activities of this agency. I understand that some of the information contained in this form may be released to persons who request such information in accordance with the requirements of the Virginia Freedom of Information Act (VFOIA), VA. Code §2-2-3705. As this statement indicates, not all information the after-school program collects is subject to availability under the VFOIA. *
Behavioral Issues: If the actions of a participant may cause harm to anyone or interfere with middle school after-school program activities, after-school program staff reserves the right to deny his/her continuation in the program. Please see the detailed Student Code of Conduct below. *
Students are required to follow all Fairfax County Public Schools Students Rights and Responsibilities, Fairfax County Public Schools Digital Citizenship, and Fairfax County Public Schools User Agreement Policy while participating in all Synchronous and Asynchronous sessions. *
Participation: The Middle School After-School Program will offer a combination of synchronous (live) structured enrichment, recreation, and academic activities, as well as asynchronous activities that the students can access independently to actively pursue their interests during this time of social distancing. *
Parental Responsibilities: Parents should be monitoring their child(ren)’s physical activity and their online activity during the after-school program. *
I have read all portions of the After-School Application with my child. We fully understand the middle school after-school program hours of operation, policies and procedures and the behavior expectations. *
A copy of your responses will be emailed to the address you provided.
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