Brochure & Enrollment Form - Chappaqua Children Workshop

CCW/KU After School Program
at Seven Bridges Middle School
Joanne Saporta, Director, CCW
Elliot Semel, Director,
After School Program
_____
For additional information or questions relating to this program, please
contact Elliot Semel at
(914) 238-7203 ext. 4550
After School Program
SB
SPRING 2015 SESSION INCLUDES:
FENCING! CARTOONIZED ME!
BADMINTON!
TABLE TENNIS!
ULTIMATE FRISBEE!
CHESS!
Tuesdays
Thursdays
Fridays
4/14, 4/21, 4/28, 5/5, 5/12, 5/19, 5/26, 6/2
4/16, 4/23, 4/30, 5/7, 5/14, 5/21, 5/28, 6/4
4/17, 4/24, 5/1, 5/8, 5/22, 5/29, 6/5, 6/12
IMPORTANT INFORMATION
All students must complete and return
registration forms to the main office by
Friday March 27, 2015. You may
register for classes on more than one day if
space is available. Please enclose a separate
check for each class day requested . Please
note: There is a $20 discount for each class
for forms received by 3pm on Friday March
27, 2015.
Class lists and rooms will be posted in the
Dining Commons by Tuesday,
April 7, 2015. CONFIRMATION OF
ENROLLMENT IS NOT SENT HOME.
Late buses will be running every day when
there is an activity. Early dismissal or school
closure automatically cancels After School
Program activities. Please make contingency
plans with your child for possible last minute
cancellations, as the school will not be calling
parents for ASP cancellations. Attendance is
taken at all after school classes requiring
registration. Please notify the office if a
student will be in school but not staying for
his/her after school class.
Some courses have very limited enrollments,
so please list second or third choices. In the
event that a course has more applicants than
can be accommodated, students are chosen by
lottery. No late applications can be included
in the lottery. Please note that no refunds can
be given once student enrollment is complete
unless class is cancelled by CCW due to under
enrollment. On the last page there is a release
and waiver that all participants and parents
need to sign.
Check out our website for a full listing of after school activities
with registration and release/waiver form at:
Chappaqua Children’s Workshop http://ccwkids.org
Seven Bridges PTA:
http://www.chappaquapta.net
Seven Bridges MS:
http://sb.ccsd.ws
CCW/KU After School
Program at Seven Bridges
Middle School
_____
For additional information or
questions relating to this
program, please contact
Elliot Semel at:
(914)238-7203 ext. 4550
SB
After School Program
CLASS SIZE IS LIMITED SO PLEASE LIST ALTERNATIVE CHOICES IF POSSIBLE.
ENROLLMENT LISTS WILL BE POSTED IN THE CAFETERIA BY TUESDAY
APRIL 7. NOTIFICATION IS NOT SENT HOME. NO REFUNDS CAN BE GIVEN ONCE
THIS APPLICATION IS SUBMITTED UNLESS CLASS IS CANCELLED BY CCW DUE TO
UNDER ENROLLMENT. A DOWNLOADED RELEASE/WAIVER FORM FROM THE
BROCHURE MUST BE INCLUDED WITH YOUR APPLICATION.
Please return this form to the Main Office by 3 p.m. Friday, March 27, 2015
Student’s Name ____________________________________ Grade __________
Team _________
Parent’s Name _____________________________ Phone (day) ______________ (eve) _______________(cell)______________
Student’s Address ______________________________________________Parent email_________________________________
Do you plan to take the late bus? (circle one) Yes / No

Register me for one class only. My choices, in order of preference, are marked below.

If spaces are available, register me for two classes. My choices are marked in order of preference.

If spaces are available, register me for three classes. My choices are marked in order of preference.
Please attach separate checks to the back of this form—one for each course—payable to “CCW/KU”
My choices for after school classes are marked below (please number 1,2 or 3) in order of preference:
TUESDAYS
____ Ultimate Frisbee* $115
____ Cartoonized Me * $235
THURSDAYS
____ Table Tennis*$115
____ Introduction to Fencing*$255
FRIDAYS
____ Badminton* $115
____ Table Tennis* $115
____ Recreational Chess* $115
.
Please note: There is a $20 discount for each class for forms received by 3pm on Friday March 27, 2015.
*limited enrollment—In the event that a course has more applicants than can be accommodated, students are chosen
by lottery. No late applications can be included in the lottery.
Please make sure to download and attach a release/waiver form from the After School Program brochure in order
to complete your enrolment. http://sb.ccsd.ws ; http://ccwkids.org or http://www.chappaqupta.net
Student Signature ___________________________ Parent Signature _____________________________________
KIDS UNLIMITED
- an affiliate of Chappaqua Children’s Workshop
Dear Students and Parents:
Kids Unlimited is pleased to be able to sponsor the After School Enrichment
Program at Seven Bridges Middle School. The After School Program will be in session three days
per week with instructional classes held on Tuesdays, Thursdays and Fridays. A nominal fee is
assessed to cover the cost of each class. After School classes begin at 2:30 pm and, unless otherwise noted, conclude at 3:25 pm in time for students to take the late bus home.
Special thanks to the Chappaqua Central School District Board of Education, Dr. Lyn
McKay, Superintendent, Dr. Michael G. Kirsch, Seven Bridges Interim Principal and Mr. Gregory
Stiefel, Seven Bridges Assistant Principal. We wish everyone a happy spring season!
Sincerely,
Elliot Semel, Director, After School Program
Joanne Saporta, Director, KU/CCW
All students must complete and return registration forms to the main office by Friday,
March 27, 2015. You may register for classes on more than one day if space is available. Please
enclose a separate check for each class day requested .
Class lists and rooms will be posted in the Dining Commons by Tuesday, April 7, 2015.
CONFIRMATION OF ENROLLMENT IS NOT SENT HOME.
Late buses will be running every day when there is an activity.
Early dismissal or school closure automatically cancels After School Program activities.
Please make contingency plans with your child for possible last minute cancellations, as the
school will not be calling parents for ASP cancellations.
Attendance is taken at all after school classes requiring registration. Please notify the office if a
student will be in school but not staying for his/her after school class.
Some courses have very limited enrollments , so please list second or third choices. In the event
that a course has more applicants than can be accommodated, students are chosen by lottery. No
late applications can be included in the lottery. Please note that no refunds can be given once
student enrollment is complete unless class is cancelled by CCW due to under enrollment.
Attached is a release and waiver that all participants and parents need to sign.
Please note: There is a $20 discount for each class for forms received by 3pm on 3/27/15.
CCW/KU AFTER SCHOOL PROGRAM at SEVEN BRIDGES MIDDLE SCHOOL
Joanne Saporta, Director, KU/CCW; Elliot Semel, Director, After School Program
For additional information or questions relating to this program, please contact Elliot Semel at
(914)238-7203 ext. 4550
4/14, 4/21, 4/28, 5/5, 5/12, 5/19, 5/26, 6/2
Please note:
There is a $20 discount for any class request received by 3pm on Friday March 27, 2015.
Ultimate Frisbee
limited to 14 students $115
Ultimate Frisbee is a field game. The goal is to catch the disc in the other team’s end zone
(think touchdown). If the other team has the disc, we want to intercept it or make them drop it,
but we can’t touch the other team’s players. Three steps are the maximum a person can take
while in possession of the disc. (Think Basketball) We’ll learn the rules and fundamentals and
then we will play!
Meets with Mr. Tortorello-Allen, Seven Bridges English teacher.
Cartoonized Me!
limited to 12 students $235
Do you have a great idea for a comic book or a graphic novel? Have fun turning photos of you
and/or your friends (with permission only, of course) into cartoons and being the stars of a
comic story. Create comics using a web camera, photo-editing software, images and templates.
Learn photo editing software techniques such as converting photos into cartoons, creating
background images, adding lighting, editing text bubbles and many more. The important skills
of thinking through a storyline; planning and creating the characters; and writing a plot with
dialogue; are all taught in an exciting and stimulating environment.
After the class completion, students can download their projects,
the software and resource files that they used in class.
Meets with staff from “Bits, Bytes and Bots”.
4/16, 4/23, 4/30, 5/7, 5/14, 5/21, 5/28, 6/4
Please note:
There is a $20 discount for any class request received by 3pm on Friday March 27, 2015.
Table Tennis
limited to 18 students
$115
Give it your best shot to play the game and develop your skills in this exciting clinic/
tournament format If you’re a beginner or an experienced pro, this class is for you. We have
also added a Friday section due to popular demand.
Meets with Mr. Yuen, former college table tennis doubles champion.
Introduction to Foil Fencing
limited to 14 students maximum (10 students minimum)
$255
Fencing will help you acquire the reflexes of a boxer, the legs of a high jumper, and the concentration of a tournament chess player. The sport develops your agility, strength, speed, and cunning. Because it is action-packed, it is known as the fastest martial art. But the best thing about
fencing is- IT'S FUN!" All equipment will be provided for use in this safe, structured beginner’s foil fencing class.
Meets with Ms. David, Fencing Academy of Westchester coach. Ms. David was a member of
the Romanian national and Olympic Team from 1987 to 1999. She earned two silver medals at
World Championships: in 1993(Essen,Germany) and in 1997 (Cape Town, South Africa).
- a great way to ease into the weekend:
4/17, 4/24, 5/1, 5/8, 5/22, 5/29, 6/5, 6/12
Please note:
There is a $20 discount for any class request received by 3pm on on Friday March 27, 2015.
Badminton
limited to 18 students
$115
Join the fastest racquet sport in the world with participation in the badminton after school
program. Learn to play with a certified USA Badminton coach and former ranked player. You
will work on your hand eye coordination as well as getting a great work-out. Beginners through
advanced players are welcome. Even if you have never touched a racquet, you can give it a try.
Meets with Mr. Kittredge, Seven Bridges phys. ed. teacher.
Table Tennis
limited to 18 students
$115
Give it your best shot to play the game and develop your skills in this exciting clinic/
tournament format If you’re a beginner or an experienced pro, this class is for you.
This section has been added due to popular demand.
Meets with Mr. Yuen, former college table tennis doubles champion.
Recreational Chess
limited to 18 students
$115
Have you ever wanted to play chess but couldn't talk your parents, nanny or little sister into
playing with you? Well, we have just the after school program for you! Come play chess, for
fun, with other students who want to play as much as you do!
Meets with Mr. Tortorello-Allen, Seven Bridges English teacher.
Chappaqua Children’s Workshop
P.O. Box 918
Chappaqua, NY 10514
RELEASE AND WAIVER OF LIABILITY AGREEMENT
I, (“Participant”), acknowledge that I have voluntarily applied to participate in activities at
CCW/KU.
I AM VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH KNOWLEDGE OF THE DANGER INVOLVED, AND AGREE TO ASSUME ANY AND ALL
RISKS OF BODILY INJURY, DEATH OR PROPERTY DAMAGE, WHETHER
THOSE RISKS ARE KNOWN OR UNKNOWN.
I verify this statement by placing my initials here:________________
Parent or Guardian’s initials (if under 18):_____________________
As consideration for being permitted to participate in these activities, I forever release any
CCW affiliated organization, and their respective directors, officers, employees, volunteers, agents, contractors, and representatives (collectively “Releasees”)from any and all
actions, claims, or demands that I, my assignees, heirs, distributees, guardians, next of
kin, spouse and legal representatives now have, or may have in the future, for injury,
death, or property damage, related to (i) my participation in these activities, (ii) the negligence or other acts, whether directly connected to these activities or not, and however
caused, by any Releasee, or (iii) the condition of the premises where these activities occur,
whether or not I am then participating in the activities. I also agree that I, my assignees,
heirs, distributees, guardians, next of kin, spouse and legal representatives will not make a
claim against, sue, or attach the property of any Releasee in connection with any of the matters
covered by the foregoing release.
I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS
CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A
CONTRACT BETWEEN MYSELF AND CCW, AND SIGN IT OF MY OWN FREE
WILL.
If Signed by Parent or Guardian: I verify that the dangers of the activities and the significance of this Release and Waiver were explained to the Participant and that the Participant understood them.
Executed and dated on , / /20____ .
PARTICIPANT/RELEASOR
PARENT OR GUARDIAN
_____________________________
________________________________
Signature
Signature
Address:______________________
Address:_________________________
_____________________________
________________________________
IF YOU ARE UNDER 18 YEARS OF AGE, YOU AND YOUR PARENT OR
GUARDIAN MUST SIGN AND INITIAL THIS FORM WHERE INDICATED.