Redlands ASES After School Program Registration 2022-23

Redlands ASES After School Programs 2022-2023

Redlands Unified School District Families Only: You may apply for your child to enroll in the ASES program at the school they are enrolled in for the 2022-23 school year. There is no registration fee. Completion of the form does not guarantee enrollment in the program. All students who attend the school are eligible to attend ASES. Program subject to capacity limits. You will need to complete this form for each child you want to enroll.
Pre-Registration Form
STOP: Families of currently enrolled students should not re-register. You can renew your child's application for the new year at your school site's ASES program.

This applicaiton may be completed by the PARENT or GUARDIAN only. Student must be enrolled at the school selected.

PARE: Las familias de los estudiantes actualmente matriculados no deben volver a registrarse. Puede renovar la solicitud de su hijo para el nuevo año en el programa ASES de su escuela.

Esta solicitud puede ser completada únicamente por el PADRE o TUTOR. El estudiante debe estar matriculado en la escuela seleccionada.
Student Information / Información del estudiante
Student's Name (must match Aeries information)*

First NameMiddleLast Name
Grade Attending (Kindergarten is limited capacity due to staffing ratios, and TK is not accepted this school year.) *
Student's Date of Birth *

MonthDayYear
Date
School*
Does the student identify as any of the following? Please check all that apply. Foster Youth and Homeless students are given first priority from the waiting list.

Foster YouthHomeless Student
Gender *
Student Home Phone Number *
Student Home Address*

Street Address

Street Address Line 2

CityState

Zip Code
Parent/Guardian Information
Parent / Guardian (1) Name*

First NameMILast Name
Parent 1 Relationship to Student /*

Mother/StepmotherFather/StepfatherGrandparentAunt/UncleGuardian
Student ID Number from Aeries. If you do not have the number, enter 0*
Look up in your student's Aeries Information
Parent 1 Home Phone Number*
Parent 1 Cell Phone Number
Optional
Parent 1 Work Phone Number
Optional
Parent/Guardian (1) E-mail *
example@example.com
Early Release Policy: The intent of the legislature that governs ASES is that students attend the full length of the program, however, at Redlands Unified School District:
- We understand the safety of our students is our first priority,
- We recognize the value of extracurricular activities,
- We encourage family togetherness, and
- We want student’s health needs met.
If you pick-up your student before the end of the program, you will need to complete an Early Release Form. The form will be provided to you by the staff and remain on-site. By doing so, you allow us to continue to receive our full funding and offer the program at a very low-cost. Please remember that you must complete this form in a timely manner. It needs to be included with our records for each month.

Allow yourself 3-5 minutes once per month to be sure that this is completed and signed. Many of our programs may have a waiting list this year, and those who do not comply with our Early Release Policy will be dropped from the program for non-compliance.

TIMED RELEASES: All Redlands ASES programs have moved to a “Timed Release” policy effective, Monday, March 14, 2022. We will open the doors at assigned times only. You must follow the Time Releases set by your child’s ASES program in order for your student(s) to remain enrolled. We understand that there may be an emergency situation that arises that may mean you need to pick up your child outside of these times. Please contact your Site Lead if this occurs so that we can help. These Emergency Pick-Ups are limited to 3 times per year.
I agree to complete the Early Release Form. / Acepto completar el formulario de salida anticipada

Clear

Parent/Guardian Information (2) / Información del padre (2)
Parent Guardian (2) Name

First NameMiddle NameLast Name
Parent 2 Relationship to Student

Mother/StepmotherFather/StepfatherGrandparentAunt/UncleGuardian
Parent 2 Home Phone Number
Parent 2 Cell Phone Number
Parent 2 Work Phone Number
Parent/Guardian (2) E-mail
example@example.com

Other Information
If your student has allergies, please check yes.

Yes
If you answered yes, please list the known allergies. / Si respondió que sí, indique las alergias conocidas.
Does your student have any health condition that the staff need to be aware of? Please include heart conditions, breathing conditions, and other conditions that may affect their daily activities including PE. If none, please type "none."
Does your student require any kind of medication? This can include asthma inhalers, epi-pens, or other medications.
Does your child have any siblings at other ASES Programs or Schools? If yes, list their name and grade(s) below. If not in school, leave blank.
Emergency Contact - Other than Parent/Guardian

These are adults (age 18 or over) who are local, that we may contact if we are unable to reach you. Persons on this list may also sign-out your student. Please keep this information current and notify us when there are changes.
#1 Emergency Contact Name*

First NameMiddle NameLast Name
#1 Em. Contact Phone Number *
#2 Emergency Contact Name

First NameMiddle NameLast Name
#2 Em. Contact Phone Number
#3 Emergency Contact Name

First NameMiddle NameLast Name
#3 Em. Contact Phone Number
#4 Emergency Contact Name

First NameMiddle NameLast Name
#4 Em. Contact Phone Number
#5 Emergency Contact Name

First NameMiddle NameLast Name
#5 Em. Contact Phone Number
Special Education Information / Información sobre educación especial

Special education students are welcome in our program. Depending on their unique needs, we may need to make arrangements to best serve them and provide for their safety. / Los estudiantes de educación especial son bienvenidos en nuestro programa. Dependiendo de sus necesidades únicas, es posible que debamos hacer arreglos para brindarles un mejor servicio y velar por su seguridad.
Does your student have an IEP, 504 Plan, or need other Special Education modifications?*

YesNo
If you answered yes, please describe how we can meet your student's unique needs in the after school program.

ASES Family Agreements / Acuerdos de atención de cuidado prolongado de ASES
These expectations help us best serve your students in our program.

Parents/Guardians:
1. Please be prompt in picking up your student, bring your ID with you, and sign him/her out each day
2. Please keep your student home if they are ill or have any COVID-like symptoms, have a fever of more than 100.4, are having trouble breathing, have symptoms of a respiratory illness, have diarrhea, vomiting, or nausea, or have had contact with an individual who has a positive test for COVID or COVID-like symptoms.
3. Please notify your student's Site Lead if you have questions or concerns.
4. Students may not use their cell phones during program. The phone number to reach the Site Lead will be provided to you. Please use this number when you need to reach your student or the program.
Students:
1. Please be respectful, responsible, and ready for fun each day.
**********************************************

Estas expectativas nos ayudan a brindar un mejor servicio a sus estudiantes en nuestro programa.

Padres / Tutores:
1. Por favor sea puntual en recoger a su estudiante, traiga su identificación con usted y firme su salida cada día
2. Por favor mantenga a su estudiante en casa si está enfermo o tiene algún síntoma similar a COVID, tenga fiebre de más de 100.4, tiene problemas para respirar, tiene síntomas de una enfermedad respiratoria, tiene diarrea, vómitos o náuseas, o ha tenido contacto con una persona que tiene una prueba positiva de COVID o síntomas similares a COVID.
3. Por favor notifique al instructor de su estudiante si tiene preguntas o inquietudes.
4. Los estudiantes no pueden usar sus teléfonos celulares durante el programa mientras estén en el campus de la escuela. Se le proporcionará el número de teléfono para comunicarse con el Coordinador del sitio. Utilice este número cuando necesite comunicarse con su estudiante o el programa.
Estudiantes:
- Sea respetuoso, responsable y esté listo para divertirse todos los días.
***********************************************************

I, the parent, along with my child or children, agree to follow the ASES Agreements. We understand that if the expectations are not followed, that the student or students will be dis-enrolled from the program. / Yo, el padre, junto con mi hijo o hijos, acepto seguir los acuerdos de ASES. Entendemos que si no se siguen las expectativas, el estudiante o los estudiantes serán dados de baja del programa.
*

Yes
Communication is key to your child's success in our program. All parents/guardians are added to our Remind App. We will use the primary contact's name, phone number and email to enroll you in Remind. / La comunicación es clave para el éxito de su hijo en nuestro programa. Todos los padres / tutores se agregan a nuestra aplicación Remind. Usaremos el nombre, el número de teléfono y el correo electrónico del contacto principal para inscribirlo en la aplicacion Remind.
*

I agree
Photo Release Permission Slip: As a parent or guardian of this student, I hereby consent to the use of photographs/videotape taken during the course of the school year for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet or other media sources). I do this with full knowledge and consent and waive all claims for compensation for use, or for damages.Hoja de permiso de divulgación de fotos Como padre o tutor de este estudiante, por la presente doy mi consentimiento para el uso de fotografías / cintas de video tomadas durante el curso del año escolar con fines publicitarios, promocionales y / o educativos (incluyendo publicaciones, presentación o difusión a través de periódicos, Internet u otros medios de comunicación). Hago esto con totalconocimiento y consentimiento y renuncia a todas las reclamaciones de compensación por el uso o por daños.
Photo Release Agreement

YesNo
Should be Empty:

Redlands ASES After School Programs 2022-2023

Pre-Registration Form

Student Information / Información del estudiante

Parent/Guardian Information

Parent/Guardian Information (2) / Información del padre (2)

Other Information

Emergency Contact - Other than Parent/Guardian

Special Education Information / Información sobre educación especial

ASES Family Agreements / Acuerdos de atención de cuidado prolongado de ASES