After School Program Enrollment Form

After School Youth Entrepreneur Program Enrollment Form

2024-2025
Rising Visions is pleased to offer our After School Entrepreneurship Program for at risk youth that will like to participate in a 12 month learning enviroment tailored towards creating their own start up business. Their are no contract rates Rising Visions is a 501(c)(3) public charity.Early Dismissal Days, Facilitators/Parents meetings, Public/Directors Conference Days, and Volunteer workdays are also included in the contract .

Please complete and submit one form per student being enrolled in the After School Youth Entrepreneur Program.
Parent's Name*

First NameLast Name
Please check the After School Program enrollment option desired for your child:*

1 day per week2 days per week3 days per week
Parent's Phone Number*

Area CodePhone Number
Parent's Email*
Student's Name*

First NameLast Name
Grade in fall (2024-2025)*

9 Grade10 Grade11 Grade12 GradeOther
Effective date for enrollment in After School Program*

MonthDayYear
Please indicate the month and day that this agreement is to take effect. For example, if you will be using the After School Program from the first day of school, enter 09-20-2024
Indicate the day(s) that you anticipate utilizing the After School Program:*

FRIDAYSATURDAYSUNDAY
Please indicate your child's default dismissal plan:
My Child will remain in the After School Program until being picked up on:

FRIDAYSATURDAYSUNDAY
Please note any known allergies:
Please specify each person, including the name of parents, who has permission to pick up your child from the After School Program.
Authorized Person 1:

First NameLast Name
Phone Number 1:

Area CodePhone Number
Authorized Person 2:

First NameLast Name
Phone Number 2:

Area CodePhone Number
Authorized Person 3:

First NameLast Name
Phone Number 3:

Area CodePhone Number
Authorized Person 4:

First NameLast Name
Phone Number 4:

Area CodePhone Number
Statement of Policy
- An Enrollment Form is required for all students participating in this program.
- Contracts will be signed in September and mailed off to the provide address in January. Their will be no drop-in charges or late fees. Consistent Delinquency may result in dismissal of student from the entrepreneurship after school Program. Please note that contract changes can only be made in August & January of each year.
- The After School Program ends promptly at 6:00 p.m.
- If a student’s use of the program exceeds the number of days of his/her yearly contract students can renroll (for ages 15-21 only)
- 9th-12th grade students remaining at the center after 3:00 p.m. are required to attend our After School Program unless they are participating in a supervised program such as sports, tutoring, clubs, or a Beyond the Bell enrichment offering.
- Students may participate on a drop-in basis with prior notification from parents. If no Enrollment Form has been previously submitted, you will be sent an email with the link to this form to complete and submit.
- Only persons authorized by the parent or guardian may pick up your child from the After School program. Please notify the Director of Program in writing if anyone other than a parent/guardian will pick up your child.
- All students attending the After School Youth Entrepreneurship Program are required to follow all school and program rules. Behavioral problems will result in parent notification and possible suspension from the program.
- Students with a fever or contagious illness may not participate in the program.
- This program is available for all United States Of America At Risk Youth.
- Fall semester After School Program runs from August 15, 2024 – December 21, 2024.
- Spring semester After School Program runs from January 7, 2025 – May 30, 2025.
Signature*

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After School Youth Entrepreneur Program Enrollment Form

Statement of Policy