Youth LIFE 2025-2026 Application

Important Information! PLEASE MAKE SURE TO READ ALL OF THE FOLLOWING:

Program Details:

Contact: Nikki Polliard - 412-537-8826 (cell) or 412-829-7112 (office)

Location: Human Services Center, 519 Penn Avenue, Turtle Creek, PA 15145

Time: 3:30PM-7:00PM, Monday-Friday *When Woodland Hills School District (WHSD) is closed the Program is closed along with a few other days. A full list of days off will be provided in the orientation materials if accepted.

Dates: September 8, 2025-May 1, 2026

Grades: 1st-5th grade in Fall 2025

Cost: The Progam is offered completely free of charge! 

The Facts:

• Enrollment is first come, first served so apply ASAP (however those that fit into the income guidelines may be considered first)!
• Transportation to the Program is provided by the Woodland Hills School District as long as you live within the district.  Transportation will not be provided home. *
• Educational and fun program! 
• Math and reading remediation activities
• Physical recreation
• Arts and crafts and educational activities
• Fun Friday activities
• FREE snack
• Homework help

*If your child attends Turtle Creek STEAM Academy, Youth LIFE staff will walk the students to the program as the District does not provide transportation from this school. 

Mandatory Orientation:

Orientation will take place via email and will include all Program information!

o   Every family must have one parent complete a sign-off form, after reviewing orientation email and discussing with your child. 

o   If a signature is not submitted by the deadline, your child will not be permitted to attend the Program and your spot will not be saved.

o   ALL families will be required to review the orientation email, even if your child has participated in the Youth LIFE After-School Program in the past.

o   Any additional questions families have after reviewing the orientation email can be answered by contacting Nikki Polliard at npolliard@hscmonvalley.org OR 412-829-7112.

After submitting your application, Program staff will reach out via phone or email confirming your child's enrollment status. If it has been longer than a week since you submitted your application, please reach out to Nikki ASAP at 412-829-7112, Monday-Friday, 9AM-4PM or npolliard@hscmonvalley.org.

Applicants will be accepted on a first come, first serve basis, however, families that fall below the following guidelines MAY be given enrollment priority. Grade of students will also play a role in enrollment in order to maintain appropriate classroom sizes. 

Youth LIFE 2025-2026 Program Rules

 General Rules and Regulations:

1. Masks will be optional. The Human Services Center reserves the right to change this at any time. 
2. If your child is sick during Program hours, staff will contact parents/emergency contacts immediately for the child to be picked up.  Promptness is required when picking up a sick child in order to avoid any spread of illness.
3. Please do not allow your child to bring valuables or any other personal items to the Program (Cell phones, books, craft supplies, card games, etc.).  The Human Services Center Mon Valley is not responsible if valuables are lost or stolen.
4. DO NOT send your child to the Program with an infectious disease or ailment.  If your child has an infectious disease or ailment they will be sent home from the Program immediately and will NOT be allowed to return without a doctor’s note.
5.  Children must be potty trained before start of the Program.  No staff member is permitted to change and/or assist children with soiled pants under any circumstances.  In the event of an accident, a parent must either pick up their child promptly or must bring clean clothes and assist the child with changing.                                  
6.  Participants are responsible for their own items at the Program.  At no time will HSCMV staff bear responsibility by holding any child’s possessions 
7. Before your child leaves, an authorized adult (18 years or older only) must sign the child out with a staff member.  Under no circumstances will your child be released to a sibling, while a parent waits in the car!!
8.  If your child is absent for more than two weeks, a staff member will contact you and your child’s spot may be forfeited; there is a waiting list and this Program is in high demand.
9. Each day, dress your child appropriately for both indoor and outdoor activities. We go outside as much as possible when the weather permits. 
10. Read all papers and materials sent home.  Hang up the calendar for you and your child to see as a reminder of special events and activities.
11.  Provide CORRECT and UP-TO-DATE contact information (addresses and phone numbers).  Emergency contacts listed in your application should not be the parent/guardian information.
12. Parents must support the Rules of the Program and act in a cooperative, respectful manner with Youth LIFE participants and staff.  Excessive and/or unrealistic complaints/requests by parents as well as negative behavior towards HSCC staff are grounds for your child to be removed from the Program.
13. NO Cell Phones.  Parents must call 412-829-7112 OR call/text 412-537-8826 (during program hours) if you need to get a hold of your child. IF CAUGHT ON THEIR PHONE, Points will be taken the first time. Then the phone will be locked up, until a parent picks up the student. 

 Behavioral Rules and Expectations:

1.  Dangerous, disruptive, or disrespectful behavior towards children or staff will not be tolerated.  Such behavior will be grounds for suspension or permanent expulsion!               
2.  Fighting will not be tolerated.  You will be suspended and could be expelled from the Program if caught fighting!  The very minimum penalty for hitting of any kind will be an automatic 30 points off and a two day suspension.
3.  Children MUST stay with their class at all times.  Children leaving the designated area without prior permission created a safety hazard and will result in loss of points.
4. Classroom, courtyard, and hallways rules need to be followed at all times.  These rules are detailed later in this packet, and are reviewed with all student when the program begins.
5. Use of inappropriate language will result in loss of points, and potential suspension.  No cursing or abusive language of any kind will be tolerated.
6.  Bullying, gossiping, and aggressive behavior will NOT be tolerated at the Program. It is unacceptable for students to name call, harass, intimidate, or make fun of another student. This type of behavior is taken very seriously by the staff and will result in the loss of points and the potential suspension or removal from HSCMV Youth Programs. 

Point System Regulations:

1.  By the end of Thursday, your child MUST have 75 or more points to participate in the Friday activity scheduled.  If your child does not have enough points, your child will not be permitted to attend on Friday. 
2.  If your child is ineligible to attend three Fridays due to behavior issues, the participant will be placed on probation for the remainder of the Program and a letter notifying you of this change will be mailed home.  If the child is ineligible for a fourth Friday your child will automatically be removed from the Youth LIFE Program.
3.  If your child loses 30 points or more within a day they are subject to up to a two day suspension from the Program and will not be eligible for that Friday’s special activities
4. The HSCMV has the right to remove a child for severe behavioral problems at any time.  If it is shown that a child needs excessive or special accommodations and/or cannot function safely in a group setting, the child will be removed from the Program.

Probationary Status:

1. If a participant violates the rules and does not change his or her behavior, that student may be placed on probationary status for the remainder of the Program.  Probationary status means that the student may be removed from the Program if the behavior persists, AND/OR he/she will not be accepted into future HSCMV Youth Programs.

Late Fee Regulations:

1. Students must be PICKED UP no LATER than the Program closing time (7:00PM).  Failure to do so will result in a charge of $1.00/minute/child for each minute dropped off early or picked up late.  The designated fee must be paid before your child is permitted to return.  
2. If a child is dropped off on a CLOSED Program day, or on an INELIGIBLE day, a $2.00/minute/child fee will be assessed for each minute an ineligible student is in our care (10 minutes = $20.00).  You must pay the designated fee before your child is permitted to return.
3. If your child is picked up late THREE times, the child will be removed from the Program – no exceptions.

 Safety Protocols and Procedures:

1. Students and staff are required to stay home if they are feeling ill or having any symptoms of Covid-19. If any staff, student, or volunteer begins to develop symptoms while at the Program, they will be sent home immediately. 
2. IF a child is sent home early, a parent will be called first and then other contacts until someone is reached. Prompt pick-up is required.
3. There is a 2-day attendance policy (MON-THURS.) in order to attend program on Friday. 
4. Please let Nikki know of any extended periods of time being missed.
5. Building and Program staff will clean and disinfect frequently touched surfaces and objects within the building at least daily, including door handles, sink handles, and drinking fountains.

Other General Rules:

• No standing or sitting on the picnic or classroom tables.
• No climbing up or on the slides. 
• No hogging, twisting, or jumping off of the swings.
• No standing on the top of the playground railings and hanging over.
• No throwing mulch/wood chips.
• No taking yours or anyone else’s shoes off.
• No bringing slime with you to the Program.
• No viewing community Internet sites (social media, youtube, instagram, tiktok, etc.), send emails or chat while in the computer lab or on the tablets.
• No roaming the building or hallways by yourself, or run/make noise in the hallways.
• No stealing, destroying or touching things that are not yours.  Vandalizing or destruction of HSCMV or any other organizations’ property will be grounds for removal from the program.
• No food or drinks in the computer labs.
• No using the vending machines.
• No hanging, swinging, leaning, shaking, or sitting on any parts of the basketball hoops.
• No gossiping about friends and others in the Youth LIFE Program.
• No crossing the street at the Program or on field trips without an adult. If an attempt to cross the street without an adult is made, you will be removed from the Program.
• Enter the building quietly.
• Follow directions and raise your hand to ask/answer a question.
• Ask an adult if you need to be excused.
• Remain in your seat during classroom activities.
• Listen to the staff and volunteers.
• Be respectful and kind to other students, staff, and volunteers.
• Use appropriate language at all times (No swearing or abusive language).
• Clean up after yourself (inside and outside).
• Keep your hands to yourself.
• Do your best on all activities, academic work, and Study Island.

Parents and child/children have read the Youth LIFE After-School Program, General Rules and Regulations, Behavioral Rules and Expectations, Lunch Policies and Procedure, Late Fee Regulations, Point System Regulations, Classroom Rules and Probationary Status. By signing, both my child/children and I acknowledge that we understand the rules and regulations of the Youth LIFE After-School Program as well as Probation Status.

Due to the increasing demand for the Program, it is essential that ALL students behave and follow the Rules, Regulations, and Probationary Status as negative behavior is not tolerated.

 

 

 

Youth LIFE 2025-2026 Safety Protocols and Procedures

ACKNOWLEDGEMENT CONTRACT

Parents and child/children have read the Youth LIFE 2025-2026 After-School Program  Safety Protocols and Procedures.  By signing, both my child/children and I acknowledge that we understand the Safety Protocols and Procedures of the Youth LIFE After-School Program.

 

I grant permission for my son/daughter to participate in all scheduled activities of the Youth LIFE After-School Program. In addition, I grant authorization for my son/daughter to be taken off-site by Human Services Center Mon Valley staff for field trips or other special events. I release the Human Services Center Mon Valley and its insurers from any and all liability, claims, causes of action, damages, cost expenses or demands of any kind which may arise in connection with his or her participation in the activities of this program.

Occasionally, Youth LIFE After- School Program staff members wish to photograph, videotape, or otherwise record the activities of Program participants for the purpose of recording, promotions, and reporting outcomes of the Program. We sometimes provide local newspapers with information about the Youth LIFE After-School Program participants, such as the student’s name, grade, school district, and what the student has done during the Program.

I hereby give permission for my child to be photographed, videotaped, or otherwise have their image or voice recorded, in connection with the Youth LIFE After-School Program. I allow the Human Services Center Mon Valley to use the photographed, videotaped, and/or recorded materials in any publications, promotional materials, reports, websites, CD’s, DVD’s, social media, other media for publicity, reporting purposes, or in any other non-commercial manner that it chooses. I hereby waive and release any rights that I may have to the said videotaped, recorded, and/or photographed materials.

I further grant permission for the Human Services Center Mon Valley to provide local media, school districts, and foundations with information about my child. Moreover, I release the Human Services Center Mon Valley and its insurers from any and all liability, claims, causes of action, damages, cost expenses or demands of any kind which may arise in connection with his or her participation in the activities of this Program.

 

I wish to have my child participate in the Youth LIFE After-School Program. I understand that there are risks and hazards, in addition to benefits, associated with my child’s participation. I, on behalf of myself, my child, our heirs, executors, administrators, and other personal representatives, do hereby irreversibly and unconditionally remise, release, settle, compromise and forever discharge any and all manner of suits, actions, causes of action, damages and claims, known and unknown, that I or my child, have or may have against the Youth LIFE After-School Program and the Human Services Center Mon Valley arising from or connected with my child’s participation in the Program, including the securing of medical treatment for my child. I give permission for the Youth LIFE After-School Program and Human Services Center Mon Valley to secure medical treatment for my child in the event that such treatment is required during my child’s participation in the Program. I will be financially responsible for the cost of such treatment.

All medication taken at the Youth LIFE After-School Program must have parental consent for administration and must be self-administered by the child (or administered by, or with the assistance of, the child’s parent or other adult designated by the parent). Any child in possession of or taking medications not previously approved by a parent/guardian and Program staff will need to be immediately sent home from the Program until such time as necessary approvals have been provided. Staff are not permitted to administer any medications to children. In the event of an emergency, 911 will be called. In the event of an emergency requiring the administration of a child’s personal Epinephrine Auto Injector, the Epinephrine Auto Injector will be administered to that child in accordance with the Youth LIFE After-School Program Epinephrine Auto Injector Policy provided that the child’s parent/guardian has signed that Policy.

I have read and understand the terms of this release. I sign this document voluntarily, knowing that I am legally bound by it. I am over eighteen years of age, and competent to sign this document. I release the Human Services Center Mon Valley and its insurers from any and all liability, claims, causes of action, damages, cost expenses or demands of any kind which may arise in connection with his or her participation in the activities of this program.

I hereby give permission to the Human Services Center Mon Valley to share information on my child with funders, emergency care providers, counselors, medical professionals, schools, and other human service agencies on an as-needed basis. All information will be kept strictly confidential.

I authorize and instruct the Youth LIFE After-School Program to obtain my son/daughter’s report card, attendance records, assessment tests including but not limited to the PSSA, Terra Nova, 4Sight, DIBELS, OLSAT test scores, and diploma and/or final transcript for the purpose of tracking academic and social progress. In addition, I do hereby approve and instruct my child’s school and/or district to release to the Human Services Center Mon Valley any pertinent and/or necessary behavioral reports of my son/daughter for the purpose of mandatory tracking and reporting.

I release the Human Services Center Mon Valley and its insurers from any and all liability, claims, causes of action, damages, cost expenses or demands of any kind which may arise in connection with his or her participation in the activities of this Program.

*For those parents with joint custody, BOTH parents must sign this release (ONE ELECTRONICALLY). Failure to do so will result in your youth being prohibited from participating in the Youth LIFE After-School Program.

I give permission to Youth LIFE After-School Program staff to administer my child’s prescribed Epinephrine Auto Injector in case of an emergency.

• Youth LIFE Program staff and volunteers are not professional medical personnel.
• We do not provide Epinephrine Auto Injectors. They must be prescribed by a physician for a specific child and brought to the Program before the given deadline. The child’s Epinephrine Auto Injectors will be kept on site for use in case of an emergency.
• If a child requires the possible use of an Epinephrine Auto Injector it should be indicated on the Permission for Medical Treatment and Release form and signed by the parent/legal guardian.
• Epinephrine Auto Injector must be properly and clearly labeled with:
         o the child’s first and last name;
         o the dosage of Epinephrine; and
         o the expiration date (We will not accept expired Epinephrine Auto Injectors).
• Youth LIFE Program staff will only administer an Epinephrine Auto Injector in the event of an emergency where the child is unable to self administer. In such event, staff and volunteers will administer the Epinephrine Auto Injector in accordance with this Policy provided that the child’s parent/guardian previously provided permission by signing below. If an Epinephrine Auto Injector is administered, 911 and the parent/guardian of the child will be notified immediately.

In addition, I hereby authorize and instruct Youth LIFE After-School Program and Human Services Center Mon Valley staff to administer the following medication (ONLY inhalers and/or Epi pens) to my child in the appropriate dosages outlined below, if applicable. I release the Human Services Center Mon Valley and its insurers from any and all liability, claims, causes of action, damages, cost expenses or demands of any kind which may arise in connection with his or her participation in the activities of this program.