2026 Winter Session- Jefferson-Houston After-School Clubs Online Registration Form

Jefferson-Houston After-School Clubs Registration Form

It's almost time for Winter Clubs. Thanks for registering!

Week Day

Dates

Times

Tuesday

Jan 13-Feb 24, 2026

2:45-3:45pm

Wednesday

Jan 14-Feb 18, 2026

*no club Feb 25

2:45-3:45pm

Registration Deadline: Friday Dec 19, 2025

What's the registration process?

Form Submission: This form is not complete until you hit "Submit". You'll receive an automated email copy of your responses.

Contact: If you do not receive a confirmation or have questions about registration, please email us at clubs.jh.pta@gmail.com.

Enrollment: Enrollment emails will be sent when rosters are finalized by Ms. Frost. Your club choice is not guaranteed as some clubs will be full.

Payment: Do not pay enrollment fees until you receive an enrollment email (in January). For payment options (Venmo, PayPal, check, or credit card), visit www.jeffersonhoustonpta.com/clubs. Scholarships are available; please check the appropriate box to request a scholarship. Each club costs $100.

Dismissal Changes: For any dismissal changes after enrollment, please contact the school front office and Ms. Frost.

Club Descriptions


Tuesdays	Description
The Science Seed^TM (Grades K-2)	The Science Seed^TM is a science enrichment program designed to develop a love of science that will last a lifetime. We will teach geology, chemistry, biology/nature, physics, and nutrition in fun, interactive, and age-appropriate ways. Visit www.thescienceseed.com for more information about the program.
Chess Club (Grades 1-5)	Chess coach Vince Ruble will be teaching fun, camaraderie, focus, and how to play or improve your chess game. This session is open to all levels. More experienced players may help teach beginners the basics.
Upcycle (Grades K-2)	Conservation and creativity go hand-in hand. In this club you will upcycle donated materials into creative art. www.upcyclecrc.org
Art Club - Ceramics (Grades 3-5)	The kiln is up and running! Our older artists (3rd-5th) will sculpt with clay and fire their own ceramics projects with J-H art teacher Ms. Haney.
Cosmetology (Grades 4-8)	Want to learn a new skill? Come learn hair care and basic styling techniques with Ms. Monroe and Ms. Washington from the front office. Spots are limited.
Wednesdays	Description
Art Club (Grades K-2)	Our younger artists K-2 can express their creativity and develop their skills with J-H art teacher Ms. Haney. A variety of materials will be available to explore in an open studio format this session.
Fun Together (Grades K-2)	In this club, Ms. Brooke will lead students in a variety of fun activities that differ from week to week, including arts and crafts, music, games, and more! Ms. Brooke is an instructional assistant for multiple grades.
Basketball (Grades K-3)	Get active with NOVA Kids in Motion and learn some beginner basketball skills in the gym.
Robotics (Grades 2-5)	Build with a partner using LEGO Spike Essentials kits and use the LEGO Spike app to code and make your creations move. The app leads students through the steps to make a variety of fun projects, or students can explore the engineering design process with an idea of their own.
Kids Sky Lab (Grades 3-5)	This club will engage students in Science, Technology, Engineering, and Mathematics (STEM) through hands-on activities, projects, and competitions. Ms. Ross (school treasurer and former STEM teacher) will lead students to foster problem-solving skills, innovation, and teamwork while making STEM subjects fun and accessible.

How many children are you registering?*
Are you requesting scholarship assistance?*

	Yes	ACPS Bus #	Bus Drop-off Location (Bus Stop or Intersection)
My child has my permission to ride the after-school activity bus on the days enrolled in After-School Clubs.

	Parent/Guardian (provided next in form)	Emergency Contact #2 (provided next in form)	Emergency Contact #3 (provided next in form)
Indicate approved adult(s) to pick up

	Yes	ACPS Bus #	Bus Drop-off Location (Bus Stop or Intersection)
My child has my permission to ride the after-school activity bus on the days enrolled in After-School Clubs.

	Parent/Guardian (provided in form)	Emergency Contact #2 (provided in form)	Emergency Contact #3 (provided in form)
Indicate approved adult(s) to pick up

	Yes	ACPS Bus #	Bus Drop-off Location (Bus Stop or Intersection)
My child has my permission to ride the after-school activity bus on the days enrolled in After-School Clubs.

	Parent/Guardian (provided in form)	Emergency Contact #2 (provided in form)	Emergency Contact #3 (provided in form)
Indicate approved adult(s) to pick up

Parent/Guardian Contact Information
Parent/Guardian Name (Emergency Contact #1)*

First NameLast Name
Parent/Guardian Email Address (for club enrollment notification and you will receive a confirmation email when you hit the submit button with a copy of your answers)*
example@example.com
Parent/Guardian Phone Number*
Please enter a valid phone number.
Emergency Contact Information
Emergency Contact #2 Name (Someone other than above)*

First NameLast Name
Emergency Contact #2 Phone Number*
Please enter a valid phone number.
Emergency Contact #3 Name (Someone other than above)*

First NameLast Name
Emergency Contact #3 Phone Number*
Please enter a valid phone number.

Behavior Acknowledgement
Parent/Guardian, please read and sign the behavior acknowledgement below.

I understand that in order for the Jefferson-Houston PTA to provide safe, positive After-School Club experiences for all students, unacceptable behavior is not allowed. If a student has difficulties behaving during the Club, he/she will be removed from the Club and placed with a school administrator, and the parent/guardian will be notified. There is no reimbursement if a student must be removed from a Club due to behavior, for absences, or if a Club must be canceled for unforeseen circumstances such as weather, pandemic, or facility issues.
Electronic Signature:
Please type your name
Please provide any additional comments, concerns, or clarifying information below:
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Jefferson-Houston After-School Clubs Registration Form

Student #1 Information

Student #1 Club Rankings

Student #2 Information

Student #2 Club Rankings

Student #3 Information

Student #3 Club Rankings

Parent/Guardian Contact Information

Emergency Contact Information

Behavior Acknowledgement