PTAfterschool Application Form

Please use this form to sign-up for After-School Enrichment. You must complete one application for EACH CHILD you wish to enroll. If demand exceeds supply on any club, any applicants will be entered into a lottery. The lottery will make an effort to balance the class between all grades, and to ensure the most equitable access to at least one club. Children of parent moderators do not have to participate in the lottery and do not occupy any of the available number of spaces for each club.

Your children will be supervised by PUSD background-checked parent volunteers and we will take appropriate precautions, but accidents can happen. If admitted to a club, you will be asked to sign a liability waiver for your child. This also means that that there will be limited tolerance for misbehavior, especially anything safety related.

Deadline for signups is Friday, January 15, 2021. Parents will be notified of club placement status by Monday, January 18, 2021.

Parent Name *

First Name Last Name

Parent Email *

Parent Phone

Area Code Phone Number

Child Name *

First Name Last Name

Child Grade *

3rd 4th 5th

Don Benito Math Club *

I would like to apply my child for this club

Terms & Conditions

PTAfterschool is Free to Don Benito students (We always ask that parents consider an optional materials donation of $50 to offset necessary course expenses)
Children may apply for any course within their grade eligibility, but they will be asked to choose a course if admitted into more than one course (no concurrent enrollments are permitted per trimester).
When demand exceeds availability in each course, a random lottery will be conducted to ensure fair access. The lottery will balance admitted students across all grade eligible grade levels.
PTAfterschool is not child care - your child must actively participate in the course to be included. Don Benito PTA reserves the right to refuse futher participation in courses due to non-participation.
For virtual course where children are participating from home, a parent/caregivers must be within line of sight of their children at all times.
Parent/caregiver is granting permission for child under their care has permission to participate in a Zoom call and that their face and voice may be recorded to ensure event security and behavior monitoring.
Course capacity levels are at the sole determination of Don Benito PTA.

I have read, understood, and accepted the terms & conditions for PTAfterschool.

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