GENERAL INFORMATION. SWR Community Programs 250B Route 25A Shoreham, NY Phone: Fax:

Similar documents
LION KING, Jr. CREW PACKET

THE ALTON SCHOOL GUIDE TO SPORT

1. Mountain Vista High School Football Spring Camp

Class Schedule

2015 SUMMER SKILLS CAMPS

Boys & Girls Club of Pequannock 2017 Summer Camp Registration COMPLETE BOTH SIDES

Vance County Summer Fun

Sec123. Volleyball. 52 Resident Registration begins Aug. 5 Non-resident Registration begins Aug. 14

Emergency Medical Technician Course Application

JUNIOR HIGH SPORTS MANUAL GRADES 7 & 8

Dates and Prices 2016

New Town High. 9th Grade Bulletin H OW T O KEEP IN C O N TA CT? Today we learn, tomorrow we lead. A D M I N I S T R A T I O N

The term of the agreement will be from July 1, 2014 to June 30, 2015.

CTE Teacher Preparation Class Schedule Career and Technical Education Business and Industry Route Teacher Preparation Program

The Foundation Academy

WE ARE EXCITED TO HAVE ALL OF OUR FFG KIDS BACK FOR OUR SCHOOL YEAR PROGRAM! WE APPRECIATE YOUR CONTINUED SUPPORT AS WE HEAD INTO OUR 8 TH SEASON!

HOLLAND ELEMENTARY SCHOOL PARENT/TEACHER ORGANIZATION

ATHLETIC TRAINING SERVICES AGREEMENT

Cincinnati Country Day Middle School Parents Athletics Handbook

Holy Cross School. August Sun Mon Tue Wed Thu Fri Sat. Orientation. Development. Calendar Template by

Area XIV Northampton, Monroe, Carbon, Lehigh, and Schuylkill County Residents Only

INTERNATIONAL STUDENT TIMETABLE BRISBANE CAMPUS

Earl Grey School. February, 2016

Kougar Kamp Basics. Early Bird Registration. Drop-off/Pick-up:

Parent Information Welcome to the San Diego State University Community Reading Clinic

Valparaiso Community Schools IHSAA PRE-PARTICIPATION PHYSICAL EVALUATION SCHOOL:

Keene State College SPECIAL PERMISSION FORM PRACTICUM, INTERNSHIP, EXTERNSHIP, FIELDWORK

Adult Community Learning. Course Programme 2017/18

Foster City Elementary School

Graduate Calendar. Graduate Calendar. Fall Semester 2015

VSAC Financial Aid Night is scheduled for Thursday, October 6 from 6:30 PM 7:30 PM here at CVU. Senior and junior families are encouraged to attend.

ST. PAUL'S LUTHERAN WRESTLING BASIC INFORMATION

NEWSLETTER NOVEMBER Imperial Road South, Guelph, Ontario, N1K 1Z4 Phone: (519) , Fax: (519) Attendance Line: (519)

Anyone with questions is encouraged to contact Athletic Director, Bill Cairns; Phone him at or

Mt Olive Recreation. Great enrichment programs

PERU STATE POWERLIFTING MEET (Sponsored by Peru State Football Booster Club)

Spiritual Works of Mercy

Summer Enrichment Camp

Arizona GEAR UP hiring for Summer Leadership Academy 2017

Table of Contents. Fall 2014 Semester Calendar

ST. PAUL'S LUTHERAN WRESTLING BASIC INFORMATION

GREENBRIAR MIDDLE SCHOOL/ VALLEY FORGE HIGH SCHOOL 7TH AND 8TH GRADE ATHLETICS

2014 AIA State Cross Country

Youth Apprenticeship Application Packet Checklist

American Heritage School. Summer Camps Program Overview Grades 1 through 12. REGISTER TODAY! Limited Space Available

Graduate Student Travel Award

2016 BAPA Scholarship Application

JESSAMINE COUNTY SCHOOLS CERTIFIED SALARY SCHEDULE (188 DAYS)

WILLMAR CARDINALS ATHLETICS

SAT & ACT PREP. Evening classes at GBS - open to all Juniors!

2 nd A n n u a l A SL B o o t C a m p

Attach Photo. Nationality. Race. Religion

Timberstone Junior High Home of the Wolves! Extra-Curricular Activity Handbook

FELLOWSHIP PROGRAM FELLOW APPLICATION

LONGVIEW LOBOS HIGH SCHOOL SOCCER MANUAL

TRINITY GRAMMAR SCHOOL, KEW CRICOS PROVIDER CODE 00350M INTERNATIONAL STUDENT ORIENTATION HANDBOOK

OFFICE OF STUDENT LIFE CALENDAR/PLANNER

Fall Classes At A Glance

ESL Summer Camp: June 18 July 27, 2012 Homestay Application (Please answer all questions completely)

Fees and Dates

JEFFERSON COLLEGE LAW ENFORCEMENT ACADEMY Continuing Education Provider. Individual Contract

Class Dates June 5th July 27th. Enroll Now! Visit us on Facebook

UW-Waukesha Pre-College Program. College Bound Take Charge of Your Future!

Sample Of Welcome Back Letter From Vacation

Welcome to the University of Hertfordshire and the MSc Environmental Management programme, which includes the following pathways:

VOL.16, ISSUE 10 THE MUNDELEIN PARK & RECREATION DISTRICT OCTOBER Express Yourself with Marlene Holiday Crafts

Trent Internationale School Science Fair

The main purpose of this letter is to provide you information about the Annual Biology Day event for high school students.

After School Sports Handbook

MONTPELLIER FRENCH COURSE YOUTH APPLICATION FORM 2016

Centro de Lenguas e Intercambio Cultural. español. seville & cadiz. Dates and Prices. Sevilla y Cádiz. Clic Ih Sevilla.

20 HOURS PER WEEK. Barcelona. 1.1 Intensive Group Courses - All levels INTENSIVE COURSES OF

Middle/Junior High School Athletic Manual Public Schools of North Carolina State Board of Education North Carolina Department of Public Instruction

Cobham Hall Residential Programme

Northeast Credit Union Scholarship Application

STUDENT PACKET - CHEM 113 Fall 2010 and Spring 2011

Michigan Paralyzed Veterans of America Educational Scholarship Program

Snow Valley Basketball Schools Westmont College, Santa Barbara, CA

Sun Mon Tue Wed Thu Fri Sat

Evergreen. Never stop learning. Never stop growing. Fall bu.edu/evergreen

CALL TO ORDER. Mr. Phil Bova, President Mr. Craig Olson, Vice President Mr. Lee Frey Mrs. Nancy Lacich Mr. Barry Tancer SPECIAL RECOGNITION

FOOTBALL COACH JERRY SCHNIEPP, COMMISSIONER JOHN LABETA, ASSISTANT COMMISSIONER DATE: JUNE 24, FOOTBALL PRESEASON BULLETIN

A. Permission. All students must have the permission of their parent or guardian to participate in any field trip.

Department of Social Work Master of Social Work Program

Work Placement Programme. Learn English in the heart of Ireland. Shannon Academy of English.

Western Colorado Peace Officers Academy

SAN ROQUE BOARDING HOUSE

ACCA PROSPECTUS JAN-JUN 2018 SEMESTER 1 SANDTON CAMPUS BECOME YOUR VISION, A CHARTERED FINANCE PROFESSIONAL!

Schedule at a Glance Fall 17 thru Spring 18

Albert Einstein High School s 45 th Birthday Crewcuts and Bobby Socks

2018 Summer Application to Study Abroad

UNDERGRADUATE APPLICATION. Empowering Leaders for the Fivefold Ministry. Fall Trimester September 2, 2014-November 14, 2014

Don t miss out on experiencing 4-H Camp this year!

To the parents / guardians of students of the ISE Primary School

White Mountains. Regional High School Athlete and Parent Handbook. Home of the Spartans. WMRHS Dispositions

SHAWANO COMMUNITY MIDDLE SCHOOL

Newsletter No 24 Dear Parents and Friends Friday 18 March 2016

New Jersey Society of Radiologic Technologists Annual Meeting & Registry Review

THEODORE ROOSEVELT HIGH SCHOOL Home of the Roughriders since 1923 August 31 September 7, Student Section

OHIO COUNTY BOARD OF EDUCATION SALARY SCHEDULES Revised 7/3/12

Transcription:

SWR Community Programs 250B Route 25A Shoreham, NY 11786-2192 Phone: 631-821-8116 Fax: 631-929-3001 www.swrschools.org GENERAL INFORMATION REGISTRATION INFORMATION: NOW AVAILABLE: Online Registration As a convenience to parents, the Shoreham-Wading River Central School District now provides an easy way to register and pay for their child s courses. Parents may pay with Discover, VISA, or MasterCard credit or debit cards for these items. Our Web Store accepts payments over the internet 24/7. By contracting with RevTrak, a national credit card payment processor, we provide you a secure site for making payments. If you don t want to register on-line, for accounting purposes, please write out a separate check for each program the only exceptions are for multiple persons in the same program. NO REGISTRATIONS ACCEPTED AT SITE ON THE FIRST DAY OF THE PROGRAM. Contact Community Programs if you want to register late to see if program is running or if space is available @ 631-821-8116. NO CASH ACCEPTED ONLY CHECKS OR MONEY ORDERS. Of course you can still mail the check to the office to the address above. Online Registration: https://swr.revtrak.net. You may also feel free to pay by check. NO CASH ACCEPTED ENROLLMENT: at least 5 people must register for a class before it can be offered. Maximum enrollments are determined by the nature of the course. CLASSES ARE FILLED ON A FIRST-COME, FIRST-SERVED BASIS. REFUNDS: will only be given if we are notified 1 week prior to the class or activity. NO REFUNDS will be given thereafter. Nonattendance of classes does not entitle you to a refund. Many opportunities are offered to establish a resume of volunteer work within our programs. Volunteering for the Foot Races (Thanksgiving Day), Egg Hunts (March). We would hope that the students of our Middle School and High School take advantage of this opportunity to enrich their volunteer resume. Contact the Community Programs Office with your requests to volunteer 821-8116. Revised: 9/13/18

YOUTH CO-ED BASKETBALL ~ COACHES: PARENT VOLUNTEERS GRADES PK thru 3 (co-ed) GRADES 4 thru 8 (not co-ed) TIMES 8:00am-3:00pm DATES: DEC 15 thru MAR 16, 2019 FEE: $65.00 (9 sessions) DESCRIPTION: PK thru Grade 3 will play on a rotating schedule on Friday evenings/saturdays (1 hr. session per team) @ Miller Avenue or Wading River Elementary. DESCRIPTION: Grades 4 thru 9 Boys and Girls will play their games @ the Middle School on a rotating schedule starting at 8:00am to 3:00pm. Practice time is extremely limited. In order to put together the teams, we must close registration on Friday, November 16 th. INSTRUCTIONAL BADMINTON INSTRUCTOR: JUSTIN BEYERSDORFER DATES: MONDAYS OCT 22, 29, NOV 5, 12, 19 & 26 LOCATION: MIDDLE SCHOOL FRONT GYM TIMES: 6:00pm 7:30pm GRADES: 5 thru 8 DESCRIPTION: This program will help develop skills needed to play competitive badminton. Instruction will cover racket control. Shot mechanics, footwork and court movement for singles and doubles play. FIELD HOCKEY ~ INSTRUCTOR: MELISSA MOLLOY DATES: SUNDAYS OCT 7, 14, NOV 4 & 11 LOCATION: SWR HIGH SCHOOL TURF FIELD GRADES 1 thru 6 FEE: $25.00 TIMES: 4:00pm to 5:30pm DESCRIPTION: Learn the basic skills of Field Hockey in a short clinic setting introduction. Equipment needed bring your own stick and goggles. FLOOR HOCKEY ~ GRADES K thru 2 (max 25) INSTRUCTOR: DONALD COUSINS & MATT TEES DATES: TUESDAYS - OCT 16, 23, 30, NOV 6, 13 & 20 LOCATION: WADING RIVER ELEMENTARY GYM TIMES: 5:30pm to 6:30pm SWR STUDENTS ONLY DESCRIPTION: Learn while you play. Teams will be made each night. Equipment recommend: stick with plastic blade, gloves, elbow, knee pads, shin guards and helmet.

FLOOR HOCKEY ~ GRADE 3 (max 15) INSTRUCTOR: NICOLE CALLAHAN, JIM DAVIS & ERIN HUNT DATES: WEDNESDAYS - NOV 7, 14, 28, DEC 5, 12 & 19 LOCATION: MILLER AVENUE ELEMENTARY GYM TIMES: 6:15pm to 7:15pm SWR STUDENTS ONLY DESCRIPTION: Learn while you play. Teams will be made each night. Equipment recommend: stick with plastic blade, gloves, elbow, knee pads, shin guards and helmet. FLOOR HOCKEY ~ GRADE 4 (MAX 15) INSTRUCTOR: MIKE LEWIS & STEVE ZOUMAS DATES: THURSDAYS - OCT 18, 25, NOV 1, 8 & 15 (5 sessions) LOCATION: WADING RIVER ELEMENTARY GYM TIMES: 7:30pm to 8:30pm SWR STUDENTS ONLY FEE: $35.00 DESCRIPTION: Learn while you play. Teams will be made each night. Equipment recommend: stick with plastic blade, gloves, elbow, knee pads, shin guards and helmet. FLOOR HOCKEY ~ GRADES 5 & 6 (MAX 15) INSTRUCTOR: STEVE McCLAIN DATES: THURSDAYS - OCT 18, 25, NOV 1, 8 & 15 (5 sessions) LOCATION: WADING RIVER ELEMENTARY GYM TIMES: 6:30pm to 7:30pm SWR STUDENTS ONLY FEE: $35.00 DESCRIPTION: Learn while you play. Teams will be made each night. Equipment recommend: stick with plastic blade, gloves, elbow, knee pads, shin guards and helmet. GIRLS LACROSSE ~ GRADES 2 thru 6 INSTRUCTOR: TBD DATES: TUESDAYS JAN 8 thru APR 2, 2019 TIMES: Grades 2-3 6pm to 7pm Grades 4 & 5 7pm to 8pm Grades 6 8pm to 9pm LOCATION: ALBERT G. PRODELL MIDDLE SCHOOL FRONT & BACK GYMS SWR STUDENTS ONLY FEE: $60.00 DESCRIPTION: The fee covers instructions in basic skills and practice sessions will take place. Required equipment needed: "girls" stick and face goggles. We will supply the mouth guards.

INDOOR BOYS & GIRLS SOCCER AGES SEE BELOW INSTRUCTOR: JAMES KELSH & CERTIFIED TRAINERS DATES: DEC 2, 16, JAN 6, 13, 20, 27, FEB 3 & 10 LOCATION: SWR HIGH SCHOOL GYM TIME: 10:00am to 3:00pm (1-hour sessions see ages below) FEE: $95.00 per player 10-11am: 4-5 year olds 11-12pm: 6-7 year olds 12-1pm: 8-9 year olds 1-2pm: 10-11 year olds 2-3pm: 12-14 year olds This Community Program is for non-sound Beach Soccer Club players. It allows those athletes interested in learning soccer to be trained by professional soccer trainers. DESCRIPTION: The program is suitable for all players, regardless of ability levels. Sessions will be run by Certified Trainers under the Direction of James Kelsh-Director of Training for Sound Beach Soccer Club. The program includes skill work, technical training, small games and scrimmaging. Please bring the following equipment to each training session: Soccer ball, shin guards, indoor sneakers and water or sports drink. Mail to the address above with your check made out to Community Programs or through REV TRAC (credit card system)wwwschools.org (under Community Programs). Sound Beach Soccer Club Players must register through the club website online at: www.soundbeachsoccer.org ~ GRADES 6 thru 8 INSTRUCTORS: DOTSIE BUBARIS & EILEEN BAIRD DATES: GRADE 6 ~ OCT 19, NOV 16, DEC 7, JAN 4, FEB 1, MAR 1, MAY 3 & MAY 31 DATES: GRADES 7 & 8~ OCT 20, NOV 17, DEC 8, JAN 5, FEB 2, MAR 2, MAY 4 & JUNE 1 5 th Graders are invited to attend the Friday, May 31st Teen Rec ~ invitations will go out mid-may LOCATION: ALBERT G. PRODELL MIDDLE SCHOOL TIMES: 7:00pm 10:00pm SWR STUDENTS ONLY FEE: $5.00 per night Refreshments will be sold DESCRIPTION: Join us for a variety of activities such as: basketball, indoor soccer, table tennis, air hockey, etc. or just hangout with your friends and relax! CO-ED YOUTH VOLLEYBALL ~ GRADES 4 thru 7 INSTRUCTOR: SEAN DOWD DATES: MONDAYS OCT 22, 29, NOV 5, 19, 26 & DEC 3 TIMES: 6:00pm - 7:30pm LOCATION: ALBERT G. PRODELL MIDDLE SCHOOL BACK GYM SWR STUDENTS FEE: $50.00 DESCRIPTION: Preparation for scholastic programs and beginning training for those interested in playing the sport.

CHILDREN S YOGA WORKSHOPS GRADES 3 thru 5 (MAX 15) INSTRUCTOR: LINDA LINDAMAN DATES: WEDNESDAYS Oct 10, 17, 24, NOV 7, 14 & 21 TIMES: 2:55pm - 3:55pm LOCATION: WADING RIVER ELEMENTARY GYM FEE: SWR STUDENTS ONLY: $45.00 DESCRIPTION: Children will learn how the ancient science of yoga can help improve muscle tone, flexibility and strength. They will also learn how to create a wonderful feeling of well -being and calm within themselves. Please wear loose clothing and bring a large towel or yoga mat. We have a few mats if you don t have one.. Must fill out Wading River After School Permission slip (see attached). GRADES 3 thru 5 (MAX 15) INSTRUCTOR: CATHERINE KELLER DATES: TUESDAYS OCT 16, 23, 30, NOV 13 & 20 TIMES: 2:55pm 3:55pm LOCATION: WADING RIVER ELEMENTARY GYM FEE: SWR STUDENTS ONLY: $40.00 DESCRIPTION: Classes incorporate key childhood development elements like leadership, respect, team work, confidence, self-esteem, memory, creativity and coordination. Must fill out Wading River After School Permission slip (see attached). INTRODUCTORY CHESS FOR KIDS - GRADES 4 & 5 (MAX 14) INSTRUCTOR: BOB VLAHAKIS DATES: WEDNESDAYS OCT 10, 17, 24, NOV 7 & 14 LOCATION: WADING RIVER ELEMENTARY CAFETERIA TIMES: 5:45pm 6:45pm DESCRIPTION: This beginning course is designed to create an interest in learning, understanding and playing the wonderful game of chess. We will introduce all the pieces and play simulated games using just pawns, rooks and pawns, bishops and pawns, etc. with the ultimate goal of playing a complete game with all the pieces by the end of the course. CHESS FOR MIDDLE SCHOOL KIDS - GRADES 6 thru 8 (MAX 16) INSTRUCTOR: BOB VLAHAKIS DATES: THURSDAYS OCT 11, 18, 25, NOV 1 & 8 LOCATION: WADING RIVER ELEMENTARY CAFETERIA TIMES: 7:00pm 8:00pm DESCRIPTION: This beginning course is for both beginners and advanced players, designed to create an interest in learning, understanding and playing the wonderful game of chess. Learn extra tips to improve and have a chance to play others of varying ability.

TAI CHI, QIGONG & MEDITATION FOR HS STUDENTS - GRADES: 9 thru 12 (MAX 20) INSTRUCTOR: BOB VLAHAKIS DATES: TUESDAYS NOV 20, 27, DEC 4, 11 & 18 LOCATION: SWR HIGH SCHOOL AUX GYM TIMES: 7:15pm 8:30pm DESCRIPTION: Learn how powerful the mind, body connection can be. Learn to balance the anxieties and stresses of being a high school student, varsity athlete and a teenager growing up in an age filled with devices designed to grab your attention. EQUIPMENT: Yoga mat, wear comfortable clothes and sneaker, water (no bear feet). MENS BASKETBALL OVER 35 INSTRUCTOR: JIM TRAINA DATES: SEPT 17 thru JUNE 5, 2019 TIMES: MON 7:30pm - 9:30pm and WED - 5:30pm 7:30pm LOCATION: MIDDLE SCHOOL FRONT GYM FEE: $140.00 DESCRIPTION: Good way to keep fit! Time change on Monday only to 5:30pm to 7:30pm starting March 19, 2019. LINE DANCING INSTRUCTOR: NATALIE BOYLE DATES: MONDAYS DEC 3, 10, 17, JAN 7, 14 & 28 TIMES: 7:00pm 8:30pm LOCATION: MIDDLE SCHOOL AUX GYM (DEC DATES) & WR CAFETERIA (JAN DATES) DESCRIPTION: Get ready to kick up your heels for some fun Country Line Dancing lessons. Learn fun dances that the top Long Island bands play. Great way to exercise and socialize. Come meet new friends! All levels are welcome - basic and intermediate steps will be shared.

CO-ED ADULT VOLLEYBALL 20 and OVER INSTRUCTOR: HOWARD COHEN DATES: MON & WED - SEPT 17 to JUNE 5, 2019 TIMES: 8:00pm - 9:45pm LOCATION: MIDDLE SCHOOL BACK GYM FEE: $100.00 DESCRIPTON: Join us for a night of competitive volleyball. ADULT YOGA INSTRUCTOR: ANNE O BRIEN DATES: TUESDAYS OCT 16, 23, 30, NOV 6, 13 & 20 TIME: 4:30pm - 5:30pm LOCATION: MIDDLE SCHOOL AUX GYM DESCRIPTION: Based on the practice of asana poses taught in the Hatha tradition, this class uses basic poses as the foundation for awareness of body alignment, natural movement principles, and breathing. Greater strength, flexibility, energy, balance and concentration are just some of the benefits gained in this progressive practice. Wear comfortable clothing that allows free movement. Bring a yoga mat and a smile. Blankets, blocks and strap optional. ZUMBA INSTRUCTOR: CATHERINE KELLER DATES: TUESDAYS OCT 16, 23, 30, NOV 13 & 20 TIMES: 6:00pm 7:00pm LOCATION: MIDDLE SCHOOL AUX GYM DESCRIPTION: Latin inspired dance-fitness class designed for all fitness levels. Using an aerobic/fitness approach I incorporate dance and exercise and most of all fun. So ditch the workout and come join the party!

SPRING 2019 DRIVER EDUCATION: Information available in the Guidance Dept. Available to students who are 16 years of age the week of December 17 th February 1st thru June 15, 2019. 45th ANNUAL EGG HUNT ~ APRIL 13, 2019 ~ 1:15pm Behind the Shoreham-Wading River High School on the Varsity Field Hockey Field Rain Date APRIL 14, 2019 ROUND OUT JULY 8 thru AUGUST 9, 2019 at Miller Avenue Elementary School.

SHOREHAM-WADING RIVER COMMUNITY PROGRAMS 2018/2019 YOUTH BASKETBALL Co-Ed Grades PK thru 3 ~ Grades 4 thru 9 (not co-ed) Games start Saturday, Dec 15 th thru March 16 th PK thru Grade 3 will play on a rotating schedule on Friday evenings/saturdays (1 hr. session per team) @ Miller Avenue or Wading River Elementary Grades 4 thru 9 Boys and Girls will play their games @ the Middle School on a rotating schedule starting at 8:00am to 3:00pm. Practice time is extremely limited. In order to put together the teams, we must close registration on Friday, November 16th 1 st. Over the last 4 years there has been an issue with the imbalance of some teams. Some coaches have used the coach with John or Jane trick and the car pool need trick to create some really strong teams. We are not playing in Nassau County we play in your hometown. As the abuses of the above have grown over the last four years, we have come to a time of adjustments. This year the teams will be drawn by random lot. Of course attention will be paid to Parent and child combinations. But, no special cases will be accepted. We would hope our coaches will step up, support this idea and stay coaching with their child s team. I realize many coaches will not coach or assist under these rulings, we are going to the luck of the draw. Student s Name Complete Mailing Address Home Phone # E-mail Address M or F Grade & DOB SWR RESIDENTS FEE: $65.00 (Make checks payable to SWR Community Programs) Mail to: SWR Community Programs, 250B Route 25A, Shoreham, NY 11786-2192 or you can register on-line swr.revtrak.net Attention Parents - The program needs volunteer coaches (circle position desired). TEAM COACH or ASST. COACH Name Email: I, the undersigned, intending to be legally bound, hereby, for myself, my heirs, executors and administrators, hereby waive, release and hold harmless Shoreham-Wading River Central School District, SWR Community Programs and their agents, employees, representatives and successors and assigns, from any and all liabilities, claims, demands and causes of action whatsoever arising directly or indirectly from my child or my participation in this program, even if any such liabilities, claims, demands and causes of action arise in whole or in part out of the negligence of any of the above-mentioned organizations or individuals. (When signed by a parent, the parent agrees to waive, release and hold harmless the above-mentioned organizations and individuals from any and all said liabilities, claims and causes of action which may be asserted on behalf of the entrant.) In addition I hereby grant permission to any and all of the above mentioned organizations and individuals to use any photographs, videotapes, motion pictures, recording or any other record of this event and my child s or my participation in this event for any program related advertisement or news releases. Signature of parent or legal guardian Date

SHOREHAM-WADING RIVER CENTRAL SCHOOL DISTRICT 250 B Route 25A Shoreham, NY 11786-2192 COMMUNITY PROGRAMS Phone: (631) 821-8116 Fax: (631) 929-300 E-Mail: jshamoun@k12.us.ny Web Site: swrschools.org REGISTRATION FORM STUDENTS & ADULTS (fill in the information below) STUDENT Name GRADE MAILING ADDRESS TOWN HOME EMERGENCY PHONE PHONE # ZIP E-MAIL ADDRESS PROGRAM FEE: $ PROGRAM FEE: $ ADULT Name MAILING ADDRESS TOWN ZIP HOME PHONE E-MAIL ADDRESS PROGRAM FEE: $ I, the undersigned, intending to be legally bound, hereby, for myself, my heirs, executors and administrators, hereby waive, release and hold harmless Shoreham-Wading River Central School District, SWR Community Programs and their agents, employees, representatives and successors and assigns, from any and all liabilities, claims, demands and causes of action whatsoever arising directly or indirectly from my child or my participation in this program, even if any such liabilities, claims, demands and causes of action arise in whole or in part out of the negligence of any of the above-mentioned organizations or individuals. (When signed by a parent, the parent agrees to waive, release and hold harmless the above-mentioned organizations and individuals from any and all said liabilities, claims and causes of action which may be asserted on behalf of the entrant.) In addition I hereby grant permission to any and all of the above mentioned organizations and individuals to use any photographs, videotapes, motion pictures, recording or any other record of this event and my child s or my participation in this event for any program related advertisement or news releases. Signature Date

WADING RIVER ELEMENTARY SCHOOL Shoreham-Wading River Central School District AFTER SCHOOL PERMISSION SLIP Please complete this form giving your child permission to stay after school at Wading River Elementary to attend the listed activity. Student Name: Grade: Classroom Teacher: I give my child permission to attend Name of Activity on the following dates: List of Activity Dates. (Please put these dates on your calendar.) I understand that my child will stay after school on these dates and NOT be put on the bus. In the event something changes and my child should NOT stay on any of the dates listed, I will send a note to the teacher indicating the change. Parent/Guardian Signature Date Print Name: Parent/Guardians: Please return this completed form to your child s teacher prior to the start of the program. 1900 Wading River Manor Rd., Wading River, NY 11792 tel: (631) 821-8254 fax: (631) 821-8258