Page 1 ... Visit us at www.facebook.com/NSAGirlsProgram. Program offered in partnership with: .... Insurance Company: Ph
The Program for Girls & Young Women at New Settlement offers FREE summer programs for girls & young women!
July 5-August 11, 2017 Programs meet at 1525 Townsend Ave or 1501 Jerome Ave. Bronx, NY 10452 For girls aged 10-15 Morning + Afternoon session may be combined (for a full day of programming, M-Th) or taken separately:
Morning Session (Mon-Fri) 9am-1pm—only 15 spots! Mon—Learn To Ride* Bike NY takes girls from zero to street ready in 5 weeks! Tues—Swim + Yoga Swim instruction at NSCC followed by Yoga in our program space Wed—Garden Club Workshops at the Grove Hill Learning Garden Thurs— Fit 4 Life + Art Sports& Fitness (outdoors, weather permitting), followed by Art Projects Fri—Fit 4 Life + Woodworking Sports& Fitness (outdoors, weather permitting), followed by fun carpentry projects
Afternoon Sessions (Mon-Thurs) 1 or 2-5pm—25 spots available Mon, Tues & Thurs—Project V.I.P. (Voice, Identity, Power) Writing & Performance 1-4pm (ages 10-12) OR 2-5pm (ages 13-15) Wed—Arts & Recreation Cool off in the AC with art projects and games Wed 2-5pm
For ages 14+ only Fri— Food Justice Workshops* Lead by the manager of New Settlement’s Community Food Action Farm stand, these workshops educate youth leaders about food justice issues. *Required for youth leaders hired to staff the farm stand, open to other participants also.
Want to learn more, or enroll?? Contact Director Joy Leonard @ (718) 716-8000 x119 or
[email protected] Visit us at www.facebook.com/NSAGirlsProgram
Program offered in partnership with:
Program for Girls & Young Women Summer 2017 Enrollment Packet For ages 10-15 This summer we will partner with other organizations to bring more exciting and enriching opportunities to the girls and young women we serve! There may be waivers or additional health forms to be completed, so that all of our partners get the documentation they need to offer these amazing programs at no cost to your family. Location: All sessions and any trips begin and end at our basement program space, at 1525 Townsend Avenue. The group will walk or travel as a group by train to offsite locations, including St. Mary’s Park (Learn to Ride), New Settlement Community Center (swimming), the Grove Hill Learning Garden (Garden Club), and Claremont Park (Fit for Life). It is very important that participants arrive on time, because the morning group will often be departing by 9:15am for other locations. Please mark with an X which session(s) you/your daughter wish to enroll. Note that girls may enroll in one or both sessions, and may stay through lunch (with supervision) if participating in morning and afternoon sessions. ______MORNING SESSION 9AM-1PM Monday – Friday Only 15 morning spots! Mon—Learn To Ride Bike NY takes girls from zero to street ready in 5 weeks. Tues—Swim + Yoga Swim instruction at NSCC followed by Yoga in our program space Wed—Garden Club Workshops at the Grove Hill Learning Garden Thurs— Fit 4 Life + Art Sports& Fitness (outdoors, weather permitting), followed by Art Projects Fri—Fit 4 Life + Woodworking Sports& Fitness (outdoors, weather permitting), followed by fun carpentry projects ______AFTERNOON SESSION 1 or 2PM - 5PM Monday – Thursday Up to 25 Afternoon spots Mon— Project V.I.P. Writing & Performance ensemble 1-4pm (ages 10-12) OR 2-5pm (ages 13-15) Tues— Project V.I.P. Writing & Performance ensemble 1-4pm (ages 10-12) OR 2-5pm (ages 13-15) Wed—Art Projects & Recreational games, in the AC (cooling off after morning Garden Club) 2-5pm Thurs— Project V.I.P. Writing & Performance ensemble 1-4pm (ages 10-12) OR 2-5pm (ages 13-15)
For ages 14+ only
______Friday 2-3:30pm *Food Justice Workshops Lead by the manager of New Settlement’s Community Food Action Farm stand, these workshops educate youth leaders about food justice issues. These Friday workshops may also include trips to visit urban farms or green markets (dates TBD); trip days will be longer. *Required for youth leaders who are hired to staff the farm stand; but open to other participants also.
DROP OFF/PICK-UP Please let us know if your daughter can travel to and from program on her own, or whether she will always be dropped off and picked up by an older family member or adult. ______My child has permission to walk to and from program by herself. ______My child may NOT leave the program without an adult/family member.
MEALS We recommend that participants who are enrolled in morning (AM) and afternoon (PM) sessions bring lunch; we can also provide daily packed lunches (sandwich, fruit and drink) through the School Food Summer Meals program. IF your child will participate in both AM and PM sessions, and does NOT have your permission to leave the supervised program space (go to the store, get lunch), she MUST bring lunch OR be able and willing to eat the packed lunch provided by School Food. Our program staff cannot accompany participants to the store or to get lunch.
If your child will participate in both morning and afternoon sessions, please mark one of the following: ______My child may leave at lunch time and return for afternoon program. (We cannot be responsible for her timely return to program.) ______My child will bring lunch. ______Please provide a School Food packed lunch for my child.
*Small snacks will be provided for afternoon sessions. If your child will participate in AM sessions, please ensure that she eats a good breakfast! School food provides free breakfast and lunch for all school age children at their summer feeding sites.
Participant’s Name (print): _____________________________________________________ Parent/guardian’s name (print): _________________________________________________ Parent/guardian’s signature: ____________________________________________________
New Settlement
PROGRAM FOR GIRLS & YOUNG WOMEN 2017-18 Registration Form (Summer)
Personal Information (please fill in ALL spaces) Participant first name: ________________________ Last name: _________________________ Parent/Guardian name : __________________________________________________________ Address: _____________________________________________ Apt. # ___________________ City: _____________________________ State: _____________ Zip Code: _________________ Home phone: (
) _______________ Parent/Guardian Daytime phone: (
Participant cell phone: (
) _______________
) _______________ Parent/Guardian cell phone: (
) _______________
Participant Email Address: ___________________________________________ Date of Birth: ______/______/______
Age: ___________
School (fall 2017): ________________________________________ Grade (fall '17):_____________
If accepted, I agree to uphold the following requirements of New Settlement's Program for Girls & Young Women: 1. Abide by all rules and regulations of the program. 2. Respect self, other participants and staff at all times. 3. Make a commitment to only miss program days when it is unavoidable. Participant Signature: ____________________________________________
Date: _____________
Parent/Guardian Signature: __________________________________________ Date: _____________
This is a violence and drug free program
New Settlement Program for Girls & Young Women 2017-18 EMERGENCY MEDICAL CARE (To be completed by the parent or guardian)
Participant’s Name:
Date of Birth:
1. If my child requires emergency medical care and I cannot be reached, I give my consent to the above after-school program to obtain the necessary medical care for my child. I agree to pay all of the costs associated with the emergency medical care that my child receives. I understand that every effort will be made to contact me before and after medical care is provided. 2. Following emergency medical care, my child may be released to the following people: Name: Address: Home Phone:
Relationship to Student:
Name: Address: Home Phone:
Relationship to Student:
Name: Address: Home Phone:
Relationship to Student:
Employer: Work Phone:
Employer: Work Phone:
Employer: Work Phone:
3. Health/Insurance Information: Participant’s Doctor: Phone: Allergies: Last Tetanus: Address
Insurance Company: Policy Holder’s ID: Religious Preference: (optional) Medication(s) being taken:
(student’s doctor):
Additional Comments:
4. I understand that this consent will be in effect as of the date of my signing this form and will continue as long as my child is enrolled in this youth program.
Parent/Guardian Signature
Date
NSA
NEW SETTLEMENT APARTMENTS
1512 TOWNSEND AVENUE BRONX, NEW YORK 10452 TEL (718) 716-8000 FAX (718) 294-4085
Permission to Use Photograph I give my permission to New Settlement to use my photograph in all forms and media, such as brochures, calendars, newsletters, news articles, and the Program for Girls & Young Women’s Facebook page (facebook.com/NSAGirlsProgram). I have read this release and am fully familiar with its contents.
_____________________ Name of Participant
__________________________ Signature & Date
_____________________ Name of Parent/Guardian
__________________________ Signature & Date
Address
_____________________ _____________________ _____________________
