PΑΥΜΕNT Union City Community & Recreation Services PLAN Afternoons at CLUB UNE AVAILABLE Itliong-Vera Cruz Middle School Fall Session August 21, 2019 - January 17, 2020 Club Une offers a variety of before and after-school recreational activities, enrichment *******, and homework assistance in a safe and supervised middle school environment. We offer small staff to student ratios with one staff to every fifteen students. There are two program options available: AM Care provides before school supervision M- F, from 7 am - 8:40 am. PM Care provides fun and supervision from school dismissal until 6 pm. Club Une offers care on early dismissal Wednesdays and on minimum days at no additional charge for registered students. ITLIONG-VERA CRUZ MIDDLE SCHOOL: Afternoons with Club Une will be located in Class Room S10 Please CIRCLE activity codes below for the days you wish to register. AM Care: FEE: $515 Monday Friday 7 am - 8:40 am Code: FA19CU-100 Before School Supervision PM Care: Dismissal - 6:00 pm Tues Wed Fri Mon Thurs FA19CU-103 Activity Codes FA19CU-101 FA19CU-102 FA19CU-104 FA19CU-105 $228 $228 $228 $228 $228 FEES DOB Total Fees: Participant's Name: Grade: City/Zip Address Email Work/Cel ( Home #: ( Parent's Name (Checks should be made payable to City of Union City) or Credit Card (Please circle): MasterCard Visa Discover Credit Card Verification # (CID) Payment: Cashier's Check / Money Order: Check # Card # Exp. Date (M/Y):_ _/_ _ Signature Print Name as it appears on card: Ways to Register: Complete form and turn in at Holly Community Center, 31600 Alvarado Blvd or Kennedy Youth Center 1333 Decoto Rd., fax (510) 471-6878 or register online at www.UnionCity.org/reg. Call 675-5488 or 675-5825 for more information Yes, my child has special needs that might require special accommodations. I, the undersigned, agree to indemnify and hold harmless the City of Union City from any loss or liability which is alleged to have resulted from my participation in this program. I have read and understand the activity description as listed on this flyer and I comprehend all of the risks involved by participating in this activity. I hereby give my dependents permission to participate in these activities indicated and in doing so absolve the City of Union City; its employees and officers from liability. Ialso grant full permission to any and all of the foregoing to use my name and any photographs, video graphs, motion pictures or recording for any publicity and promotion purposes without obligation or liability to me. Signature of Parent: Date:
UNION CITY communily & recreation services IVC Afternoons with Club Une Drop In Fees Daily Drop-in AM Care $10 (7 am 8:30 am) Daily Drop-in PM Care $15 (dismissal until 6 pm) Daily Drop-in Minimum Day $20 (11:40 am 6 pm) Club Une is a before and after-school program that provides homework help, recreation ******* and occasional field trips at Itliong-Vera Cruz middle school. Parents can register for specific days of supervision for their middle school student or take advantage of our drop in program, prices above. All drop-in participants must have an emergency card on file with the Club Une Program prior to dropping in. All fees must be paid in advance or on the day of drop in, failure to pay will result in removal from the program. Registered Club Une participants have first priority if space is limited For more information, contact the Holly Community Center (510)675-5488 *EVERY WEDNESDAY - DIMISSAL TIME 1:44PM** MINIMUM DAYS (DISMISSAL TIME 11:44AM) Wednesday 8/21/2019 Tuesday 9/24/2019 Thursday 10/24/2019 Friday 10/24/2019 Friday 11/15/2019 Thursday 1/30/2020 Thursday 3/12/2020 Monday 5/4/2020 Tuesday 5/5/2020 Wednesday 5/6/2020 Thursday 5/7/2020 Friday 5/8/2020 Thursday 6/4/2020 O оооо
Flyer ID 792978
Sent from Itliong-Vera Cruz Middle School
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