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Page 1:  · you have any questions, please call 412-492-6000 (Ext. 5023) or email kinney@ht-sd.org PLEASE RETURN THIS FORM TO YOUR SCHOOL COUNSELOR ON OR BEFORE FRIDAY, April 12, 2019 I will
Page 2:  · you have any questions, please call 412-492-6000 (Ext. 5023) or email kinney@ht-sd.org PLEASE RETURN THIS FORM TO YOUR SCHOOL COUNSELOR ON OR BEFORE FRIDAY, April 12, 2019 I will
Page 3:  · you have any questions, please call 412-492-6000 (Ext. 5023) or email kinney@ht-sd.org PLEASE RETURN THIS FORM TO YOUR SCHOOL COUNSELOR ON OR BEFORE FRIDAY, April 12, 2019 I will
Page 4:  · you have any questions, please call 412-492-6000 (Ext. 5023) or email kinney@ht-sd.org PLEASE RETURN THIS FORM TO YOUR SCHOOL COUNSELOR ON OR BEFORE FRIDAY, April 12, 2019 I will
Page 5:  · you have any questions, please call 412-492-6000 (Ext. 5023) or email kinney@ht-sd.org PLEASE RETURN THIS FORM TO YOUR SCHOOL COUNSELOR ON OR BEFORE FRIDAY, April 12, 2019 I will

Fifth Grade Students from Central, Poff and Wyland*

Hampton Middle School

Thursday, May 2, 2019

5:45-6:00 P.M. (Registration)

Ends at 8:00 P.M.

Get acquainted, talk about the middle school, and eat!

*This event is sponsored by the Hampton Township School District and is meant to enhance our students’ transition to middle school. HTSD students

and students who currently attend other elementary schools, but who are registered to attend 6th grade at HMS in 2018-2019 are invited to attend. If

you have any questions, please call 412-492-6000 (Ext. 5023) or email [email protected]

PLEASE RETURN THIS FORM TO YOUR SCHOOL COUNSELOR ON OR BEFORE FRIDAY, April 12, 2019

I will attend the Mingle in the Middle on Thursday, May 2, 2019, from 5:45-8:00 p.m.

Name: _______________________________________ Teacher/school: ________________________________

My parent/guardian’s signature: __________________________________________

Parent/guardian’s phone (cell, if possible): __________________________________

Students may be dropped off at the Cafeteria Entrance (at the rear of the building) by 5:45 p.m. and are required

to stay for the entire event unless arrangements have been made ahead of time. Pick-up is at 8:00 p.m. at the

Cafeteria Entrance and will be supervised by school personnel. If you are attending the parent night, please walk

to the cafeteria to reunite with your child. If you are not attending the parent night, please meet your child outside

of the Cafeteria Entrance. Cell phones are not necessary and are discouraged. Dress is casual.

Mingle in the Middle

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Parents in the Middle

Parents of 5th graders are invited to come to Hampton

Middle School on the night of the Mingle in the Middle,

May 2, 2019. Mrs. Lux and Mr.Silbaugh will present in the

Auditorium about the middle school experience and

answers questions. The Parent Meeting will begin at 7:00

and will end at 8:00, just in time for you to take your 5th

grader home.

See you there!

Page 7:  · you have any questions, please call 412-492-6000 (Ext. 5023) or email kinney@ht-sd.org PLEASE RETURN THIS FORM TO YOUR SCHOOL COUNSELOR ON OR BEFORE FRIDAY, April 12, 2019 I will

Thursday 6-10pApril 11th

TO PURCHASE YOUR TICKET PRIORTO THE EVENING, please CONTACT

Laura Moser // [email protected]

2195 SAMPLE ROAD | ALLISON PARK {PA}

mom’snight

outA casual night out with fellow Wyland moms.

If you’re a current Wyland mom or a mom of an incoming Kindergarten student (Fall 19), all are welcome!

Tickets are $40 per person includes food andone drink ticket. Tickets may be purchased at the door.

Wildwood Golf Club

W y l a n d ’ s

Page 8:  · you have any questions, please call 412-492-6000 (Ext. 5023) or email kinney@ht-sd.org PLEASE RETURN THIS FORM TO YOUR SCHOOL COUNSELOR ON OR BEFORE FRIDAY, April 12, 2019 I will

K-5 Elementary School One Day Program

DATE: April 26, 2019 TIME: 9:00-1:30 p.m. SCHOOL: Wyland Elementary School ADDRESS: 2284 Wyland Ave, Allison Park PHONE: 412-492-6345

K-5 One Day Program Overview

Junior Achievement will train all new volunteers at 6:00 P.M. on Wednesday, April 3 at Wyland. Training lasts approximately one hour.

During training, volunteers will receive all their program materials. Volunteers will be given everything they need.

On the day of the event: Volunteers will check in with the school office and wait in the

Library area until classes begin at 9:00a.m. The volunteers will work with their assigned class throughout the day, presenting the five activities outlined in their program kits. They will have breaks throughout the day as the students attend their “specials” and lunch. Parents may enjoy lunch with their child.

The classroom teacher will stay in the classroom and assist the volunteer when needed.

Program Theme Overview

Kindergarten – Ourselves - Five stories and activities emphasize the importance of work, teamwork and saving money. First Grade – Our Families - Students identify needs and wants, explore jobs and create a neighborhood map. Second Grade – Our Community - Students vote, pay taxes and identify jobs that can be found in a community. Third Grade – Our City - Students design a city and learn about businesses in a typical city, including: restaurants, a newspaper and bank. Fourth Grade – Our Region - The students focus on regional economic resources in terms of people, equipment and materials. Fifth Grade – Our Nation - Students learn about sole proprietorships, partnerships and corporations. Students develop a mini corporate business plan.

Page 9:  · you have any questions, please call 412-492-6000 (Ext. 5023) or email kinney@ht-sd.org PLEASE RETURN THIS FORM TO YOUR SCHOOL COUNSELOR ON OR BEFORE FRIDAY, April 12, 2019 I will

Frequently asked questions about JA Day:

1. What is Junior Achievement’s JA Day?

Junior Achievement is the world’s largest and fastest-growing organization dedicated to educating young people about business, economics, and free enterprise. Junior Achievement volunteers serve over 79, 000 students annually in a 21 county area of western Pennsylvania and the Panhandle of West Virginia. Elementary schools often hold a JA Day. On this day, volunteers act as the classroom teacher, presenting all five JA activities in one day. Classes that usually rotate from teacher to teacher are asked to remain in their homerooms (except for specials, lunch and recess) for the entire day.

2. How much time do volunteers need to commit to JA?

Upon arrival, volunteers are asked to report to the school office and wait in a designated area. Volunteers remain with their class throughout the academic day, having breaks when the children have their specials (art, music, phys. ed., etc.) and lunch. The school is asked to provide a room in which they may stay while their classes attend their specials. The school is also asked to provide lunch for the volunteers, if possible. The lower grades (Kindergarten – 2nd) may finish early, but the upper grades generally last the entire school day. 3. Do volunteers have to know how to teach?

Volunteers don’t have to know how to teach to present JA’s interactive hands-on activities. JA provides training, easy to use materials, a concise Consultant Guide and support to help each volunteer have a successful experience.

4. What is JA training like?

Training allows the volunteer to become familiar with the program kit materials, reviews student characteristics, classroom management techniques and teacher and volunteer roles. Sessions usually last approximately 45 - 60 minutes. Group training or individualized instruction can be scheduled. Training is also available on-line at http://pittsburgh.ja.org. 5. Is the volunteer alone in the classroom?

The teacher stays in the classroom. JA is a teaching partnership. The volunteer presents each activity and the teacher provides classroom management, offers insights into the class and helps out if the volunteer needs assistance. The volunteer, as part of the training, is told “Never be alone with a child.” The teacher will be with the students at all times.

Page 10:  · you have any questions, please call 412-492-6000 (Ext. 5023) or email kinney@ht-sd.org PLEASE RETURN THIS FORM TO YOUR SCHOOL COUNSELOR ON OR BEFORE FRIDAY, April 12, 2019 I will
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HAMPTON TOWNSHIP

SCHOOL DISTRICT

SUMMER PROGRAM 2019

Session I: June 17 - June 21

Session II: June 24 – June 28

Session III: July 15 - July 19 Camp Invention

GENERAL INFORMATION (Sessions I & II)

**SNACKS**

Students are

encouraged to

bring their own

snack for a mid-

morning break.

Students currently in Grades K-11 may register for the summer program. Immediate

registration by mail is recommended. Complete the attached registration form and health

form and mail your check or money order, made payable to:

“HAMPTON TOWNSHIP SCHOOL DISTRICT”

Mail to : HTSD Summer Program – 2284 Wyland Ave, Allison Park, PA 15101

While registration by mail is recommended, in-person registration will occur Tuesday, June

11th and Wednesday, June 12th at Hampton Middle School from 9:00 AM to 12:00 PM, in the

Main Office. This program is open to both Hampton residents and non-residents. Tuition

cannot be refunded after June 17th; however, a credit will be issued for a later session or

the next year for student cancellations after the deadline.

CLASS TIMES: Classes meet for five consecutive days, Monday through Friday, at

Hampton Middle School.

**DROP-OFF**

Students should enter through the library entrance, door #10, which is at the rear of the

Middle School. Students will report to the library where they will be met by their teachers.

**PICK-UP**

All students will be escorted to the parking lot outside the library entrance, door #10.

Please plan to meet your child there. If you have made arrangements for your child to

carpool with another student, you must provide the teacher with a note.

GENERAL INFORMATION (Camp Invention)

Camp Invention is a nationally-recognized STEM program where students will have the

opportunity to work together in a hands-on environment (please see page 7 for more

details). This camp is held at WYLAND ELEMENTARY the week of July 15th. The K-5

Camp Invention Program is a full-day camp, 8:30 am to 3 pm. Please drop off and pick up

your child at the front entrance of Wyland Elementary.

**NURSE**

A certified nurse

will be on duty.

**STUDENT

PARKING**

High School

students who wish

to drive must park

in the lot across

the street from

the Middle School,

adjacent to the

stadium.

COURSES WITH

INSUFFICIENT

ENROLLMENT

MAY BE

CANCELED.

Parents will be

notified ONLY if a

course has been

canceled.

QUESTIONS: Laurie Tocci or Michael Silbaugh

412-492-6346 412-492-6358

[email protected] [email protected]

Starting June 17th the Summer Program Office will be located in the Middle

School Library.

Please call 412-492-6362 June 17th-June 28th

Page 12:  · you have any questions, please call 412-492-6000 (Ext. 5023) or email kinney@ht-sd.org PLEASE RETURN THIS FORM TO YOUR SCHOOL COUNSELOR ON OR BEFORE FRIDAY, April 12, 2019 I will

SESSION I: June 17 – June 21 Page 2 #001-1 SUMMER INTRAMURALS

Grades: K-5

SESSION I – 9:00 AM TO 12:00 PM*

Summer Intramurals will offer a

variety of games and activities with

peers of similar ages in a safe and

secure environment. The focus of the

program will be on teamwork,

cooperation, movement, fitness, and fun. Outdoor and

indoor games will take place based upon grade level in a

semi-competitive environment.

Instructors: Matthew LaPorte, Jonathan Floss

Room : Auxiliary Gym Fee: $80

*Also offered in Session II

#002-1 INCREDIBLE EDIBLE SCIENCE

EXPERIMENTS

Grades: 2-5

SESSION I - 9:00 AM TO 12:00 PM

Have you ever thought of your kitchen as a

science laboratory? There are many

similarities between a chemistry lab and a

kitchen. Come experience a science lab

where all of your creations are edible! We

will be experimenting with different ingredients and how

they interact with each other. We will also be creating

mixtures and chemical reactions that taste delicious!

Instructor: Breanne Vodde Fee: $90

Room: D405

#003-1 ART EXPLORATIONS

Grades: 3-5

SESSION I – 9:00 AM TO 12:00 PM

Do you love to explore and create with art materials?

If you like to try new things in art, this may be the

class for you! Each day, we will explore a new art

medium. Students will draw, paint, sculpt, weave, and

print. Please bring a pencil, sketchbook (if you have

one) and wear an art shirt to class.

Instructor: Kelly Koble Fee: $90

Room: B209

#004-1 PROGRAMMING FUN!

Grades: 3-6

SESSION I – 9:00 AM TO 12:00 PM*

Do you love to play video

games? In this camp, you

will learn the basics of

computer programming

using Hopscotch, Tynker,

and Cargo-Bot to create your very own unique games and

animations! After learning how to create them, how about

using your reading, writing, and math skills to create

amazing and unique worlds in Minecraft?

Instructor: John Lee

Fee: $85 Room: D409

*Also offered in Session II

#005-1 BABYSITTING

Grades: 3-7

SESSION I - 9:00 AM TO 12:00 PM*

Successful babysitting experiences require the caregiver to provide a fun and safe

environment. This course provides future babysitters the opportunity to learn about

safety, proper nutrition and behavior management. In addition, students will create games

and activities, as well as materials for advertising. By the end of the week, students will

have had the opportunity to become CPR CERTIFIED. All participants will receive a certificate of completion.

Instructor: Kelsey Kowalczyk Fee: $95 Room: D408

* Also offered in Session II

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SESSION I: June 17 – June 21 Page 3 #006-1 CREATE & INVENT WITH LITTLEBITS

Grades: 3-7

SESSION I – 9:00 AM TO 12:00 PM

Invent and code your own projects using LittleBits electronic bricks. This session

combines circuit building, creativity and coding to "make things that do things."

What if you wanted to create and code your own inventions without having to use the

traditional Arduino, breadboard and jumper wire setup? That’s where the Arduino

Coding Kit comes in and is a perfect fit. This session will allow you to explore the

Arduino bit, LittleBits and other accessories that will allow you to code your own

interactive hardware projects.

Ready to incorporate a carrot, your sunglasses, or great-grandma into your LittleBits

creations? The Makey Makey Bit turns everyday conductive objects (like bananas) into triggers that control your

circuit and even your computer.

Instructor: Abby Kuwik Fee: $85 Room: D414

#007-1 KIDS COOKING: WORLD CUISINE

Grades: 4-7

SESSION I – 9:00 AM TO 12:00 PM

Come travel the world through food! Students will

have hands-on experience preparing and tasting dishes

from American, French, Asian, Italian, and Mexican

cultures. One day will be spent on each culture. In

addition to the food preparation, students will learn

about meal-time traditions that surround each dish,

which are specific to the dish’s region of the world.

Instructor: Rebecca Schratz Fee: $90

Room: C308

#008-1 SUMMER THEATER

Grades: 4-7

THIS IS A TWO WEEK COURSE:9:00 AM -12:00 PM

JUNE 18-JUNE 22 and JUNE 25-29

Come and join our summer theater program! Students

will explore the fundamentals of acting concepts and

techniques through a combination of exercises in

improvisation, acting, vocals, dance, auditioning, and

musical theater. Students will also be taught “behind the

stage” developing costumes, scenery, and the technical

side of theater. Camp will culminate on Friday, June 28,

at 10:30 with a performance of a musical.

Instructors: Greg Shumaker, Melissa Survinski &

Matthew Derby

Fee: $185 Room: Auditorium

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SESSION I: June 17 – June 21 Page 4 #009-1 ROBOTS IN MOTION

Grades: 4-7

SESSION I – 9:00 AM TO 12:00 PM

Discover the world of

robots exploring the Hummingbird

and Finch robots! Using the Finch

Robot you will learn to program a

robot to move with lights and

music, traverse through a maze, and much more! You

will also craft and code your very own robotic creation

using the Hummingbird Robotics Kit, programming

tools, and imagination. The robots aren’t the only ones

who will have an amazing time!

Instructor: Joe Cangilla Fee: $85

Room: C311

#010-1 CHINESE LANGUAGE AND CULTURE

Grades: 6-8

SESSION I – 9:00 AM TO 12:00 PM

This course is designed for students

who have a desire to explore Chinese

language and culture. Each day, the

class will start with a simple Chinese

language lesson: greetings, counting

numbers, stating your name and age,

etc. followed by an outdoor Chinese game such as bean

bag toss, shuttlecock or Chinese yo-yo. Students will

then return indoors for an artistic activity such as

origami, paper cutting, Chinese storytelling or Chinese

music where they will learn, among other songs, how to

sing “Happy Birthday” in Mandarin Chinese. They will also

be taught to use chopsticks and play traditional indoor

games such as Chinese Checkers and /or Chinese Chess.

Instructor: Jun Gee Fee: $85

Room: D416

#011-1 INTRODUCTION TO ROBOTICS

Grades: 7-9

SESSION I – 9:00 AM TO 12:00 PM

Explore the cool world of

Robotics. You will be working

with the VEX Clawbot Robot and

the RobotC programming

language. You will learn how to

set-up the robot’s motors and

sensors. You will learn how to program the robot to

move forward and backwards, make turns, open and

close the claw and to lift the claw arm. And with the

aid of some sensors, you will be able to program your

robot to navigate through many obstacle courses.

Instructor: Joe Afflerbach Fee: $85

Room: D415

#012-1 READING & WRITING SAT PREP

Grades: 9-11

SESSION I – 9:00 AM TO 12:00 PM

Feeling anxious about the SAT test? Calm your fears

with preparation! In the Reading and Writing SAT Prep

summer course, we will review concepts found on the

SAT’s including vocabulary, passage comprehension,

sentence structure, grammar, usage, and composition. We

will also cover test taking strategies for multiple choice

questions and timed writing assignments.

The course will follow The Official Redesigned SAT

Study Guide, which can also be used in the Math SAT

Prep course.

A textbook is required for this course: please bring it

to the first class

The Official SAT Study Guide 2018 edition

ISBN-13:978-1457309281

ISBN-10: 1457309289

Instructor: Mary Davis

Fee: $80

Room: C309

Page 15:  · you have any questions, please call 412-492-6000 (Ext. 5023) or email kinney@ht-sd.org PLEASE RETURN THIS FORM TO YOUR SCHOOL COUNSELOR ON OR BEFORE FRIDAY, April 12, 2019 I will

SESSION II: June 24 – June 28 Page 5

#001-2 SUMMER INTRAMURALS

Grades: K-5

SESSION II – 9:00 AM TO 12:00 PM*

Summer Intramurals will offer a variety

of games and activities with peers of

similar ages in a safe and secure

environment. The focus of the program

will be on teamwork, cooperation, movement, fitness,

and fun. Outdoor and indoor games will take place

based upon grade level in a semi-competitive

environment.

Instructors: Matthew LaPorte, Jonathan Floss

Room: Auxiliary Gym Fee: $80

*Also offered in Session I

#013-2 KITCHEN BREAK-OUT

Grades: K-3

SESSION II – 9:00 AM TO 12:00 PM

Come together with your

peers to make the best

tasting and healthiest dishes.

Students will work with their

kitchen groups to create

dishes that include a healthy mix of proteins, veggies,

fruit, and whole grains (as well as a few dessert recipes!).

As a culminating activity, the students will cook a full

“buffet” meal with the whole class!

Instructor: Rebecca Schratz Fee: $90

Room: C308

#014-2 BEGINNING COLOR GUARD

Grades: 3-5

SESSION II – 9:00 AM TO 12:00 PM

Do you love to dance? Please join us as we learn the basics of Color Guard. Color Guard combines

dance and spinning flags into an exciting and entertaining art form. Super fun! The class will end with

a special performance for parents, family and friends.

Instructor: Lurrene Parker Fee: $80 Room: B212

#015-2 CHINESE LANGUAGE AND CULTURE

Grades: 3-5

SESSION II – 9:00 AM TO 12:00 PM

This course is designed for

students who have a desire to

explore Chinese language and

culture. Each day, the class will

start with a simple Chinese

language lesson: greetings,

counting numbers, stating your

name and age, etc. followed by an outdoor Chinese game

such as bean bag toss, shuttlecock or Chinese yo-yo.

Students will then return indoors for an artistic

activity such as origami, paper cutting, Chinese

storytelling or Chinese music where they will learn,

among other songs, how to sing “Happy Birthday” in

Mandarin Chinese. They will also be taught to use

chopsticks and play traditional indoor games such as

Chinese Checkers and /or Chinese Chess.

Instructor: Jun Gee Fee: $85

Room: D416

#016-2 INTERMEDIATE CHESS

Grades: 2-6

SESSION II - 9:00 AM TO 12:00 PM

Does your child want to improve their chess skills? This

intermediate class is for students who already know how

to play chess. Skills such as open/end game, competitive

strategies, and fun game will be taught. Your child will

form a chess plan to implement during class. On the last

day a mini-chess tournament will be held.

Instructor: Erin Prosser Fee: $85

Room: D414

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SESSION II: June 24 – June 28 Page 6

#004-2 PROGRAMMING FUN!

Grades: 3-6

SESSION II – 9:00 AM TO 12:00 PM*

Do you love to play video games? In this camp, you will learn the basics of computer

programming using Hopscotch, Tynker, and Cargo-Bot to create your very own unique

games and animations! After learning how to create them, how about using your reading, writing, and math skills to

create amazing and unique worlds in Minecraft?

Instructor: John Lee Fee: $85 Room: D409 *Also offered in Session I

#005-2 BABYSITTING

Grades: 3-7

SESSION II - 9:00 AM TO 12:00 PM*

Successful babysitting experiences

require the caregiver to provide a fun

and safe environment. This course

provides future babysitters the

opportunity to learn about safety,

proper nutrition and behavior management. In addition,

students will create games and activities, as well as

materials for advertising. By the end of the week,

students will have had the opportunity to become CPR

CERTIFIED. All participants will receive a certificate of

completion.

Instructor: Kelsey Kowalczyk Fee: $95

Room: D408 *Also offered in Session I

#017-2 EXPLORING MICRO:BIT

Grades: 3-8

SESSION II – 9:00 AM TO 12:00 PM

Did you know that you can code your BBC Micro:bit using

Blocks, JavaScript, and Python? Use a mini-computer to

create fun projects in our Exploring Micro:bit summer

session. Students will become familiar with

programming concepts and electronics components, while

building practical, hands-on

electronics projects using the

micro:bit. The micro:bit has all

the features you need to code

awesome stuff - the

possibilities are endless!

Instructor: Kelsey Newcamp Fee: $85

Room: D415

#018-2 LEARN TO CODE WITH ”COZMO” & “CUE”

Grades: 4-7

SESSION II – 9:00 AM TO 12:00 PM

Cue is a witty, entertaining robot

with four hero avatars & enhanced

AI that takes personality,

interactive communication, and

programming to a new level.

Students will explore MakeCode

plus other programming languages.

Cozmo is so much fun, but that's just the beginning. His

abilities and skills develop the more you play with him.

With Code Lab, there are no limits to what you can

create with Cosmo. All it takes is imagination. Explore

the world of Robots with us!

Instructor: Abby Kuwik Fee: $85

Room: C311

#019-2 MATH SAT PREP

Grades: 9-11

SESSION II – 9:00 AM TO 12:00 PM

This quick SAT Preparation course for the SAT Math

will provide a review to further develop mathematical

skills including numbers and operations, algebra,

geometry, measurement, data analysis, and probability.

All of these subjects are eligible content for the SAT.

The students will learn test-taking strategies geared to

both multiple choice problems and open-ended questions.

Students will practice these skills by

interacting in activities on the Smart

Board and by taking multiple practice

tests. The course will follow The

Official Redesigned SAT Study Guide, which can also be

used in the Reading and Writing SAT Prep course.

A textbook is required for this course: please bring

it to the first class

The Official SAT Study Guide 2018 edition

ISBN-13:978-1457309281, ISBN-10: 1457309289

Instructor: Amy Leya Fee: $80

Room: C309

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CAMP INVENTION (Elementary): July 15 – July 19 Page 7

Page 7

SPOTS AVAILABLE ON A – FIRST COME FIRST SERVED BASIS

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HTSD Summer Program 2019 Registration Forms

DATES AND TIMES OF PROGRAM: SESSION I: JUNE 17 - JUNE 21 9:00 AM to 12:00 PM HMS

SESSION II: JUNE 24 – JUNE 28 9:00 AM to 12:00 PM HMS

CAMP INVENTION: JULY 15 – JULY 19 8:30 AM to 3:00 PM WYLAND

Please complete and cut out one registration block per class for each child you wish to enroll.

Name: ______________________________

Address: ____________________________

____________________________

e-mail: _____________________________

Phone(s): ____________________________

School: ____________________ (M/F)____

Current Grade: __________ Age: _________

Course Name _________________________

Course # ______ Session #_____ Fee:_____

Name: ______________________________

Address: ____________________________

____________________________

e-mail: _____________________________

Phone(s): ____________________________

School: ____________________ (M/F)____

Current Grade: __________ Age: _________

Course Name _________________________

Course # ______ Session #_____ Fee:_____

OFFICE USE ONLY: Do not write below OFFICE USE ONLY: Do not write below

Name: ______________________________

Address: ____________________________

____________________________

e-mail: _____________________________

Phone(s): ____________________________

School: ____________________ (M/F)____

Current Grade: __________ Age: _________

Course Name _________________________

Course # ______ Session #_____ Fee:_____

Name: ______________________________

Address: ____________________________

____________________________

e-mail: _____________________________

Phone(s): ____________________________

School: ____________________ (M/F)____

Current Grade: __________ Age: _________

Course Name _________________________

Course # ______ Session #_____ Fee:_____

OFFICE USE ONLY: Do not write below OFFICE USE ONLY: Do not write below

Name: ______________________________

Address: ____________________________

____________________________

e-mail: _____________________________

Phone(s): ____________________________

School: ____________________ (M/F)____

Current Grade: __________ Age: _________

Course Name _________________________

Course # ______ Session #_____ Fee:_____

Name: ______________________________

Address: ____________________________

____________________________

e-mail: _____________________________

Phone(s): ____________________________

School: ____________________ (M/F)____

Current Grade: __________ Age: _________

Course Name _________________________

Course # ______ Session #_____ Fee:_____

OFFICE USE ONLY: Do not write below OFFICE USE ONLY: Do not write below

SEND: (ALL 3 ARE REQUIRED)

❑ Payment(Check or Money Order) made payable to: HTSD

❑ Completed Registration Blocks

❑ Completed Health Form (s)

TO: HTSD SUMMER PROGRAM

WYLAND ELEMENTARY SCHOOL

2284 Wyland Ave

ALLISON PARK, PA 15101

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HTSD SUMMER PROGRAM HEALTH FORM

JUNE / JULY 2019 EMERGENCY CONTACT INFORMATION FOR SUDDEN ILLNESS OR INJURY

STUDENT NAME _____________________________________ DATE OF BIRTH _______________ LAST FIRST M.I.

ADDRESS_______________________________ZIP____________HOME PHONE_______________

EMAIL ADDRESS: ________________________________

PLEASE INDICATE CONTACT ORDER (1ST, 2ND, 3RD, 4TH)

● FATHER’S NAME_________________________________________HOME PHONE_______________

WORK PHONE________________________ CELLULAR PHONE__________________________

● MOTHER’S NAME_________________________________________HOME PHONE______________

WORK PHONE________________________ CELLULAR PHONE__________________________

● CONTACT NAME__________________________ RELATIONSHIP___________________________

HOME PHONE____________________________ WORK PHONE_____________________________

● CONTACT NAME__________________________ RELATIONSHIP___________________________

HOME PHONE____________________________ WORK PHONE_____________________________

● FAMILY/PRIMARY CARE PHYSICIAN__________________________ PHONE___________________

HOSPITAL PREFERENCE ____________________________________________________________

● DENTIST_____________________________________________ PHONE_____________________

PLEASE LIST ANY MEDICAL CONDITIONS (i.e. diabetes, epilepsy, asthma, allergies, etc.)

________________________________________________________________________________

PLEASE LIST ALL MEDICATIONS THAT STUDENT TAKES:

________________________________________________________________________________

I UNDERSTAND AND AGREE THAT ANY MEDICAL INFORMATION MAY BE SHARED WITH APPROPRIATE SCHOOL AND MEDICAL

PERSONNEL.

PARENT OR GUARDIAN’S SIGNATURE _________________________________________________

PLEASE COMPLETE A HEALTH FORM FOR EACH CHILD ATTENDING THE HTSD SUMMER PROGRAM

*For an extra copy of this form, please visit our website www.ht-sd.org.

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BEFORE AND AFTERSCHOOL ENRICHMENTat HAMPTON MIDDLE & POFF ELEMENTARY SCHOOLS

As the largest provider of school-age programs in the Greater Pittsburgh area, we help thousands of children every day reach their fullest potential in a welcoming, supportive environment. By incorporating the values of caring, honesty, respect and responsibility into all of our youth programs, we give children the solid foundation they need to thrive.

THEIR FAVORITE PLACE AFTER SCHOOL

BASEYMCA of GREATER PITTSBURGH

Learn more about Before and After School Care at the Y by visiting us today at ymcapgh.org/programs

Registration will open online at

9:00am onMarch 4, 2019.

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Hampton Middle School4589 School Dr.Allison Park, PA 15101

Before and After School Care serving children from Central, Poff and Wyland Elementary Schools.

Poff Elementary School2990 Haberlein Rd. Gibsonia, PA 15044

Kindergarten Wrap serving children from Central, Poff and Wyland Elementary Schools.

K - 6

Before School Care 6:45-8:00amAfter School Care 3:00-6:00pmKindergarten Wrap- 8:30am-12:45pm

PROGRAM LOCATIONS

GRADES SERVED

TIMES OFFERED

YMCA PROGRAM MEMBER RATESProgram Individual – $70/YearProgram Family – $110/Year

Purchase your membership today by visiting us at pittsburghymca.org

YMCA MEMBERSHIP RATESAssociation Family $111/Month

REGISTRATION INFORMATION

Before School Care at Hampton Middle SchoolAfter School Care at Hampton Middle School

1-3 Days Weekly 4-5 Days Weekly

Program Offerings

For a better us.

Register today for BASE by visiting us at pittsburghymca.org

PROGRAM INFORMATION

NOT A Y MEMBER?A Y membership allows you to connect to your community with access to healthy living programs for the spirit, mind, and body. Receive exclusive rates on YMCA Before and After School Enrichment, aquatics, and more. For information regarding financial assistance please contact the Youth Development Business Office at 412 573 4166.

If you participate in ELRC or other third party funding please contact the Youth Development Business Office for registration.

BAIERL FAMILY YMCA

YMCA of GREATER PITTSBURGH

At the Y, we believe the values and skills learned early on are vital building blocks for quality of life and future success. That’s why our before and after-school programs are staffed with people who understand the cognitive, physical and social development of kids, the need children have to feel connected and supported in trying new things and the caring and reinforcement parents and families need to help each other. At the Y, school-age kids make friends, play and have fun, learn new skills and get help with their homework. Most importantly, they learn how to be their best selves. That makes for confident kids today, and contributing and engaged adults tomorrow.

Facility Member

Program Member

Facility Member

Program Member

$110 $124

$267 $298

$141 $158

$341 $380

Kindergarten Wrap at Poff Elementary School $420 $465

EXPLORING EDUCATIONAL EXPERIENCES

NA NA

Youth Development Business Office7140 Bennett St.Pittsburgh, PA 15208412 573 4166

All rates shown are monthly.

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BAKING & BAKEWARE HoRneAdo y pRoductos para horNEar• Annie’s® Baking Mixes• Fiber One™ Mixes • Reynolds Kitchens® Parchment Paper• Reynolds® Bakeware Pans• Reynolds Kitchens® Oven Bags • Reynolds Kitchens® Slow Cooker Liners• Reynolds® StayBrite® Baking Cups

cereAl cereAlEs• Annie’s® • Apple Cinnamon Toast Crunch™ • Batman™ Chocolate Strawberry • Basic 4™ • Blueberry Toast Crunch™ • Cascadian Farm™• Cascadian Farm™ Farm Stand Harvest Granola • Cheerios™ • Chex™ • Cinnamon Toast Crunch™• Cinnamon Toast Crunch™ Blasted Shreds™• Cocoa Puffs™• Cookie Crisp™• Fiber One™• French Toast Crunch™• Golden Grahams™ • Kix™ • Lucky Charms™ • Lucky Charms™ Frosted Flakes• Nature Valley™ Granola• Nature Valley™ Oat Cereals • Oatmeal Crisp™• Peanut Butter Chocolate Blasted Shreds™ • Raisin Nut Bran • Reese’s Puffs® • Strawberry Toast Crunch™ • Total™• Trix™• Wheaties™

food stoRAgE coNtenedores para AlImENtos• Ziploc® brand Big Bags XL (4 ct.)• Ziploc® brand Freezer Bags• Ziploc® brand Smart Snap Containers• Ziploc® brand Storage Bags• Ziploc® brand Twist ‘n Loc® Containers• Ziploc® brand VersaGlass® Containers• Ziploc® brand Vacuum Freezer System• Ziploc® brand Zip ‘n Steam™ Bags

fRozEN congElAdos• Annie’s® Frozen Snacks • Cinnamon Toast Crunch™ Bites• Pillsbury™ Toaster Scrambles • Totino’s™ Party Pizza®

Household clEaning

lImpiEzA del hoGar• Finish® Dishwashing Detergent • Lysol® Bathroom Cleaners • Lysol® Disinfectant Spray & Wipes

mEals & sides comidas y GuARnicioNEs• Annie’s® Mac & Cheese • Annie’s® Microwaveable Mac & Cheese Cups • Annie’s® Soups • Betty Crocker™ Specialty Potatoes & Potato Buds • Betty Crocker™ Suddenly Salad • Hamburger Helper™• Old El Paso™ Bold Stand n’ Stuff Shells • Old El Paso™ Dinner Kits • Old El Paso™ Rice & Beans • Old El Paso™ Shells & Seasonings• Old El Paso™ Soft Tortilla Taco Boats• Old El Paso™ Stand n’ Stuff Shells

paper pRoducts pRoductos de papel• Select Kleenex® Tissue bundles• Scott® Bath Tissue • Scott ® Paper Towels • Scott Naturals™ Flushable Cleansing Cloths

Produce Frutas y verduRAs• Green Giant™ Fresh Herbs• Green Giant™ Fresh Vegetables

refRIgERAtEd & daIRy refRIgERAdos y láctEos• Annie’s® Refrigerated Dough • Annie’s® Yogurt Tubes • Go-Gurt® Multipacks • Yoplait® Original and Yoplait® Light Fridge Packs

scHool & oFfice supPliEs ARtículos para EscuElA y oFIcina• Boise POLARIS® Premium Paper• Boise® FIREWORX® Premium Colored Paper• Paper Mate® Clearpoint® Mechanical Pencils• Paper Mate® Flair® Felt Tip Pens• Paper Mate® InkJoy® Ballpoint Pens• Paper Mate® InkJoy® Gel Retractable and Stick Pens• Paper Mate® Liquid Paper®• Paper Mate® Mirado® WoodcasePencils• Paper Mate® Paper Mate® Handwriting• Paper Mate® PinkPearl® and White Pearl® Erasers• Paper Mate® Profile® Ballpoint Pens• Paper Mate® SharpWriter® Mechanical Pencils• Paper Mate® Write Bros.® Pens• Paper Mate® WriteBros.® Mechanical Pencils

snacKs bocadillos • Annie’s® Cookies• Annie’s® Crackers• Annie’s® Crispy Snack Bars • Annie’s® Fruit Snacks• Annie’s® Granola Bars• Annie’s® Organic Popcorn • Annie’s® Organic Puffs • Annie’s® Snack Mix• Annie’s® Toaster Pastries • Betty Crocker™ Fruit Flavored Snacks• Bugles™• Cascadian Farm™ Granola Bars• Cereal Treat Bars• Chex Mix™ • Fiber One™ Bars, Brownies, Cookies, and Streusel• Fiber One™ Cookie & Brownie Bites• Food Should Taste Good™ Snacks• Gardetto’s™ Snacks• LÄRABAR™ Kid• LÄRABAR™ (multipacks)• LÄRABAR™ RENOLA Grain Free Granola• Mott’s® Medleys Fruit Flavored Snacks• Nature Valley™ Backpacker Chewy Oatmeal Bites • Nature Valley™ Baked Oat Bites• Nature Valley™ Bars• Nature Valley™ Clusters• Nature Valley™ Granola Bites• Nature Valley™ Granola Cups• Nature Valley™ Layered Granola Nut Bars• Nature Valley™ Protein Soft-Baked Granola Bites• Nature Valley™ Soft-Baked Filled Squares • Nature Valley™ XL Sweet & Salty Bars

tablEWARE mANteleríA• Hefty® Deluxe™ Plates and Platters• Hefty® Party Cups• Hefty® Everyday™ Bowls• Hefty® Everyday™ Cups• Hefty® Everyday™ Plates• Hefty® Printed Cups• Hefty® Style Plates• Kleenex® Dinner Napkins (50 ct.)

wastE baGs Bolsas de basura

• Hefty® Compostable Trash Bags• Hefty® Contractor Trash Bags• Hefty® Recycling Trash Bags• Hefty® Renew® Recycled Content Bags• Hefty® Small & Medium Trash Bags• Hefty® Steel Sak• Hefty® Strong Large Trash Bags• Hefty® Strong Tall Kitchen Trash Bags• Hefty® Ultra Strong Blackout Tall Kitchen Bags with Arm & Hammer™• Hefty® Ultra Strong Tall Kitchen Bags with Arm & Hammer™• Hefty® Ultra Strong™ Multipurpose Trash Bags

Participation in the Box Tops for Education program may vary among individual products and package sizes. © General Mills

CLIPPING IS EASY! Find Box Tops on hundreds of products you know and loveREcoRta BoX toPs ¡Y REcAuda dINERo PARA tu escuela!TM

It’s easy to find Box Tops. In fact, you may have some in your home right now. Clip Box Tops from your favorite products and turn them in to your child’s school today! Box Tops are each worth 10¢ and they add up fast!Encontrar Box Tops es fácil. De hecho, tal vez tengas algunos en tu casa en este momento. Recorta Box Tops de cientos de tus productos favoritos. Cada cupón de Box Tops tiene un valor de 10¢ para tu escuela ¡y esas cantidades se suman rápido!

All Boise trademarks are owned by Boise Paper Holdings, L.L.C., or its affiliates. The trademark BOISE is owned by Boise Cascade, L.L.C., or its affiliates. Ziploc® is a registered trademark of S.C. Johnson and Son, Inc. All rights reserved. Kleenex®, Scott®, and Cottonelle® are the registered trademarks of Kimberly-Clark Worldwide, Inc. Hefty®, Easy Grip®, Elegantware®, ZooPals®, The Gripper®, Cinch Sak®, Renew®, OdorBlock®, Ultra Flex®, EasyFlaps®, BlackOut®, Kitchen Fresh® Basics®, Elegantware®, EZ Foil®, Supreme™, Superweight™, and Hearty Meals™ are registered trademarks of Reynolds Consumer Products Inc. Avery®, Hi-Liter® and Marks-A-Lot® are registered trademarks of Avery Dennison Corporation. LAND O LAKES, ALPINE LACE, FRESH BUTTERY TASTE, and SNACK’N CHEESE TO-GO! are registered trademarks of Land O’Lakes, Inc. Yoplait and GOGURT are registered trademarks of YOPLAIT MARQUES (France) used under license. MOTT’S and MOTT’S HEALTHY HARVEST are registered trademarks of Mott’s LLP. The HERSHEY’S® trademark and trade dress are used under license.

Earn Bonus Box Tops while you shop with the

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