Meyerholz-CLIP After School Enrichment Program (ASEP) 2011-2012 Application

Registration Closed

Please complete and submit this form between 5/24/2011-6/2/2011. You are not guaranteed to get into all the classes that you signed up for. You will make separate check for each ASEP class. You will be notified by email with a confirmation when you submit the form electronically and later with updates. These classes are open to all Meyerholz students and the CLIP middle school students. Click here to see class descriptions and here to see FAQ

Please make checks payable to: CLIPCO. check memo:Child name,grade (2011-2012), asep class. Please drop off the checks in the ASEP box in the office before 6/2/2011 3:00pm
Please date check 8/1/2011


Note: This is not a fundraising activity for CLIPCO. Class fees are use for intructors cost, class equipments, class materials and any ASEP related activities.

* Required

Child's Last Name * Child's First Name *
Grade (2011-2012)*
Parents'/Guardians' Last Name * Parents'/Guardians' First Name *
Email (for confirmation)* Type Email Again *
Cell Phone Number *
Emergency Contact Person Emergency Contact Number
Child's T-Shirt Size * Child's Pant Size *
Shoe Size (Requred for Wushu and Lion Dance) Yes

    Option Description Grade Date Time Place
    Length
    Cost
    		 Check #

    • Chinese Game - Go (SQ2012) (English-speaking)
    2/27,3/5,3/12,3/26,4/2,4/9,4/23,4/30,5/7,5/14,5/21
    3rd and up
    Monday
    		 3:10-4:10pm Rm20
    1 hr
    $60

    • Chinese Dance I
    Fall: 8/30,9/6,9/13,9/20,9/27,10/4,10/18,10/25,11/1,11/8,11/15,11/29,12/6
    Spring: 2/28,3/6,3/13,3/20,3/27,4/3,4/10,4/23,4/30,5/1,5/8,5/15,5/22,5/29
    1st and up
    Tuesday
    		 3:20-4:20pm Rm19
    1 hr
    $210

    • Chinese Dance II
    Fall: 8/30,9/6,9/13,9/20,9/27,10/4,10/18,10/25,11/1,11/8,11/15,11/29,12/6
    Spring: 2/28,3/6,3/13,3/20,3/27,4/3,4/10,4/23,4/30,5/1,5/8,5/15,5/22,5/29
    Adv, 2yrs ASEP
    Tuesday
    		 2:15-3:15pm Rm19
    1 hr
    $210

    • Dance I for Boys (SQ2012)
    2/28, 3/6,3/13,3/20,3/27,4/3,4/10,4/23,4/30,5/1,5/8,5/15,5/22,5/29
    1st and up
    Tuesday
    		 3:20-4:20pm Rm19
    1 hr
    $80

    • Dance II for Boys (SQ2012)
    2/28, 3/6,3/13,3/20,3/27,4/3,4/10,4/23,4/30,5/1,5/8,5/15,5/22,5/29
    Adv, 2 yrs ASEP
    Tuesday
    		 2:15-3:15pm Rm19
    1 hr
    $80

    • Chinese Penmanship & Calligraphy I (FQ2011)
    8/29,9/12,9/19,9/26,10/3,10/17,10/24,11/7,11/14,11/28,12/5
    3rd and up
    Monday
    		 2:40-3:40pm Rm20
    1 hr
    $80

    • Chinese Penmanship & Calligraphy II (FQ2011)
    8/29,9/12,9/19,9/26,10/3,10/17,10/24,11/7,11/14,11/28,12/5
    4th and up
    Monday
    		 3:10-4:10pm Rm20
    1 hr
    $80

    • Lion Dance I (English-speaking)
    Fall: 8/26,9/2,9/9,9/16,9/30,10/7,10/28,11/4,11/18,12/2
    Spring: 3/2,3/9,3/16,3/23,3/30,4/13,4/27,5/4,5/11,5/18,6/1
    1st and up
    Friday
    		 3:05-3:50pm GLC
    45 min
    $160

    • Lion Dance II (English-speaking)
    Fall: 8/26,9/2,9/9,9/16,9/30,10/7,10/28,11/4,11/18,12/2
    Spring: 3/2,3/9,3/16,3/23,3/30,4/13,4/27,5/4,5/11,5/18,6/1
    Adv, 1 yr ASEP
    Friday
    		 3:25-4:15pm GLC
    50 min
    $160

    • Percussion (English-speaking)
    Fall: 8/26,9/2,9/9,9/16,9/30,10/7,10/28,11/4,11/18,12/2
    Spring: 3/2,3/9,3/16,3/23,3/30,4/13,4/27,5/4,5/11,5/18,6/1
    1st and up
    Friday
    		 4:15-5:15pm GLC
    1 hr
    $160

    • Wushu I (English-speaking)
    Fall: 8/26,9/2,9/9,9/16,9/30,10/7,10/28,11/4,11/18,12/2
    Spring: 3/2,3/9,3/16,3/23,3/30,4/13,4/27,5/4,5/11,5/18,6/1
    K
    Friday
    		 2:40-3:20pm Rm19
    40 min
    $160

    • Wushu II (English-speaking)
    Fall: 8/26,9/2,9/9,9/16,9/30,10/7,10/28,11/4,11/18,12/2
    Spring: 3/2,3/9,3/16,3/23,3/30,4/13,4/27,5/4,5/11,5/18,6/1
    1st and up
    Friday
    		 3:20-4:10pm Rm19
    50 min
    $160

    • Chinese Brushpainting 310 (English-speaking)
    8/26,9/2,9/9,9/16,9/30,10/7,10/28,11/4,11/18,12/2
    2nd and up
    Friday
    		 3:10-4:10pm Rm20
    1 hr
    $80

    • Chinese Brushpainting 415
    8/26,9/2,9/9,9/16,9/30,10/7,10/28,11/4,11/18,12/2
    2nd and up
    Friday
    		 4:15-5:15pm Rm20
    1 hr
    $80

    • Chinese Flute I
    Fall: 8/26,9/2,9/9,9/16,9/30,10/7,10/28,11/4,11/18,12/2
    Spring: 3/2,3/9,3/16,3/23,3/30,4/13,4/27,5/4,5/11,5/18,6/1
    3rd and up
    Friday
    		 4:15-5:15pm Rm20
    1 hr
    $160

    • Chinese Flute II
    Fall: 8/26,9/2,9/9,9/16,9/30,10/7,10/28,11/4,11/18,12/2
    Spring: 3/2,3/9,3/16,3/23,3/30,4/13,4/27,5/4,5/11,5/18,6/1

    3rd and up

    1 yr ASEP Flute
    Friday
    		 4:15-5:15pm Rm19
    1 hr
    $160

FQ2012 -Fall session only ; SQ2012- Spring session only ; If not specified, the class fee includes both Fall and Spring sessions

* Dance - 2a combine with 3a; 2b combine with 3b.
* Performing Arts Classes require students to attend 12/07/2011 (all except class 1, 3a, 3b), 5/23/2012 (all except class 1, 4a, 4b, 8a, 8b) and 6/1/2012 (all except class 1, 4a, 4b, 8a, 8b) performances.


*10/6~10/14 : Parent Teacher Conferences days. No ASEP classes
*4/6/2012: Spring family picnic/bookfair, No ASEP classes


Comments

Electronic Signature Agreement: Click on following agreements to see details: Waiver Agreement Rules and Policy


By selecting the "I Accept the agreements" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting "I Accept" you consent to be legally bound by this terms and conditions. By selecting "I Accept" I HEREBY CERTIFY that I am the parent and/or legal guardian of the participant listed above, and I agree to the terms of this ASEP (After School Enrichment Program) Consent, Waiver and Release of Liability and Photo and video release and I have read the “Meyerholz/CLIP After School Enrichment Program Policies for Students” and the “General Information and Class Rules” and agree to follow the rules for my child’s participation. I also understand that if the rules are not followed, my child may be dropped from the class and refunds will not be honored. I agree to paid class fee specified above for each class that my child is accepted. POSITIVELY NO REFUNDS . PLEASE DON'T ASK.


I accept the agreements


The After School Enrichment Program classes are established and administered by CLIP parent volunteers. Thank you for your understanding and cooperation. Questions regarding ASEP programs can be directed to asep@googlegroups.com