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Instructions

Complete a separate student registration application for each student you wish to enroll. Please note that the completion of this form does not guarantee your student will be enrolled into the program; students are admitted to After-School All-Stars on a first-come, first-served basis. 

What is After-School All-Stars?

After-School All-Stars Las Vegas (ASAS) provides a free, comprehensive after-school program at Herr Elementary School. Our mission is to keep children safe and help them achieve in school and in life. Our program gives students a chance to complete their homework and receive tutoring, and also to have fun and learn new skills. You can learn more at www.asaslv.org.

Herr Elementary School Program Dates and Times

Session 1: August 21, 2023 - December 14, 2023

The program runs Mondays - Thursdays. There is no program on Fridays. The program does not run on holidays or days when the school is closed.

Segment of Program	Time	What It Is
Snack	2:15 pm - 2:30 pm	Students receive a snack
Academic Hour	2:30 pm - 3:30 pm	Complete homework and receive tutoring in math and reading
Enrichment Hour	3:30 pm - 4:30 pm	Classes like sports, art, and life skills that help students build new skills and have fun
Dismissal	4:30 pm	Students are picked up from the program.

Expectations

• Attendance: Our program is designed so that students come to each day of program. ASAS is not a drop-in program. It is required that students attend their academic class to be allowed in their enrichment class. Students who have more than three unexcused absences per session, will be in jeopardy of losing their space within the program. If your student is absent from the program, please provide a signed note detailing the reason of the absence upon their return.

• Early Pick-Up:  ASAS participants are required to attend the full program (snack, academic hour, enrichment hour) daily. Early pick-ups disrupt class time and learning. Student pick-up/dismissal time is designated at each site and must be adhered to. Any pick-up prior to the designated pick-up/dismissal time is considered an early pick-up. All early pick-ups will be documented. Students who have more than three early pick-ups per session will be in jeopardy of losing their space within the program.

• Late Pick-Up: ASAS staff are only available until the end of the program. Therefore, all students must be picked up by the designated time. Any student who is picked up after the designated pick-up/dismissal time is considered a late pick-up. All late pick-ups will be documented. Students who have more than two late pick-ups per session will be in jeopardy of losing their space within the program. 

  We understand emergencies occur that cannot be avoided, which is why we allow three unexcused absences, three early pick-ups and two late pick-ups per session before your student is in jeopardy of losing their space in the program. We appreciate your cooperation with these policies. Please contact your ASAS Site Leaders if you have any questions.

• Behavior: We adhere to the same behavior standards as the CCSD school day during after-school programming. Site Leaders will work with students to address negative behaviors, including bullying, and find a solution. Parents/guardians will be notified about unacceptable student behavior. Students may be dropped from the program if the behavior continues; students will be immediately dropped from the program if they willfully injure, or threaten to injure, another student and/or staff member.

• Field Trips: We offer fun and exciting field trips at all of our schools each year. Your student will share a permission slip if their class has been selected to attend a field trip. The permission slip must be turned in by the deadline for your student to attend.

• Dismissal: On the registration form, select how your student is allowed to get home each day. If selecting adult sign-out, please plan on arriving to pick up your student at dismissal time.

Academic Hour

Monday - Thursday | 2:30 pm - 3:30 pm

Academic classes provide support for math and reading. Students will be placed into Academic Hour classes based on grade level. 

Enrichment Hour

Monday - Thursday | 3:30 pm - 4:30 pm

Classes Available: 

1. Arts and Crafts 
2. Life Skills  
3. Performance Arts 
4. Sports and Physical Activities 
5. STEM

Please select your top 1st, 2nd, and 3rd choices for the Enrichment Hour for Monday - Thursday

Your student will be placed in one of their top 3 choices chosen below. Please select a different class for each choice. 

Space in the After-School All-Stars Program is limited. Once program reaches capacity, students will be placed on a waitlist. 

Classes are filled on a first come, first served basis. Please remember to complete the entire form to complete the registration process.

By signing below, you are giving your child permission to enroll and participate in the 2023-2024 After-School All-Stars Las Vegas program at Herr Elementary School.

Student Name: {studentName}

Parent/Guardian Name: {parentguardianName}

I hereby consent to participation in interviews, the use of quotes, and the taking of photographs or videos of the child named below by After-School All-Stars Las Vegas. I also grant After-School All-Stars Las Vegas the right to edit, use, and re-use said products for non-profit purposes including use in print, on our website and social media pages, and all other forms of media. I also hereby release After-School All-Stars Las Vegas from all claims, demands, and liabilities whatsoever in connection with the above. I understand that the information I provide may be edited and shared both immediately and in the future with ASAS’s audience on websites, videos, and on other public online forums (email, social networking sites, newsletters, etc.). I understand that only my child’s first name, never their last name, will be used in any such publications.

Student Name: {studentName}

Parent/Guardian Name: {parentguardianName}

I, the undersigned parent/guardian, hereby express my desire and approval for participation of my child in After-School All-Stars Las Vegas’ program, and acknowledge that such participation may include, without limitation, travel, participation in physical activities, and the use of equipment and supplies as applicable.

I further acknowledge that participation in the program is entirely at my risk and the risk of my child. I understand that participation in the After-School All-Stars Las Vegas program activities is voluntary and requires an acceptance of risk. With my signature, I hereby agree to release and hold harmless After-School All-Stars Las Vegas, its sites, employees, affiliates, agents, volunteers, sponsors, any equipment manufacturers and distributors, and all other persons and entities associated with After-School All-Stars Las Vegas, the Clark County School District, from any and all injuries or damage for any claims or causes of action whatsoever for any loss or injury suffered by my child.

The risk of injury from the activities involved in this program is significant, including the potential of permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my child’s participation. I authorize After-School All-Stars Las Vegas staff to administer first aid as they deem necessary. I understand that reasonable care will be provided to the below participant in the event of injury or illness during any After-School All-Stars Las Vegas sponsored activity, and I authorize emergency medical care should it be needed.

I authorize the release of the following school information regarding my child to After-School All-Stars Las Vegas, including but not limiting: student identification number, attendance, achievement, and behavior data. Additionally, I understand that the information as noted above will be shared with qualified professional staff from After-School All-Stars Las Vegas.

As parent/guardian of the child, I have read and fully understand the above and certify and represent that as parent/guardian for the child, all registration and release information provided is true. I hereby represent that I have authority to bind and sign on behalf of all parents/guardians of the below participants.

Student Name: {studentName}

Parent/Guardian Name: {parentguardianName}

The Nevada Department of Education (“NDE”) would like to collect data on activities and events taking place in classrooms, schools, and school-related programs throughout the state. The Family Educational Rights and Privacy Act (“FERPA”) requires the NDE and After-School All-Stars Las Vegas (“ASAS”) 21st Century Community Learning Centers (21st CCLC) program to obtain prior written consent from the student’s parent or guardian before releasing any personally identifiable information about a student. The information requested will be used to calculate the impact 21st CCLC has on student performance and to meet reporting requirements as a result of receiving state and federal funds.

NDE and ASAS are dedicated to establishing a community learning center designated to provide students with academic and enrichment opportunities, as well as additional activities to complement their regular academic programs. Quality programs are those that demonstrate a high daily attendance rate and engagement with family members of active participants.  Programs that demonstrate these characteristics are more likely to have higher student growth, increased passage rates of local and state assessments, and students pursue post-secondary education.

I understand that this authorization is made pursuant to the FERPA set forth in 20 USC §1232g and its regulation in 34 CFR Part 99 (as amended in 2012). Furthermore, I understand that this consent is made pursuant to 34 CFR 99.30(a), which requires that (1) the parent or eligible student’s consent specify the records to be disclosed, (2) state the purpose of the disclosure, and (3) identify the party or parties to whom the disclosure may be made.

By signing this form, I grant Herr Elementary School permission to disclose to ASAS the following information. I also grant permission to ASAS to re-disclose the following information to the re-disclosure parties.

1. Records Disclosure: School Registration Information/Demographic Data, Assessment Data, Student Grades, School Day Attendance, Survey Data, Free and Reduced Lunch Status, Attendance Data Student Grades, Assessment Data, Demographic Data

2. Disclosure Parties: After-School All-Stars Las Vegas

3. 21st CCLC Re-Disclosure Parties:

a. Nevada Department of Education

b. NDE contracted statewide evaluator & local 21st CCLC site program evaluators and Data Collection System Providers

c. United States Department of Education

d. 21st Century Student Support Services

4. Purpose of Each Disclosure: Collect data to calculate the impact 21st CCLC has on student performance.

All records and information regarding services will be protected by FERPA, which governs the exchange of confidential information. The exchange of information will be limited to the authorized staff of ASAS and the re-disclosure parties. No individual student data will be released beyond that which is specified in this authorization. This authorization, to receive services from ASAS and to exchange confidential information, shall remain in effect for the period of my student’s enrollment in the ASAS program, or until rescinded in writing. I understand that this release may be revoked by me at any time with a written request dated and signed by me, except to the extent that the ASAS has already acted in reliance upon this consent.  Written revocations shall be sent to:

After-School All-Stars Las Vegas, 8485 W. Sunset Road, Ste. 106, Las Vegas, NV 89113

I understand that personal records are protected by FERPA and any additional disclosure or re-disclosure, not authorized by this consent or otherwise permissible pursuant to federal or state law, is prohibited.

I have read this authorization before signing and I fully understand the contents, meaning, and impact of this release.

Student Name: {studentName}

Parent/Guardian Name: {parentguardianName}

Your student isn’t fully accepted into the program until they have received an email or other communication from the Site Leaders confirming they have been accepted into the program. 

If the program is at capacity, you will receive a notification that your student is on a waitlist.