After School & Expanded Learning Sign-Up

Aspen Valley Prep is committed to transforming our community by nurturing exceptional leaders, and our After School Program plays a pivotal role in this mission. At Aspen Public Schools, we are dedicated to unlocking the potential of future leaders in Fresno by maintaining high expectations and fostering a culture that celebrates diverse strengths and backgrounds. Our Expanded Learning and After School programs are integral to this mission, extending our educational goals beyond the traditional school day. Our Valley students can participate in the after school program on a daily basis through ASES, or as desired based on their special interests through ELOP.

ASES provides students with a daily after-school program in a structured learning environment, where students receive academic support, homework assistance, tutoring, and partake in various enrichment activities such as art, STEM, social emotional, physical fitness, clubs, and youth development. Through ASES students are also provided with healthy snacks that are compliant with school meal nutritional standards.

ELOP provides enrichment programs for students in TK- 6th grade before and after school, during summer, and intersession days. ELOP programs are designed to support students in their academic, social, emotional, and physical development by creating engaging, hands-on experiences for students that complement the regular school day. Through ELOP, students also get the flexibility of attending the after school program on select days based on their interest in participating in activities such as sports, tutoring, music, Sensational Saturdays, or Blast Program events.

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Step 1 of 10 - Student Info

Student Info

Student Name*

First Last

Student Grade Level*

Date of Birth*

Gender*

Email*

What is the student’s race and ethnicity(s)?*

What school does your child attend?*

What school year are you applying for?*

Pick-up & Early Release

The California Department of Education requires each school to develop an Early Release Policy specifically for before and after-school programs, ensuring that students can participate fully while accommodating necessary early departures.

Education Code: After School Safety and Education (ASES) and Expanded Learning

EC Section 8483(a): This code mandates that every after-school program must begin immediately after the conclusion of the regular school day and operates for a minimum of 15 hours per week. The program must remain open until at least 6 p.m. on all regular school days. Elementary school students must participate in the after-school program each day until it ends at 6:00pm, unless early release justification is allowed under the provision codes of Aspen’s Early Release Policy which aligns to the specific conditions outlined in subparagraph (B) of paragraph (1) of this section or paragraph (2) of subdivision (f) of EC Section 8483.76.

EC Section 46210: This section pertains to the operation of the Expanded Learning Opportunities Program. It requires these programs to run for at least 30 non-school days, including extended school year days as defined in paragraph (3) of subdivision (b) of Section 56345. Each of these 30 program days must provide no less than nine hours of in-person expanded learning opportunities. These opportunities may include a combination of instructional time, recess, meals, and before or after-school activities, ensuring a comprehensive day of learning that totals at least nine hours.

These requirements underscore the commitment to providing expanded learning opportunities that align with the regular school day while offering the flexibility needed to support family schedules. The Early Release Policy is in place to accommodate unique circumstances while maintaining the integrity of the program’s objectives.

Early Release Justification: Please select a code from the options below to tell us the reason your student(s) need to leave early (any time before 6:00 PM) on each day of the week.

Early Release Schedule

Day of the Week	Time Student is Leaving	Early Release Code Number	Reason for Early Release	Actions

There are no Early Release Days.

Early Release Codes Must Be Documented Daily:

The appropriate early release code must be documented on the digital or paper sign-out sheets when picking up students before 6:00 PM. For extended absences from the after school (more than three consecutive days), please notify the after school staff at least three days in advance. Annually, parents/guardians can complete an enrollment form authorizing staff to sign out students for early release, students walking home, taking public transportation, or other reasons. The program follows policies outlined in the Aspen Public School Family/Student Handbook.

Student Walker (Early Release Code# 1)

I give permission to my student(s) to sign themselves out of the program to walk home or take district transportation.

For Parents Requesting Their Student to Walk Home “Student Walkers" (Early Release Code# 1):

Parents must sign and date this “Student Walker” release section of the application which authorizes staff to sign students out of the program early (Prior to 6:00pm) to walk home or take public transportation. With this release arrangement, students will be released at a designated time set by the After School Program staff prior to the end of the after school program, which operates daily at 6:00pm. Any student picked up before 6:00 PM requires that an early release code be documented in the student pick-up kiosk or paper sign-out sheets.

Parent Agreement for Requesting Student to Walk Home “Student Walkers”:

I understand and acknowledge that my child will be unsupervised during their commute from the Aspen Ridge Public campus to the Aspen Valley campus. With this request for permission of this arrangement, I hereby release, waive, and discharge Aspen Valley, its administrators, employees, agents, and representatives from any and all liability, claims, demands, actions, or causes of action, including but not limited to any injury, harm, or damage that may occur to my child during their commute to and while on the Aspen Valley campus. This release includes any claims arising out of negligence, whether active or passive, on the part of Aspen Valley or its representatives.

By signing below, I give permission to my student(s) to sign themselves out of the program to walk home or take district transportation.

Parent/Guardian Name*

First Last

Date*

Signature*

Policy on Parent/Guardian Sobriety at Pick-Up

At Aspen Valley, the safety and well-being of our students is our highest priority. We are committed to creating a secure environment where students feel protected at all times, including during pick-up. Allowing an impaired parent or guardian to transport children poses a significant risk to their safety as well as to others on the road. This policy ensures that all students are picked up by individuals who are capable of providing safe and responsible transportation, reinforcing our commitment to safeguarding every child in our care.

Policy Details:

If a parent/guardian appears to be under the influence of drugs or alcohol, including but not limited to smelling of marijuana or alcohol, the After School Program staff reserves the right to deny them permission to take the student(s) home.
In such cases, the parent/guardian will be required to arrange for another authorized individual to pick up the student(s).
If no alternative arrangements can be made, law enforcement (Police Department) will be contacted for assistance to ensure the student(s)' safety.

Indicators of Being Under the Influence: To ensure clarity and transparency, the following are some signs that a parent/guardian may be under the influence:

Behavioral Signs: Stumbling, swaying, or unsteady movements; slurring or difficulty speaking clearly.
Physical Signs: Red or glazed eyes; dilated or constricted pupils.
Sensory Signs: Smelling strongly of alcohol or marijuana.
Cognitive Signs: Confusion, disorientation, or an inability to follow directions.

Parent Acknowledgment of Sobriety Pick-Up Policy:

By signing this application, you acknowledge and agree to this policy. The safety of our students is our top priority, and we appreciate your cooperation in maintaining a secure environment.

Parent/Guardian Name*

First Last

Date*

Signature*

Parent or Guardian #1

Name*

First Last

Email*

Home Address*

Street Address Address Line 2 City State ZIP Code

Home Phone*

Cell Phone*

Employer Company*

Work Phone*

Preference for After School Communications*

Additional Parent or Guardian

I would like to add another parent/guardian.

Parent or Guardian #2

Name*

First Last

Email*

Home Address*

Street Address Address Line 2 City State ZIP Code

Home Phone*

Cell Phone*

Employer Company*

Work Phone*

Authorized Pick-Up Persons

Please list the individuals authorized to pick up your student from the After School Program. For your child's safety, they will only be released to the people you specify below. Individuals who are not listed will NOT be allowed to pick up your student. All authorized individuals must state their name and present a valid ID at the time of pick-up. To add or update names on this list, please notify the after-school program staff promptly. Please notify After School Program leadership at (559) 225-1583 if there are any changes to your students approved pick up list within 24 hours after change is made to ensure its implementation.

Pickup Contacts

Name	Relationship	Phone	Actions

There are no Contacts.

Are there any court-mandated custody/visitation orders limiting access to this student?*

Yes

Legal Order

*If so, please attach the file here or ensure the front office has a copy of the latest court order on file.

Drop files here or

Max. file size: 20 MB, Max. files: 5.

Student lives with:*

AB 1567: Priority Enrollment for Foster Youth and Homeless Youth Students

In accordance with Assembly Bill 1567 and the McKinney-Vento Homeless Assistance Act (42 U.S.C. Sec. 11434a), It is required that first priority for enrollment into ASES and ELOP programs be given to students who are identified as Foster Youth or Homeless Youth.

Homeless or Foster Youth

Please check the box below if you wish to self-certify that your child identifies as a Foster Youth or Homeless Youth. (Note: Verification may be requested by the school site.)

YES, my child identifies as a Foster Youth or Homeless Youth.

Student Medicine/Prescriptions

If your child requires medication at school, you must inform both the school nurse and the after-school program. All medication, including pills, inhalers, liquid medications, or other forms, must be in the original prescription container with a current date and the child's name clearly displayed.

Medications

Medication Name	Dosage	Hour(s) Given	Actions

There are no Medications.

Student Medical History

Vision Requirements*

Date of Last Eye Exam*

Hearing Aids*

Diabetes*

Current Asthma

Uses inhaler

On daily medication

Current Seizures

On medication

Please specify the type of medication:*

Severe Allergies

Epi-Pen required

Benadryl required

Please list all known allergies here:*

Please explain any recent illnesses, hospitalization, surgery, or any medical condition which might require accommodation at school.*

Permissions & Acknowledgements:

By initializing here, I give my son/daughter permission to attend the Expanded Learning Program beginning at the conclusion of the regular school day until the program’s dismissal or early release time. I am aware my son/daughter must be picked up by the dismissal time or have a documented early release time. I understand anyone picking up my son/daughter may be required to provide identification to the Expanded Learning Program staff.*

By initialing here, I acknowledge I have read the After School pick-up and early release (pg. 2-3) guidelines and program policies. I understand, as a parent/guardian, I must follow these attendance guidelines and policies in order for my child to participate in the Expanded Learning/After School Program.*

By initializing here, I have received a copy of the Aspen Public Schools Expanded Learning Handbook and/or know that I can access it on the school website. I understand that by enrolling my child in the program, my child agrees to follow the program’s rules and expectations, and I, as their parent/guardian, agree to support and uphold these behavioral expectations with my child. I understand that failure to meet these expectations may result in disciplinary actions, including suspension or removal from the program.*

By initializing here, I permit my son/daughter to view movies during the Expanded Learning Program in accordance with the school district’s policy. I understand that as part of the Expanded Learning enrichment and classroom academic activities, instructors may occasionally show movies to the Expanded Learning participants.*

The Expanded Learning Program will choose movies in accordance with the school district’s movie selection guidelines. This form will serve as a permission slip to watch PG movies.

By initializing here, I permit my child to be photographed or filmed by after school or its approved representatives during APS programs or activities. These images and recordings may be used to promote APS programs and inform the public about our activities and methods.

By initializing here, I permit my student to participate in the after-school surveys conducted by Aspen Public Schools. These surveys, given in the fall and spring, are vital for evaluating and improving the Expanded Learning Program.

Survey Details: The survey will assess how the program supports socio-emotional skills such as growth mindset, academic competence, self-regulation, and social competence.

Confidentiality: Survey results will be compiled into county-level reports without individual identifiers. The survey will ask for your child’s last name and birthday only to match pre- and post-survey data.

Parent/Guardian Authorization & Agreement

I, the undersigned, acknowledge that I am the parent or legal guardian of the above-named child and hereby authorize their participation in the Aspen Public Schools program named above. I acknowledge that my child’s participation in the program is voluntary. In consideration of my child being allowed to participate, I agree to the following on behalf of myself, my child, and our representatives, assigns, heirs, next of kin, and executors:

I acknowledge that participation in the program may involve activities that are physically, mentally, and emotionally challenging, as well as certain health and safety risks. I assume full responsibility for all risks, injuries, and losses that may arise out of or relate to my child’s participation in the program. I hereby release, waive, discharge, and covenant not to sue Aspen Public Schools (APS), its officers, employees, representatives, volunteers, and agents, as well as the Aspen Public Schools Board (ASPB), for any and all liabilities, damages, losses, or claims arising out of or related to my child’s participation in the program, including injury to my child, myself, or our property, and any loss or damage resulting in death.

I agree to indemnify, hold harmless, and save APS and ASPB from any injuries, losses, liabilities, or damages incurred as a result of my child’s actions while participating in the program. I assume full responsibility for any bodily injury, death, or property damage my child may experience while participating in the program.

I authorize Aspen Public Schools and its representatives to secure medical treatment for my child in the event of illness or injury. I accept full responsibility for any costs associated with such treatment.

I acknowledge that this agreement is intended to be as broad and inclusive as permitted under California law. I understand that if any portion of this agreement is deemed invalid, the remaining provisions shall continue in full force and effect.

I acknowledge that the after-school program reflects and upholds all policies established by Aspen Public Schools during the regular school day. I understand that this includes, but is not limited to, policies regarding cell phone use, student conduct, and general school expectations. I acknowledge that students are required to follow the same rules and guidelines in the after-school program as they do during the school day.

I understand that while the program adheres to a three-write-up policy that may result in temporary suspension, APS reserves the right to dismiss students at its discretion in cases of severe or persistent behavior concerns. I acknowledge that the program’s primary goal is to maintain a safe, supportive, and structured environment for all participants and that students who repeatedly disrupt this environment may be removed from the program.

I grant permission for my child’s image or recordings to be used for purposes such as local or national publications, newspaper articles, or online postings. I understand that I may request to review these recordings but waive any rights, titles, or interests in them. I further release APS and ASPB from any claims related to the publication or dissemination of these recordings.

I HAVE READ, UNDERSTOOD, AND VOLUNTARILY SIGN THIS AGREEMENT.

I acknowledge that no verbal statements or promises outside of this written agreement have been made. I further declare that I am the parent/legal guardian of the named child, that the information provided on this application is accurate and true, and that I will promptly notify the Expanded Learning Program of any changes to this information.
Parents must sign below acknowledging your acceptance of the after school policies in order for your child to be enrolled into the after school program.

Signature*

Signed Date*

Parent/Guardian Preferences for Expanded Learning Program:

To enhance your child’s expanded learning opportunities and experience during the after-school program, please rank the following options in order of priority, with 1 being the lowest priority and 10 being the highest. While we aim to consider all preferences, availability is subject to capacity and cannot be guaranteed.

Your responses will remain confidential and will be used solely by the Aspen Public Schools and After School program team. Participation is optional but greatly appreciated for our annual review.

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