Student name ____________________________________________ Gender M F Birth date _______________ Grade ______

Participants must be age indicated by class start date. Address __________________________________________________________________________ School __________________________ City _________________________________________ Zip _______________ Phone No.( Home) ________________________________ Accommodation needs _____________________________________________________________________________________________ Parent / guardian name _________________________________________( Work) _____________________( Cell) __________________

Parent / guardian email address ______________________________________________________________________________________

Providing us with an email address allows us to contact you in case of schedule changes.

Cash, Check No. ___________ or Visa MasterCard Discover( Check one) Amount $__________________________________ Cardholder signature required _____________________________ Exp. date _________/_________ Checks payable to Anoka-Hennepin Dist. No. 11 Credit card No. ________ ________ ________ ________— ________ ________ ________ ________— ________ ________ ________ ________— _______ ________ ________ ________ Course name _________________________________ Location ___________________ Number _________________ Fee __________ Course name _________________________________ Location ___________________ Number _________________ Fee __________ Course name _________________________________ Location ___________________ Number _________________ Fee __________ Course name _________________________________ Location ___________________ Number _________________ Fee __________ The child listed above currently receives free or reduced lunch through Anoka-Hennepin Schools( use fee listed in italics) Please check one: My child will be picked up each day My child has permission to walk home

NEW! Lunch Bunch- Our Lunch Bunch program provides participants with a nutritious lunch( Noon-12:30 p. m.) and an opportunity to enjoy fun activities( 12:30-1 p. m.), Monday-Thursday. You may sign your child up for Lunch Bunch if your child is registered for any class with an symbol next to the class description.

June 19-23 June 26-29 July 10-13 July 17-20 July 24-27 July 31-August 3( Choose all that apply) $ 10($ 5) activity fee per student, per week( regardless of number of days attending) Total Fee: $ 10 x ______# weeks = $__________

Registration Information and Frequently Asked Questions

Questions? Call 763-506-5312.

Now through June 9 Monday-Friday, 8 a. m. to 3 p. m.

June 19 through August 4 Monday-Thursday, 8 a. m. to 4 p. m.

Office will be closed Monday, May 29 and Monday-Friday, July 4-8.

Online registration Register for Community Schools activities at www. discovercommunityed. com – convenient, secure, 24-hour registration using your Visa, MasterCard or Discover Card. Click on " register " enter the class name into the search box or scroll to the bottom of page for two options, Preschool enrichment or Youth activities & classes districtwide.

Mail-in or drop-off registration Community Schools- Educational Service Center, door No. 8 2727 N. Ferry Street, Anoka, MN 55303 * Use drop box after hours

Fee assistance Students currently receiving free or reduced lunch through Anoka-Hennepin Schools pay the amount listed to the right of the class fee($ XX) with a limit of three weeks. For more information, call 763-506-5312. Monday through Friday, 8 a. m. to 3 p. m.

Inclement weather Decision to cancel will be made by instructors at the class location just prior to class time. All outdoor activities that are cancelled will not be rescheduled or refunded.

Summer Activity School Locations

Payment You may pay with a personal check, cash or credit card. Make checks payable to Anoka- Hennepin ISD No. 11. Registrations are not complete without payment. A registration confirmation will be emailed to you if an email address is provided. Classes are filled on a first-come, first-serve basis. Activities with low enrollment will be cancelled. Participants will be notified and payment refunded.

Refund policy Customer initiated cancellations made at least five business days before the class is scheduled to start may qualify for a refund less $ 10. Customer initiated cancellations made less than five business days are not eligible for a refund.