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 .