Community Education - current class catalogs Youth activities and classes - Winter/Spring 2015

REGISTRATION! Student Name ____________________________________________ Gender M F Birth Date _______________ Grade ______ 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 __________ Athletic participants must have a Sports Qualifying Physical, and Eligibility and Emergency Health form on file at your schools’ Community Education office. Do you have these forms on file? Yes No (Check one) Please list significant health, injury or concussion concerns:_______________________________________________________________ Registration Information and Frequently Asked Questions 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, classes-by school or classes-districtwide. Drop-off registration - starting Jan. 5 Drop off hours are M-F from 8:30 a.m. - 4:30 p.m. Drop off a separate form and payment for each class location at your schools’ Community Education office. Fee assistance Limited fee assistance is available for students receiving free or reduced lunch. Contact your schools’ Community Education office for more information. 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. Transportation Activity buses are available M-Th for all programs that meet immediately after school. A parent/guardian is responsible for transportation home from the school on game days. Payment You may pay with a personal check, cash or credit card. Make checks payable to AnokaHennepin 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. Middle School Activities and Athletic Locations Anoka Middle School - AMS Fred Moore Campus 1523 Fifth Ave. S., Anoka 763-506-5012 Coon Rapids Middle School - CRMS 11600 Raven St. NW., Coon Rapids 763-506-4812 Jackson Middle School - JMS 6000 109th Ave. N., Champlin 763-506-5312 Oak View Middle School - OVMS 15400 Hanson Blvd., Andover 763-506-5612 Northdale Middle School - NMS 11301 Dogwood St. NW., Coon Rapids 763-506-5412 Roosevelt Middle School - RMS 650 125th Ave. NE., Blaine 763-506-5812 Community Education funds, including participant fees, paid for the printing and distribution of this publication. Regular K-12 instruction funding was not used. Anoka-Hennepin Community Education ‘Like’ us on Facebook for activity updates and information: www.facebook.com/discovercommunityed 6

Community Education - current class catalogs Youth activities and classes - Winter/Spring 2015 | Page 7