Columbia Montessori School 2021 Summer Program

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Columbia Montessori School 2021 Summer Program
Columbia Montessori School 2021 Summer Program
                                      June 7 - August 20, 2021

Columbia Montessori School’s 2021 Summer Program for kids ages 6-10 brings us back to nature. Join
us as we dive deeper into some of our favorite topics and explore the natural world around us!

Overview:
We believe spending time with nature may reduce stress, difficulty with attention, depression, and anxiety,
while also increasing creativity, cognitive functioning, physical activity, and respect and responsibility for
the earth. We also believe learning can be fun! Throughout the 2021 Summer Program, kids will not only
develop a deeper connection and respect for nature, but we will have fun doing it by exploring materials to
use as “beaks,” creating their own habitats, identifying animal tracks, and returning to a favorite activity of
cooking with solar power!

Approach:
Using Project and Place Based methods, we will activity explore the natural phenomena occurring here in
Mid-Missouri and some of the challenges our planet currently faces. Guided by their own interests and
applying their knowledge and skills to nature that we can see and experience firsthand, we aim to foster
empathy for the natural world and instill an appreciation for all its wonders.

Activities:
Kids in the Summer Program will enjoy a variety of activities including eco-experiments, field trips, guest
speakers, art and science explorations, and nature walks. There will also be plenty of time to play games
and enjoy being a kid!

Each of the 11 weekly sessions will then focus on a different topic of nature, with various activities to
ensure there is something for everyone!

Weekly Program:

       Week            Dates                  Theme*
        Week 1         June 7-11              Habitats
        Week 2         June 14-18             Life Cycles
        Week 3         June 21-25             Birds & Beaks
        Week 4         June 28-July 2         Water Forms & Cycles
        Week 5         July 6-9               Water Systems & Pollution
        Week 6         July 12-16             Sun & Light
        Week 7         July 19-23             Pollination & Photosynthesis
        Week 8         July 26-30             Reptiles & Amphibians
        Week 9         August 2-6             Rock & Roll (Geology)
        Week 10        August 9-13            The Marks We Leave
        Week 11        August 16-20           Wilderness Survival & Foraging
*With a project led approach to learning, the weekly themes are subject to change. Themes may be extended into an
additional week or cut short based on the interest level of students.
Daily Schedule:
The daily schedule is an estimate only and is subject to change based on engagement, weather, field trip
times, etc.
        7:15-8:45            Welcoming and Work Time in Outdoor Classroom
        8:45-9:00            Set up Breakfast
        9:00-10:00           Breakfast and Cleanup
        10:00-11:00          Morning Meeting and Nature Walk
        11:00-12:15          Exploration and Activities of Weekly Topic
        12:15-12:30          Lunch Setup
        12:30-1:30           Lunch and Cleanup
        1:30-2:00            Yoga, Rest, or Quiet Work Time
        2:00-3:15            Exploration and Activities of Weekly Topic
        3:15                 Snack, Jobs, and Pack OR
                             Aftercare
        3:15-3:30            Snack and Clean up
        3:30-5:00            Work, Outside Play, Outdoor Classroom
        5:00-5:45            Jobs and Pack as getting picked up

Cost:
   ●    $30 Enrollment Fee
   ●    $185 weekly rate (8:00am - 3:15pm, drop off begins at 7:15am)
   ●    $25 weekly rate for after care (3:15pm - 5:45 pm)

     Price includes: Breakfast – Lunch – Snack – All Supplies and Materials - Field Trip Costs
                               *CMS is an equal opportunity provider.*

Admissions:
Due to construction in our building this summer, space for the 2021 Summer Program is limited. With the
limited space, this year’s program will be capped at age 10 in order to better accommodate the group of
friends in attendance.

Priority will be given to those able to enroll for the entire program. Please note that completing an
enrollment form does not guarantee a spot. We will be reviewing applications and let you know whether or
not you have been accepted. At that point, payment will be due to reserve your spot. Please see the
payment policy for additional info on payments.

                           Email office@columbiamontessori.org to enroll!

  3 Anderson Ave. Columbia, MO 65203 | P: 573-449-5418 | F: 573-442-6421 | E: office@columbiamontessori.org
                                        www.columbiamontessori.org
2021 Summer Program Enrollment Form

Child’s Name: ________________________________________ Sex: _______ DOB: _____________

Address: ____________________________________________________________________________

City: ________________________        State: ________        Zip: ______________

Previous CMS Student?         yes      no       Date(s) of previous attendance: _____________________

Grade entering fall 2021: __________            School attending fall 2021:_________________________

Parent/Guardian Information
Please list below all legal guardians and contact information.

Name: _____________________________________________ Relationship: ____________________

Address (if different): __________________________________________________________________

City: ____________________________             State: ________       Zip: ________________

Phone: Cell/Home _____________________________                   Work ____________________________

Email Address: _______________________________________________________________________

Employer/Occupation or School Attend: ____________________________________________________

Employer or School Address: ____________________________________________________________

Work/School Schedule: ________________________________________________________________

Name: _____________________________________________ Relationship: ____________________

Address (if different): __________________________________________________________________

City: ____________________________             State: ________       Zip: ________________

Phone: Cell/Home _____________________________                   Work ____________________________

Email Address: _______________________________________________________________________

Employer/Occupation or School Attend: ____________________________________________________

Employer or School Address: ____________________________________________________________

Work/School Schedule: ________________________________________________________________
Child’s Name: ___________________________________________

Emergency Contacts
Please list at least 2 additional people CMS may contact and who can pick up your child if necessary.
Your child will not be allowed to leave with anyone not on the list below, unless a written note signed by a
parent/legal guardian listed on this application is received by the front office or program teachers.

Name: _________________________________                           Relationship to child: _____________________

Phone: Cell/Home #: _________________________                     Work/Other #: __________________________

Address: ____________________________________________________________________________
                                          (street, city, state, zip)
Authorized pickup?       yes     no                                Emergency contact?      yes    no

Name: _________________________________                           Relationship to child: _____________________

Phone: Cell/Home #: _________________________                     Work/Other #: __________________________

Address: ____________________________________________________________________________
                                          (street, city, state, zip)
Authorized pickup?       yes     no                                Emergency contact?      yes    no

Name: _________________________________                           Relationship to child: _____________________

Phone: Cell/Home #: _________________________                     Work/Other #: __________________________

Address: ____________________________________________________________________________
                                          (street, city, state, zip)
Authorized pickup?       yes     no                                Emergency contact?      yes    no

Emergency Medical Care
I understand that I will be notified at once in case of an emergency with my child, and I will make
arrangements for medical care of my child with the physician or hospital of my choice. If I cannot be
reached to make necessary arrangements, or in a critical emergency requiring medical care, I authorize
Columbia Montessori School to obtain emergency medical treatment for my child.

I understand that I will assume all financial responsibility for any treatment or injuries sustained by my
child while he/she is in the care of Columbia Montessori School.

Preferred Hospital: ______________________________________ Phone: _______________________

Prefered Physician/Clinic: ________________________________ Phone: _______________________

___________________________________________________________                             _____________________
Signature of parent or guardian                                                         Date
Child’s Name: ___________________________________________

Health Information
Allergies
Please list any known allergies and reactions. Please note that certain allergies may require an additional
form due to the severity of the allergy and/or treatment plan.

____________________________________________________________________________________

Medication
Please list any medications that your child will be taking while at CMS. An additional form may be needed
to ensure the safety and proper administration.

____________________________________________________________________________________

Comments on Child’s Development
Please list any personal development, behavior, patterns, habits, and individual needs that might help us
care for your child.

____________________________________________________________________________________

____________________________________________________________________________________

____________________________________________________________________________________

Photo & Video Release
I grant or deny CMS the right to use the image of my child in the following ways:

Type of Use                                                                    Check ✓ to grant permission

Classroom Use
Cubbies, bulletin boards, etc.

CMS Use
Monthly email newsletter, CMS events, etc.

CMS Private Online Groups & Private Social Media Pages
Private CMS Facebook group, private classroom pages, etc.

Educational Materials
Teacher training, college student course projects, etc.

Printed Promotional Materials
Brochures, fliers, ads, etc.

Digital Promotional Materials
Public Social Media, CMS Website, etc.

External Sources
Local newspapers, news stations, etc.

By signing below, I understand that it is my responsibility to update this form in the event that I no longer
wish to authorize one or more of the above uses. I agree that this form will remain in effect during the
term of my child’s enrollment.

_____________________________________________________________                      _____________________
Signature of parent or guardian                                                    Date
Child’s Name: ___________________________________________

                         Non-Medication Topical Application Permission
                                            Renewed Annually

I give permission for the following non-prescription topical treatments to be applied to my child on an
as-needed basis in accordance with the directions listed on the packaging.

    ❏ Sunscreen:___________________________________________________________________
                                       (must indicate brand)

                NOTE: Lotions or manual pump spray bottles ONLY, no aerosol spray cans permitted.

    ❏ Insect Repellent: _____________________________________________________________
                                         (must indicate brand)

                NOTE: No DEET products permitted.
                      Lotions or manual pump spray bottles ONLY, no aerosol spray cans permitted.

    ❏ Other: _______________________________________________________________________
                                       (must indicate brand)

By signing below, I understand that it is my responsibility to update this form in the event that I have
changed my preference on topical applications. I understand that only products I have provided and
indicated on this form will be applied to my child and that CMS will not be applying products if I have not
provided them.

_____________________________________________________________                    _____________________
Signature of parent or guardian                                                  Date
Child’s Name: ___________________________________________

2021 Summer Program Selection
Please check which week(s) your child will be attending. If unsure, you may enroll in weeks at a later
date. However, we cannot guarantee a spot if the program becomes full unless the week has been paid
for. Weekly fees are refundable if notice of cancellation is given at least 7 days in advance.

Preference will be given to those able to commit to the whole or majority of the summer.

                                                                                   Program      After Care
 Week               Dates            Theme                                Fee
                                                                                  ✓ to enroll   ✓ to enroll
 Week 1           June 7-11          Habitats                             $185
 Week 2          June 14-18          Life Cycles                          $185
 Week 3          June 21-25          Birds & Beaks                        $185
 Week 4        June 28-July 2        Water Forms & Cycles                 $185
 Week 5           July 6-9*          Water Systems & Pollution            $165
 Week 6          July 12-16          Sun & Light                          $185
 Week 7          July 19-23          Pollination & Photosynthesis         $185
 Week 8          July 26-30          Reptiles & Amphibians                $185
 Week 9          August 2-6          Rock & Roll (Geology)                $185
 Week 10         August 9-13         The Marks We Leave                   $185
 Week 11        August 16-20         Wilderness Survival & Foraging       $185
                                           *No Summer Program on July 5

                 Price includes: Breakfast – Lunch – Snack – All Supplies and Materials

Amount Due

        _____________       x $185 =          _______________
        (Number of weeks)

        _____________       x $165 =          _______________
        (Number of weeks)

        _____________       x $25      =      _______________
        (Number of weeks)      (After Care)

        Enrolment Fee          $30     =      $30
        ______________________________________________

                        Total:             ________________

_____________________________________________________________                    _____________________
Signature of parent or guardian                                                  Date
Child’s Name: ___________________________________________

                           Acknowledgements & Receipt of Materials

                                                                                                     Initials
         I have received a copy of this facility’s policies pertaining to the admission, care,
  1
         and discharge of children.
         I have been informed that a copy of the licensing rules that govern child care
  2
         centers is available at this facility to review.

         The provider and I have agreed on a plan for continuing communication regarding
  3
         my child’s development, behavior, and individual needs.

  4      I have received a copy of CMS’ Emergency Handbook.

         When my child is ill, I understand and agree that they may not be accepted for care
  5
         or remain in care.
         I understand that, before the first day of attendance by my child, I will provide proof
  6
         of completed age appropriate immunizations or exemption from immunizations.
         I have been notified that I may request notice at initial enrollment or any time
  7      thereafter whether there are children currently enrolled in or attending the facility for
         whom an immunization exemption has been filed.

  8      I ☐ do ☐ do not give permission for this facility to transport my child.

         I understand I will be notified in advance when field trips are planned and I
  9
         ☐ do ☐ do not give permission for my child to participate in field trips/excursions.

         I understand payment for Summer Program is due in advance, and my child may
 10
         not be accepted into care if payment has not been made.
         I understand that upon enrolling the $30 enrollment fee is non-refundable and
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         weekly tuition is refundable only upon at least 7 days advance notice.

_____________________________________________________________                         _____________________
Signature of parent or guardian                                                       Date

………………………………………………………………………………………………………………………………………………………….

                                                   Office Use Only

Admission Date:                             Discharge Date:                          Door Code:

Notes:
Summer Program Payment Policy Agreement

Columbia Montessori Summer Program is a weekly program where students may enroll for as few or
many weeks as they desire, pending available spots and approval of the Executive Director. Cost is
based on the number of enrolled weeks. Should limited spots be available, priority may be given to
students who need care for more than 6 weeks.

Rates & Fees
   ● $30 Enrollment Fee, due at time of application
   ● $185 weekly rate, $165 for 4 day weeks (day ending at 3:15pm)
   ● $25 weekly rate for after care (3:15pm - 5:45 pm)

Deposit
Summer Program does fill up. To guarantee a spot, a $25 non-refundable deposit is required for each
week. Your spot cannot be guaranteed without the deposit. The $25 will be subtracted from your balance
due for each week.

Payment Policy
The remaining balance for each week must be made prior to the start of that week. If payment is not
received your child will not be able to attend.

Payment Options
   ● Check, Cash, or Money Order
         ○ Families paying by check, cash, or money order may do so by paying in full or on a
             monthly or weekly basis. Each week must be paid prior to the start of the week.
   ● ACH
         ○ Current and continuing CMS families may add their Summer Program payments to their
             regular monthly ACH payments.

Cancellation Policy
If your child is unable to attend for any reason, please provide as much notice as possible so we can give
the spot to the next family. In order to receive a refund, please provide no less than 7 days’ notice of
cancellation. Partial refunds are not available for unexpected absences, like illness.

If Columbia Montessori School cancels a week of Summer Program through no fault of your own, you will
be fully refunded for the canceled weeks.

________________________________________               _________________________________________
Printed Name                                           Child’s Name

___________________________________________________________                    ______________________
Signature                                                                      Date

  3 Anderson Ave. Columbia, MO 65203 | P: 573-449-5418 | F: 573-442-6421 | E: office@columbiamontessori.org
                                        www.columbiamontessori.org
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