At this moment in time, we do not have any information as to how our partner schools' regular school day or school calendar/schedule will be structured for the return to school in Fall 2021, however we are still proceeding with our ASPIRE program registration process as usual.

Students enrolled in the ASPIRE after school program must attend the program EVERY DAY they attend school, Monday - Friday, for the entire duration of the program, from the end of the school day until 6:00 PM. If the student is accepted into the program, their parent/guardian is required to attend a Program Orientation for Parents in Fall 2021 in order for their child to be eligible to continue attending the ASPIRE program during the 2021-22 school year. Failure to attend this Orientation may lead to the student being removed from the program and added to the Student Enrollment Wait List. For the safety of all of our program participants and staff, the program will be abiding by all the rules and regulations set for public schools by the Los Angeles County Department of Public Health, which may include limited program participation, social distancing and wearing face masks. Full details regarding these requirements will be presented at the mandatory Parent/Guardian Orientation prior to the start of the school year.

LEARN is an Equal Opportunity Non-profit Organization committed to providing all employees and program participants an environment free of discrimination and harassment regardless of race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, past or present military service, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate.

If your son/daughter is required to be administered medication during program hours, an "Authorization to Medicate" form must be completed and submitted to LEARN. The form requires the physician's signature. If you list any medications here, you will be emailed a printable copy of the form. A paper copy of this form can also be obtained from the Site Coordinator. Please follow the completion instructions on the form. If not applicable type N/A.

If your child is attending, Columbia, Durfee, Gidley, LeGore, Rio Vista, or Wright, please let us know if you are interested in receiving a registration form for our Before School ASPIRE Program. Please note that if your student's school was not listed above, this question does not apply to you as it is not currently being offered at that site.

Students in Grades TK - 5 will not be released to walk home at program-end and must be picked up by an Authorized Adult listed on this form. Students in Grades 6 – 8 may be released to walk home at program-end if a parent/guardian authorizes LEARN staff to do so. Such authorization must be provided on this form.

LEARN will include the names of both parents/guardians listed on this Registration Form as Authorized Adults in the student information system. LEARN will only remove a parent from the student information system with a legal document that instructs that action, such as valid court documentation that restricts a birth parent’s access to a child. The parent or legal guardian of a student must authorize any other adults they will permit to take physical custody of their child when picking them up from the program. Such authorization must be provided on this form. All authorized adults will be entered into the student information system as being approved by the parent/legal guardian. Only the parent/legal guardian may request changes to the list of authorized adults in the student information system. Authorized adults must produce valid, unexpired, photo identification to LEARN staff. Adults who are not able to produce valid identification will not be allowed to pick-up a student from the program, regardless of whether the adult’s name appears on this form or in the LEARN student information system as an emergency contact or authorized person. It is the sole responsibility of the parent/legal guardian to ensure that LEARN has the correct information for Emergency Contacts and Authorized Adults.

Adults other than a parent/guardian must be listed as emergency contacts below.

Students in Grade TK – 5 will only be released to an authorized adult (over 18 years of age). The Authorized Adults must be listed below.

Persons LEGALLY PROHIBITED from picking up my student (if applicable). You MUST provide your ASPIRE Site Coordinator with a copy of the legal document or court order, or fax it to LEARN at 562-945-0191.

I understand that my child must attend the ASPIRE program EVERY DAY, Monday - Friday, for the entire duration of the program. I understand that my child may be dismissed from the program for excessive absences, tardiness or inappropriate behavior. I am also aware that the program ends at 6:00 PM and if my child is picked-up after that time, my child will receive a "Late Pick-Up Warning Form." If a student receives three (3) Late Pick-Up Warning Forms, he/she may be asked to leave the program.

I understand that LEARN personnel may photograph and/or film my child during the program and I hereby consent to use of these photographs/video in LEARN's ASPIRE promotional material.

My signature below authorizes the exchange of information regarding my child’s academic progress between the ASPIRE staff and the staff at my child’s school.

I hereby waive all claims against my child's school district, LEARN and its employees for injury, accident or illness occurring by reason of participation in ASPIRE. In case of an emergency, I authorize and licensed physician or hospital to render such medical aid as may be deemed necessary and/or desirable. Any cost/liability incurred for such treatment shall be my sole responsibility.

After clicking the SUBMIT button below, you will be automatically redirected to a page where you will review the information you entered and electronically sign the completed registration form. After signing, you will be able to save and print a copy of the signed form, in addition to being emailed a PDF copy of the form.