Before School Program 2022-23

Before School Registration 2022-23

This online form should be used to enroll a student in the Before School Program at El Monte City School District.
  • BEFORE SCHOOL PROGRAM INFORMATION

  • Program Overview

    LEARN, in partnership with El Monte City School District, will be offering the Before School Program at every school in the district during the 2022-23 school year. LEARN's Before School Program provides 90 minutes of learning activities for youth before the start of their school day. Youth Leaders provide academic enrichment, along with a nutritious breakfast. The child must be enrolled in one of our participating elementary school sites in order to be able to enroll in the Before School Program (Columbia, Cortada, Durfee, Gidley, Legore, Rio Vista, Shirpser, New Lexington, Wilkerson, Potrero, Cherrylee, Cleminson, Rio Hondo and Wright). Within 5 business days after submitting the registration form, the Before School Program Coordinator will email parents to inform them of their child's status in the program. If the child is accepted, the Coordinator will also provide basic information regarding where to meet and program rules.
  • Program Guidelines

    BEFORE SCHOOL PROGRAM ATTENDANCE POLICY: This is a grant-funded program and the state requires that all students attend the program five (5) days a week for a minimum of forty-five (45) minutes from the beginning of the program to when school begins. If students are unable to attend the full 90-minute program, the parent must complete a Late Arrival Policy form. 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.
  • Equal Opportunity

    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.
  • STUDENT INFORMATION

  • This is the number located on your child's school ID card.
  • This is the grade your child WAS enrolled in for Fall 2021.
  • This is the grade your child will be GOING INTO for Fall 2022.
  • (mm/dd/yyyy)
  • PARENT/GUARDIAN INFORMATION

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  • LEARN will send a confirmation receipt to this email address immediately after you have submitted this form. LEARN will also send the Notification of Acceptance or Waitlist to this email address by the first day of school in August 2022.
  • (If different from Parent/Guardian #1)
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  • STUDENT HEALTH HISTORY & INFORMATION

    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 Before School Site Coordinator. Please follow the completion instructions on the form. If not applicable type N/A.
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  • AUTHORIZATION FOR RELEASE OF STUDENT

    Students will be released to go to their regular school day class at program-end. If a student needs to be picked up during Before School Program hours, they may be picked up only by an Authorized Adult listed on this form.
  • AUTHORIZED ADULTS

    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.
  • Emergency Contacts

    Adults other than a parent/guardian must be listed as emergency contacts below.
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  • Adults Authorized to Pick-Up Student

    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.
  • ### - ### - ####
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  • Adults NOT Authorized to Pick-Up Student

    Persons LEGALLY PROHIBITED from picking up my student (if applicable). You MUST provide your Before School Site Coordinator with a copy of the legal document or court order, or fax it to LEARN at 562-945-0191.
  • CONSENT TO USE OF VIDEO OR PHOTOGRAPHY

    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.
  • RELEASE OF INFORMATION

    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.
  • LIABILITY WAIVER

    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's Before School program. 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.
  • DIGITAL SIGNATURE OF PARENT OR LEGAL GUARDIAN

    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.
  • This field is for validation purposes and should be left unchanged.