Parents and/or Legal Guardians: Women With Focus Inc. have promoted the "Healthy Kids; Healthy Community" after-school and out-reach programs for over (15) year with the intention of encouraging children to lose weight and stay fit and active from a young age by making simple lifestyle changes in what they eat and how much activity they get daily.
In 2009 the St Croix Athletic Club was formed and the club members decided to expand the program to all students and to give training in several sports. We have make this program a reality for all students to learn most of the sports that we offer in a safe environment that encourages academic achievement; good sportsmanship; discipline; being respectful; time management; and pride in their accomplishment. Working together as a team to motivate, encourage and support one another in all that they do. Everyone is a winner. Our classes are taught by our special presenters, high school or college students or coaches who are professional in the games. We also educate and inspire our youth by hosting "Crime prevention" and "Bullying" workshop and create leadership skills training. We encourage our students to take responsibility for their neighborhoods by becoming a good role model.
Becoming a member of the “Healthy Kids, Healthy Community Outreach and the St Croix Athletic Club is easy!
Parents can register their children age’s seven to fourteen (7-14) into our after school or Fridays and weekend programs for a small fee of $20.00 annually that covers liability insurance to cover events that are done off school premises, if child does not have school insurance and $30.00 for club member t-shirts.
* Parent / guardian must complete the registration form and provide a copy of all documents that is required.
* Students must have valid school insurance to attend program at the schools.
* Students must have copy of last grade report card or GPA report.
* Students must have copy of immunization card for our records.
REGISTRATION FORM TO ENROLL NEW MEMBERS:
*Parent or guardian name: _______________________________________
*Home #_________________*Cell #____________*Work #:____________
*Physical Address: ________________________________________
*Student’s name: _______________________________________________
* Students age:_________ * Gender: Male / Female * Date of birth:_____
*School child attends____________________________________________
*Grade :_________ * time released from school_____________
I (child), agree to attend classes at the location assigned and I agree to be respectful at all time. Yes _____ No _____
I (child), will follow rules and regulations at all times. Yes ____ No ____
I will be respectful to all adults, mentors, counselors and other students.
I will not hit anyone, fight with anyone, swear or use profanity at any time.
If I have a problem, I will speak to my mentor / director.
Sports activities that will be taught to students please indicate the sports that you will like to learn to play:
Softball: ________, Basketball: _______, Volley Ball: _______, Kick ball: ________, Tennis: ________, Bowling: ________, Golf: __________, Fishing: _________.
Games that will be taught to all students please indicate the games that you would like to learn:
□ Jump rope □ Hop scotch □ Sack race □ Tag □ Relay racing
Parent signature: ______________________________Date:__________
Becoming a Youth Team Leader with the St Croix Athletic Club is easy:
Date of birth:
Grade / Level:
If younger than (18) parental consent is required.
Parent's contact #s:
Requirements to qualify please be honest in answering the questions below. All counselors will be evaluated for a few weeks, before employment is approved.
Willing to work for minimum wages required by labor __________
Willing to work for community service hours ________
Agree to conduct myself appropriately and be respectful at all time ______
Agree to dress appropriately at all time while working with students _____
Will wear proper clothes to play sport and attend outing events, including club tea-shirt and wear only sneakers with socks _________
Agree to be a mentor for the younger students and other counselors’ _______
Willing to assist students and other counselors in all areas _______
Willing to attend most outings, fun-raising events planned ______
Willing to work and assist all students assigned to me ____
Willing to give my input in planning programs, events and fun-raisers _____
Will notify the director, if I can't attend class (1) day or more in advance _____
Will not discuss anything negative that happen at class with others outside of our group ____
Will conduct myself in a respective manner at all times to other adults, counselors and the students ____
Willing to work with everyone and give encouragement to the students ________
Will not wonder off from my students or the other members at any time_______
I will avoid the use of my cell phone while at work at all time _______
I am willing to assist in bake sales and fun-raisers events and asking for donation for the organization ________
I am will to sleep over with the group and work with the students assigned to me for the duration of the outings _____
I will ask question, if I don't understand and or agree to all the above information _____.
I have read and understand all that I have read and agree to this contract.
What is needed to be turned in with this application?
* Medical report / health report /with proof of shots (need proof of whether you smoke or drink).
* Valid food handler’s card
* Valid police report
* Proof of school attendance
* (2) Letters of good standing from unrelated persons with their name and contact info.
Counselor’s name:_____________________________ Date: ____
Parent's signature if under (18):__________________ Date: ____
Director's signature: ___________________________ Date: ____