2021 Summer Camp - Student Application 

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NTP Virtual
NTP Virtual

Dear Parent(s) / Guardian(s):
  Thank you for your interest in For Love of Children (FLOC).  FLOC provides FREE educational services beyond the classroom to help students succeed from second grade through college and career. FLOC is currently accepting applications for the Summer 2021 semester, which will take place from June 28th - August 6th

COVID-19 NOTE: FLOC is responding to COVID-19 precaution measures by holding a completely virtual program for the Summer semester. We will closely monitor DCPS guidelines for the rest of the year and will update notices and changes in real time.



Application Checklist

 

In order for your student to participate in FLOC programs:

  • We must received a completed application
  • Your student must have access to a a working laptop or tablet (no phones) to join in and participate on Zoom sessions
  • Show proof of eligibility for FDPIR, TANF, SNAP, or Medicaid card. (Must provide each school year)

We MUST receive the following documents IF your student is receiving supplemental services at school:

  • Individualized Educational Plan (IEP)                      
  • Functional Behavior Assessment
  • Behavior Intervention Plan
  • 504 Plan
If you are unable to upload any of the additional documents in this form, please submit them to:

Recruitment & Outreach                     

Email: rando@floc.org              

Phone: (202) 349-3517      


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STUDENT INFORMATION


FLOC INVOLVEMENT
Summer Camp Program
Please be sure that each item you select works for the entire summer semester. 

We will place your student in program based on these dates and you will not be able to switch program dates once camp starts.

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STUDENT EDUCATION INFORMATION
Does your student have any of the following plans to receive supplemental services or accommodations at school?
PARENT / GUARDIAN INFORMATION #1


EMERGENCY CONTACT INFORMATION (Required - must be someone other than parent / guardian)  
STUDENT'S FAMILY BACKGROUND AND HOUSEHOLD INFORMATION
This information will be used to process a student's application and for FLOC's statistical reports to organizations that make donations to the FLOC program. All of your responses will be kept confidential.






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RELEASE FORM
This form is required. This page MUST be completed and signed by the student's legal parent or guardian. 

*Please Initial*
Media, Photography, and Video
I understand and give permission to For Love of Children and approved partners to use information about my student's involvement and progress in program, as well as photos or video of my child for use as FLOC deems appropriate for publicity and fundraising purposes. I understand that FLOC will keep my student's name confidential unless I give permission for use of my student’s first name for publicity purposes (or with photos or video) by answering “Yes” to the following question. 

FERPA CONSENT FORM
This form is required. This page MUST be completed and signed by the student's legal parent or guardian.
FERPA Participant Consent Form 

Education records are considered confidential documents protected by the Family Educational Rights and Privacy Act (FERPA), a federal law designed to protect the privacy of, and provide access to, student education records. FERPA gives parents, legal guardians and students age 18 and older certain rights with respect to their education records, including, but not limited to:
  • The right to inspect and review education records within 45 days
  • The right to seek to amend education records
  • The right to have some control over the disclosure of information from education records
I authorize and consent DCPS Office of the Chief of Staff and/or my child's school to provide information concerning the education of my child to For Love of Children and
Office of Out of School Time Grants and Youth Outcomes. I further authorize the release of
educational records of my child for the current school year to the parties listed above that include the following information: education transcripts, school/program enrollment information, universal student ID, attendance data, credit history, grades, assessment data, IEP information and graduation attainment (12th grade only). This authorization and release shall remain in effect from January 11, 2021 – July 31, 2021.

 

By signing below, 

1) I acknowledge and understand that I have the opportunity to review the records to be disclosed and the right to challenge the contents of such records

2) I am at least 18 years of age or I am signing this document on behalf of my child because he/she is not 18 years of age.                                                                        


OST OFFICE CONSENT

For Love of Children (FLOC) is funded by the Office of Out of School Time Grants and Youth Outcomes (OST Office). As a grantee we are required to share participant information with the OST Office that may be collected on this form.

 

In addition, we are required to administer a questionnaire called the Survey of Academic and Youth Outcomes (SAYO). The SAYO is a brief survey with questions about what your child thinks of the program and of the potential benefits from attending the program. All information collected through the SAYO is confidential and no individual child or their individual responses will be identified. Participation in the SAYO is voluntary. 


By signing below I give permission for my child to be included in the SAYO survey. I further authorize For Love of Children to provide name and date of birth to the OST Office.


SIGNATURE
  • I certify that the above information is accurate to the best of my knowledge.
  • I understand that my student is being considered for admission into For Love of Children program(s) and that submitting this application and attending testing does not guarantee my child a place in FLOC program(s).
  • I understand that before my student will be considered for FLOC's program(s), I must submit all required documentation (application, proof of eligibility and any applicable supplemental education plans required for enrollment by FLOC.)
APPROPRIATE BEHAVIOR AT FLOC

FLOC's No Tolerance Policy

The following behaviors will result in permanent dismissal from FLOC program(s). 

 

-Possession or use of a weapon / weapon look-alike. 

-Possession of / being under the influence of drugs, alcohol, or tobacco.   

-Physical fighting of ANY kind (including rough-housing). 

-Threat or intent to harm another participant and / or staff member with an object being used as a weapon.  

-Physical or sexual harassment of another student or staff (ex:  inappropriate touching, sexual language used). 

-Blatant disrespect / defiance 

FLOC's Anti-Bullying Policy

The U.S. Department of Health and Human Services (DHHS) defines bullying as “unwanted, aggressive behavior among school-age children that involves a real or perceived power imbalance. The behavior is repeated, or has the potential to be repeated, over time.” Bullying includes not just physical violence, but also aggression that is verbal (threats, name-calling, inappropriate sexual comments) and social (exclusion, rumor spreading, public embarrassment). As children increasingly use digital and online communications, cyberbullying has added an extra dimension of complexity to the problem. While FLOC can not take action against bullying, it is important for parent(s)/caregiver(s), children, and volunteers involved with our program to recognize the signs of bullying and understand how to take action if and when bullying occurs. The warning signs of bullying are detailed below. Signs that a child may be a victim of bullying include: ⦁ Unexplainable injuries ⦁ Lost or destroyed clothing, books, electronics, or jewelry ⦁ Frequent headaches or stomach aches, feeling sick, or faking illness ⦁ Changes in eating habits, like suddenly skipping meals or binge eating. Kids may come home from school hungry because they did not eat lunch. ⦁ Difficulty sleeping or frequent nightmares ⦁ Declining grades, loss of interest in schoolwork, or not wanting to go to school ⦁ Sudden loss of friends or avoidance of social situations ⦁ Feelings of helplessness or decreased self-esteem ⦁ Self-destructive behaviors such as running away from home, harming themselves, or talking about suicide Signs that a child may be bullying others include: ⦁ Get into physical or verbal fights ⦁ Have friends who bully others ⦁ Are increasingly aggressive ⦁ Get sent to the principal’s office or to detention frequently ⦁ Have unexplained extra money or new belongings ⦁ Blame others for their problems ⦁ Don’t accept responsibility for their actions ⦁ Are competitive and worry about their reputation or popularity At FLOC, we act as additional support to the children enrolled in our programs so we may help them prevent and/or cope with bullying. This policy, developed with stopbullying.org as a resource, addresses FLOC’s response to bullying of children in our programs. Parents/Caregivers, Volunteers, and Staff ⦁ Learn to recognize the warning signs that a child is involved in bullying. They may be the victim, the bully, or a witness to ongoing bullying. ⦁ Begin to open the lines of conversation about bullying before it becomes an issue. Check in often about friends, school, and any concerns the child may have. ⦁ Practice problem-solving and role-playing techniques with the child. This includes, but is not limited to, eye contact, stance, voice inflections, ignoring the bully, reacting in a different way than expected by the bully, walking away, avoiding possible conflict, and reporting incidents. ⦁ Believe a child if they report a bullying incident to you. Take the report seriously and follow the steps below according to your role with BBBSNCA. ⦁ Record all details of any incidents reported by a child. This includes name(s), location(s), date(s), type of bullying, and any other important details. ⦁ Mentors: If your mentee reports bullying to you, you must report the incident to the parent/caretaker and BBBSNCA support staff. ⦁ Parents/Caregivers: If a child reports bullying to you, the incident must be reported to the school or location where the bullying occurred. ⦁ Staff: If a child or mentor reports bullying to you, the incident must be reported to the parent/caregiver. Children ⦁ Speak up loudly and clearly. Tell the bully that you do not like their actions and/or behavior, if it feels appropriate. ⦁ Walk away from any situation that makes you feel uncomfortable. ⦁ Report the bullying incident(s) to a trusted adult immediately. ⦁ Seek involvement in activities that you find fun and interesting. ⦁ Talk to your teacher, parent(s)/caregiver, and/or mentor about your friends, activities, school, and anything that bothers you. Here at FLOC, we believe that each child in our program has the right to be treated with respect and supported by caring, trusted adults. This policy ensures those rights.

Be Respectful. Follow the instructions of FLOC staff and tutors. 
Be Present. Items other than a pencil and scratch paper are not allowed during virtual sessions. No toys, cell phones, music devices, can be used during tutoring.
Be Responsible. Students must be active participants at all times. Students cannot mute or cancel video unless agreed upon with tutor.

Attendance Policy


FLOC requires that all participating students attend regularly, log on Zoom on time, and to never leave video sessions early without consent from a FLOC staff member. 

Once accepted to the program, students are expected to maintain excellent attendance.  Students may receive no more than 3 absences over the course of the school year. The third absences will be the last absence before student is removed from program
   
Parents are requested to call FLOC’s attendance line at (202) 349-3519 or email NTP@floc.org to inform staff at least 4 hours in advance of program if students are going to be absent.  
Parent Agreement