United Learning Day Program Application

United Learning Day Program Application

The United Crescent Hill Ministries United Learning Youth Day Program is a partnership between youth, their families, their schools, and our staff and volunteers.  The overarching goal of the United Learning program is to help students achieve academic success and develop positive behaviors and relationships with peers and adults. The COVID-19 pandemic has posed many challenges to students and their families. Our newly-designed Day Program provides a safe and supportive environment, equipped with the necessary technology, where students can complete assignments (Non-traditional Instruction) with the guidance and encouragement of UCHM volunteer and staff. In addition, we provide opportunities for youth to expand their skills and knowledge, build confidence,  and develop positive social and emotional learning skills. In order to ensure the safety of students, staff, volunteers and their  families, we strictly follow up-to-date guidance from the Center for Disease Control (CDC) and local public health officials.

During the school year, UCHM uses peer tutors to work with the youth in addition to staff and adult volunteers. Each peer tutor is at least three grades ahead of any child the tutor helps. The peer tutors are excellent students who have been interviewed by our staff and approved to volunteer in our program for a designated time period. UCHM also utilizes adult volunteers to assist students with homework help as well as provide assistance with general program activities. All volunteers are screened during a background check and provided training.

UCHM’s United Learning Day program serves Kindergarten – Eighth Grade (K-8) children and operates in two-hour blocks (one morning and one afternoon) Monday – Thursday following the  Jefferson County Public School (JCPS) Calendar. Final times for the two-hour blocks will be determined following additional guidance from JCPS regarding  the synchronous/asynchronous schedule. At this time we ask that you reserve your desired morning and/or afternoon when applying.  You may apply for up to TWO two-hour blocks per week. We ask that you keep your selected blocks the same for each week throughout the NTI schedule. 

There is no fee for the United Learning Day Program. 

Student Information

Parent/Guardian Information

Medical Information

Please provide a copy of your child's insurance card to UCHM prior to the start of the program.
If not, contact Program Director as soon as possible
We collect this information for grant reporting purposes.

Emergency Contacts and Authorized Persons

List name, phone number, and relationship to child

Financial Information

The fee for the United Learning program is $25/week. Please select a payment preference below.

Consent

In the event that my child becomes ill or sustains any injury while attending the youth program at UCHM and/or while on an authorized and chaperoned activity sponsored by UCHM (on or off UCHM property), I, the undersigned, give my permission to the adult leader(s) to administer first aid and/or CPR and to select a physician and/or hospital for my child’s care, releasing her/him from liability for their actions. UCHM Youth Program Staff are CPR/First Aid Certified. Also, I give the emergency care personnel, physicians, and/or hospital my permission to examine, treat, and provide medical, dental, or surgical diagnoses for my child. They may also x-ray, administer medication or anesthesia as deemed necessary. Further I give EMS and any other emergency transportation service my permission to transport my child. I understand that this consent and release will apply to all emergency situations present and future.
I also give permission for my child to go on any UCHM sanctioned field trip. I understand that a copy of this form, after signed, is as valid as the original. This consent/release form shall remain in effect until written revocation to UCHM or until 18 months after date signed.
I give permission for my child’s picture to be taken and used in UCHM’s newsletter, social media, or other publicity materials. UCHM will not give children’s names or any identifying information within any agency publication. Pictures will be used to share the work of UCHM with the community, donors, and supporters.
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