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Agreement with Museum of Science, Inc. ao/9 - 3/0,S-5 AGREEMENT THIS AGREEMENT is made and entered into as of this(7psv. 9 2020 (the Effective Date, which shall be the date this Agreement is fully executed), by and between CITY OF MIAMI BEACH,FLORIDA (Hereinafter referred to as CMB) a body corporate and political subdivision of the State of Florida, whose principal place of business is 1700 Convention Center Drive, Miami Beach, FL 33139 And MUSEUM OF SCIENCE,INC (Hereinafter referred to as FROST SCIENCE) a Florida not-for-profit corporation whose principal place of business is 1101 Biscayne Boulevard, Miami, FL 33132 WHEREAS, Miami Beach Fienberg Fisher K-8 and Biscayne Beach Elementary School (the"CMB Program Schools")do not offer after-school science, technology, engineering, and math ("STEM") enrichment classes, while the remaining CMB public elementary schools currently offer after-school enrichment classes for their students; and WHEREAS, through this Agreement, in partnership with Frost Science, CMB seeks to combine its resources with FROST SCIENCE in order to increase the competitiveness of the CMB youth by establishing and supporting an after-school enrichment program at the CMB Program Schools pursuant to the terms and conditions set forth herein (the "Program"); and WHEREAS, this Agreement provides the guidelines for CMB to financially support the Program; and NOW, THEREFORE, in consideration of the premises and of the mutual covenants contained herein and other good and valuable consideration,the receipt and sufficiency of which are hereby acknowledged, the parties agree as follows: 1 ARTICLE 1 —RECITALS 1.01 Recitals. CMB and FROST SCIENCE (individually, a"party" and collectively, the"parties") agree that the foregoing recitals are true and correct and that such recitals are incorporated herein by reference. ARTICLE 2—DEFINITIONS 2.01 Chief Learning Officer: As referred to herein, the Chief Learning Officer shall be defined as the Chief Learning and Development Officer who is employed by CMB and responsible for the administration of this Agreement on behalf of CMB. 2.02 FROST SCIENCE Educator(s): As referred to herein, the FROST SCIENCE educator(s) shall be defined as a fulltime or part-time member of the staff of FROST SCIENCE. ARTICLE 3 —SPECIAL CONDITIONS 3.01 Term of Agreement. The term of this Agreement shall be effective from January 6, 2020 through May 29, 2020, unless terminated earlier pursuant to Section 3.02 below. This Agreement may be renewed annually upon the mutual written consent of the two Parties to this Agreement, and subject to such terms and conditions as the Parties shall determine in writing. 3.02 Termination. This Agreement may be canceled with or without cause by either party during the term hereof upon thirty(30) days written notice to the other party of its desire to terminate this Agreement. 3.03 Joint Responsibilities. CMB and FROST SCIENCE shall maintain responsibility for implementing the various components of the Program, as delineated in this Agreement. A. For the Program, FROST SCIENCE serves as the "lead" organization for afterschool STEM classes at the CMB Program Schools. As the lead organization, FROST SCIENCE is responsible for the following: 1. Requirements and Regulations: ensuring that the Program activities and supplies are in compliance with this Agreement. 2 2. Recruitment, Selection, and student mentorship: recruitment and selection of all Program staff and management of staff throughout the recruitment, selection, and onboarding process. 3. Program Content:Development,curation,and implementation of the Program content, including: curriculum and exposure opportunities (e.g. speakers, workshops, etc.). FROST SCIENCE will work in collaboration with CMB to jointly plan exposure opportunities and events, but FROST SCIENCE retains the right of final approval and confirmation of all Program class content and delivery. Prior to classes commencing, FROST SCIENCE will provide CMB with the syllabus for the Program classes. B. The Program classes to be provided in Spring 2020, in partnership with FROST SCIENCE, include the following modules: 1. Physics: Accelerate an interest in physical sciences with thrilling lessons exploring gravity, magnetism, forces and energy. Students will start off with mechanic fundamentals in simple machines and then increase momentum by investigating the laws of motion and electricity before venturing into the application of physics to cosmology and astronomy Activities include: • Assembling and testing a projectile launcher • Improving rollercoaster designs to understand motion • Analyzing the properties of light through diffraction • Simulating the gravitational pull of a blackhole • Generating the flow of electricity by connecting circuits 2. Chemistry: Students will learn the difference between acids and bases, explore pH and its importance in water quality testing, experiment with chemical reactions and more. Activities include: • Testing the pH of various substances to rate acidity and basicity levels • Using electricity to decompose water • Making non-Newtonian fluids • Investigating the effects of water quality on aquatic ecosystems • Examining oxidation reactions using steel wool 3. Fee: The fee shall be $8,000.00 per curriculum module for a total amount not to exceed $16,000.00 (the "Fee"). The City shall pay 50% of the Fee in the amount of $8,000.00, within (45) days from the Effective Date of the 3 Agreement and receipt of an invoice from FROST SCIENCE. The remainder of the Fee, in the amount of$8,000.00, shall be paid upon completion of the Program.Pricing is listed for one curriculum module conducted at two locations (one hour at each location per week)for one semester(14 weeks).It is inclusive of all staff time,use of the curriculum, materials and mileage. All Program classes shall be provided by FROST SCIENCE pursuant to the course parameters and schedules, set forth in Composite Attachment"A", attached hereto and incorporated herein by reference. C. Teaching Staff: The responsibilities of FROST SCIENCE and CMB with respect to the FROST SCIENCE Educators will be as follows: 1. FROST SCIENCE will be responsible for the development and implementation of staff recruitment, training and placement. FROST SCIENCE full-time and part- time Educators are eligible to apply. FROST SCIENCE will hold weekly meetings with FROST SCIENCE Educators. Weekly conference calls will follow with the Chief Learning Officer. 2. The Chief Learning Officer, at the Chief Learning Officer's sole discretion, may request that any FROST SCIENCE Educator be removed from participating in the Program, upon written notice to FROST SCIENCE, effective as of the date provided in the written notice. If CMB requests that FROST SCIENCE replaces the removed FROST SCIENCE Educator, FROST SCIENCE agrees to secure a replacement FROST SCIENCE Educator for the Program. D. Impact Evaluation: FROST SCIENCE will be responsible for the administration, analysis, and delivery of impact evaluation efforts including participant, teacher, and parent assessment. FROST SCIENCE will provide CMB with an impact report. Parent assessments will be conducted with the assistance of CMB for access to contact information and/or parent interaction opportunities. E. Under this Agreement, for the Program, CMB serves as "Host." As the Host, CMB agrees to: 1. Recruitment and Registration: CMB will support student recruitment efforts including mandatory support/outreach to relevant community and education partners; CMB will share additional opportunities for partner employees to engage in recruitment efforts as they become available.CMB will use the registration forms attached hereto as Composite Attachment"C"and incorporated herein by reference and/or Class Juggler. CMB will be responsible for the enrollment of students. Students may not take more than one (1)class per semester, unless the class size is 4 under-enrolled, then CMB may, at its sole discretion, permit the same student to attend multiple classes. 2. CMB requires that the Frost Science Educators go through the City's Level 2 screening and obtain contractor badges from Miami-Dade County Public Schools. 3. Space: CMB will execute a facility use agreement with Miami-Dade County Public Schools (MDCPS) for the use of the required space for the Program at the CMB Program Schools and Provide a dedicated classroom space at each CMB Program School for a minimum of twenty (20) Program students and two (2) FROST SCIENCE Educators for the duration of the 14 week Program. Classroom space must be pre-approved by FROST SCIENCE and include windows,desk space,and chairs(either one large table or portable desks), a whiteboard, and internet access. 4. Security: CMB will ensure security support and building access to Program students and FROST SCIENCE Educators involved in the Program, in line with MDCPS' policies and procedures. During the week prior to the Program start date, CMB will provide a security overview meeting to the FROST SCIENCE Educators, outlining onsite procedures in case of emergency, and during the first week of the Program, CMB will provide a security overview and procedures to the Program students and FROST SCIENCE Educators. FROST SCIENCE staff must pick up the Program students and take them to the class. FROST SCIENCE staff must remain with the Program students, at the designated location, until the authorized parent or guardian picks up the Program student. The Chief Learning Officer may remove Program students from the Program if the authorized parent or guardian fails to promptly pick them up within 15 minutes of the conclusion of the class session. F. Equipment/Supplies: CMB will make arrangements with MDCPS, through the facility use agreement, for MDCPS to provide access to computer-labs and classrooms as needed. MDCPS will provide computers/laptops with Wi-Fi and Bluetooth capabilities for twenty (20) Program students and two (2) FROST SCIENCE Educators, if applicable. G. Program Management Resources: CMB has appointed the Chief Learning Officer as the one main point of contact to serve as the internal Program manager for the Program at the CMB Program Schools from January—June. 3.04 Marketing. FROST SCIENCE and CMB will work collaboratively to market, transition, evaluate, and assess the results of the Program. 5 3.05 Notice. When any of the parties desire to give notice to the other, such notice must be in writing, sent by U.S. Mail, postage prepaid, addressed to the representatives designated below by each party (unless changed by written notice in compliance with the provisions of this paragraph): To CMB: Jimmy Morales City Manager City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 With a copy to: Dr. Leslie Rosenfeld Chief Learning Development Officer City of Miami Beach 1700 Convention Center Drive Miami Beach, Florida 33139 To FROST SCIENCE: Neil Kurlander Senior Vice President of Administration and General Counsel 1101 Biscayne Boulevard Miami, Florida 33132 With a copy to: Angela Colbert, PhD Knight Vice President of Education Museum of Science, Inc. 1101 Biscayne Boulevard Miami, Florida 33132 ARTICLE 4—GENERAL CONDITIONS 4.01 Independent Contractor.The parties to this Agreement shall at all times be acting in the capacity of independent contractors and not as an officer, employee or agent of one another. Neither party nor its respective agents, employees, subcontractors or assignees shall represent to others that it has the authority to bind the other party unless specifically authorized in writing to do so. 4.02 Default. The parties agree that, in the event that either party is in default of its obligations under this Agreement, the non-defaulting party shall provide to the defaulting party(30)days written notice to cure the default. However,in the event said default cannot be cured within said thirty(30)day period and the defaulting party is diligently attempting 6 in good faith to cure same, the time period shall be reasonably extended to allow the defaulting party additional cure time. Upon the occurrence of a default that is not cured during the applicable cure period;this Agreement may be terminated by the non-defaulting party upon thirty (30) days' notice. This remedy is not intended to be exclusive of any other remedy, and each and every such remedy shall be cumulative and shall be in addition to every other remedy now or hereafter existing at law or in equity or by statute or otherwise. No single or partial exercise by any party of any right, power, or remedy hereunder shall preclude any other or future exercise thereof. 4.03 Annual Appropriation. The performance and obligations of CMB under this Agreement shall be contingent upon an annual budgetary appropriation by CMB's governing body. If CMB does not allocate funds for the payment of services or products to be provided under this Agreement, this Agreement may be terminated by CMB at the end of the period for which funds have been allocated. CMB shall notify the other party at the earliest possible time before such termination. No penalty shall accrue to CMB in the event this provision is exercised, and CMB shall not be obligated or liable for any future payments due or any damages as a result of termination under this section. 4.04 Excess Funds. Any party receiving funds paid by CMB under this Agreement agrees to promptly notify CMB of any funds erroneously received from CMB upon the discovery of such erroneous payment or overpayment. Any such excess funds shall be refunded to CMB, as applicable, with interest calculated from the date of the erroneous payment or overpayment. Interest shall be calculated using the interest rate for judgments under Section 55.03, Florida Statutes, applicable at the time the erroneous payment or overpayment was made by CMB. This provision shall equally inure to FROST SCIENCE's benefit. 4.05 FROST SCIENCE'S COMPLIANCE WITH FLORIDA PUBLIC RECORDS LAW (A) FROST SCIENCE shall comply with Florida Public Records law under Chapter 119, Florida Statutes, as may be amended from time to time. (B) The term"public records" shall have the meaning set forth in Section 119.011(12), which means all documents,papers,letters,maps,books,tapes,photographs,films, sound recordings, data processing software, or other material, regardless of the physical form,characteristics,or means of transmission,made or received pursuant to law or ordinance or in connection with the transaction of official business of CMB. (C) Pursuant to Section 119.0701 of the Florida Statutes, if FROST SCIENCE meets the definition of"Contractor" as defined in Section 119.0701(1)(a), the FROST SCIENCE shall: (1) Keep and maintain public records required by CMB to perform the service; (2) Upon request from CMB's custodian of public records, provide CMB with a copy of the requested records or allow the records to be inspected or copied within a reasonable time at a cost that does not exceed the cost 7 provided in Chapter 119, Florida Statutes or as otherwise provided by law; (3) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed, except as authorized by law, for the duration of the contract term and following completion of the Agreement if the FROST SCIENCE does not transfer the records to CMB; (4) Upon completion of the Agreement, transfer, at no cost to CMB, all public records in possession of the FROST SCIENCE or keep and maintain public records required by CMB to perform the service. If the FROST SCIENCE transfers all public records to CMB upon completion of the Agreement,the FROST SCIENCE shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. If the FROST SCIENCE keeps and maintains public records upon completion of the Agreement, the FROST SCIENCE shall meet all applicable requirements for retaining public records. All records stored electronically must be provided to CMB, upon request from CMB's custodian of public records, in a format that is compatible with the information technology systems of CMB. (D) REQUEST FOR RECORDS;NONCOMPLIANCE. (1) A request to inspect or copy public records relating to CMB's contract for services must be made directly to CMB. If CMB does not possess the requested records, CMB shall immediately notify FROST SCIENCE of the request, and the FROST SCIENCE must provide the records to CMB or allow the records to be inspected or copied within a reasonable time. (2) FROST SCIENCE's failure to comply with CMB's request for records shall constitute a breach of this Agreement,and CMB, at its sole discretion,may: (1)unilaterally terminate the Agreement; (2)avail itself of the remedies set forth under the Agreement; and/or(3) avail itself of any available remedies at law or in equity. (3) FROST SCIENCE who fails to provide the public records to CMB within a reasonable time may be subject to penalties under s. 119.10. (E) CIVIL ACTION. (1) If a civil action is filed against FROST SCIENCE to compel production of public records relating to CMB's contract for services,the court shall assess and award against FROST SCIENCE the reasonable costs of enforcement, including reasonable attorneys' fees, if: a. The court determines that FROST SCIENCE unlawfully refused to comply with the public records request within a reasonable time;and b. At least 8 business days before filing the action, the plaintiff provided written notice of the public records request, including a statement that FROST SCIENCE has not complied with the request, to CMB and to FROST SCIENCE. (2) A notice complies with subparagraph(1)(b)if it is sent to CMB's custodian of public records and to FROST SCIENCE at FROST SCIENCE's address listed on its contract with CMB or to FROST SCIENCE's registered agent. Such notices must be sent by common carrier delivery service or by registered, Global Express Guaranteed, or certified mail, with postage or shipping paid by the sender and with evidence of delivery,which may be in 8 an electronic format. (3) FROST SCIENCE who complies with a public records request within 8 business days after the notice is sent is not liable for the reasonable costs of enforcement. 4.06 Student Records: Notwithstanding any provision to the contrary within this Agreement, FROST SCIENCE shall fully comply with the requirements of Section 1002.22, Florida Statutes, or any other state or federal law or regulation regarding the confidentiality of student information and records. FROST SCIENCE agrees, for itself, its officers, employees, agents, representatives, contractors or subcontractors, to fully indemnify and hold harmless CMB and its officers and employees for any violation of this section, including, without limitation, defending CMB and its officers and employees against any complaint, administrative or judicial proceeding, payment of any penalty imposed upon CMB, or payment of any and all costs, damages, judgments or losses incurred by or imposed upon CMB arising out of a breach of this covenant by FROST SCIENCE, or an officer, employee, agent, representative, contractor, or sub-contractor of FROST SCIENCE to the extent that FROST SCIENCE or an officer, employee, agent, representative,contractor,or sub-contractor of FROST SCIENCE shall either intentionally or negligently violate the provisions of this section or of Section 1002.22,Florida Statutes. This section shall survive the termination of all performance or obligations under this Agreement and shall be fully binding until such time as any proceeding brought on account of this Agreement is barred by any applicable statute of limitations. 4.07 Indemnification. FROST SCIENCE agrees to indemnify and hold harmless the City of Miami Beach and its officers,employees,agents, and contractors, from and against any and all actions (whether at law or in equity), claims, liabilities, losses, and expenses, including, but not limited to, attorneys' fees and costs, for personal, economic or bodily injury, wrongful death, loss of or damage to property, which may arise or be alleged to have arisen from the negligent acts,errors,omissions or other wrongful conduct of FROST SCIENCE, its officers,employees, agents,contractors,or any other person or entity acting under FROST SCIENCE's control or supervision, in connection with, related to, or as a result of FROST SCIENCE's performance of the Services pursuant to this Agreement. To that extent, FROST SCIENCE shall pay all such claims and losses and shall pay all such costs and judgments which may issue from any lawsuit arising from such claims and losses, and shall pay all costs and attorneys' fees expended by CMB in the defense of such claims and losses, including appeals. FROST SCIENCE expressly understands and agrees that any insurance protection required by this Agreement or otherwise provided by FROST SCIENCE shall in no way limit FROST SCIENCE's responsibility to indemnify,keep and save harmless and defend CMB or its officers, employees, agents and instrumentalities as herein provided. The parties agree that one percent(1%)of the total compensation to FROST SCIENCE for performance of the Services under this Agreement is the specific consideration from CMB 9 to the FROST SCIENCE for FROST SCIENCE's indemnity agreement. The provisions of this Section and this indemnification shall survive termination or expiration of this Agreement. 4.08 Place of Performance. The Program services will take place in one of the CMB Program Schools. 4.09 Governing Law and Venue. This Agreement shall be interpreted and construed in accordance with and governed by the laws of the State of Florida. Any controversies or legal problems arising out of this Agreement and any action involving the enforcement or interpretation of any rights hereunder shall be submitted to the jurisdiction of a State court of competent jurisdiction in Miami-Dade County, Florida. 4.10 Entirety of Agreement. This document incorporates and includes all prior negotiations,correspondence, conversations,agreements and understandings applicable to the matters contained herein and the parties agree that there are no commitments, agreements or understandings concerning the subject matter of this Agreement that are not contained in this document. Accordingly,the parties agree that no deviation from the terms hereof shall be predicated upon any prior representations or agreements, whether oral or written. 4.11 Preparation of Agreement. The parties acknowledge that they have sought and obtained whatever competent advice and counsel as was necessary for them to form a full and complete understanding of all rights and obligations herein and that the preparation of this Agreement has been their joint effort. The language agreed to herein express their mutual intent and the resulting document shall not, solely as a matter of judicial construction, be construed more severely against one of the parties than the other. 4.12 Amendments. No modification, amendment, or alteration in the terms or conditions contained herein shall be effective unless contained in a written document prepared with the same or similar formality as this Agreement and executed by each party hereto. The City Manager of the City of Miami Beach, Florida, on behalf of CMB, shall be authorized to execute any amendment or extension of this Agreement. 4.13 Sur.iv al. All representations and warranties made herein, regarding indemnification obligations, obligations to reimburse CMB, obligations to maintain and allow inspection and audit of records and property, obligations to maintain the confidentiality of records, reporting requirements, and obligations to return public funds shall survive the termination of this Agreement. 4.14 Authority. Each person signing this Agreement on behalf of either party individually warrants that he or she has full legal power to execute this Agreement on behalf of the party for whom he or she is signing, and to bind and obligate such party with respect to all provisions contained in this Agreement. 10 4.15 NO DISCRIMINATION. In connection with the performance of the Services, FROST SCIENCE shall not exclude from participation in, deny the benefits of, or subject to discrimination anyone on the grounds of race,color,national origin, sex,age, disability, religion, income or family status. Additionally, FROST SCIENCE shall comply fully with the City of Miami Beach Human Rights Ordinance, codified in Chapter 62 of the City Code, as may be amended from time to time, prohibiting discrimination in employment, housing, public accommodations, and public services on account of actual or perceived race, color,national origin, religion, sex, intersexuality, gender identity, sexual orientation, marital and familial status, age, disability, ancestry, height, weight, domestic partner status, labor organization membership, familial situation, or political affiliation. The Parties hereto have made and executed this Agreement on the date last signed below. 11 FOR THE CITY OF MIAMI BEACH: (Corporate Seal) CITY OF MIAMI BE•/ H, FLORIDA: 1111' -qmom. By: 'MIN` Jimm ' . Morales, City Manager Date: i t 1 3I %9 7.) ATTEST: C 401.���...�.v�.t��I By: jf s A ... .... Ra ael E. ranado, City Clerk i ..... ),( ...° I . INCORii rO / RATED:' J $� ?: t oilit ie. Approve to Form and Legal Content: c4_,.."01,‘ _.--, Office of the City Attorney ,/'r' Date: ' • 12 I OR THE REPRESENTATIVES FOR PHILIP AND PATRICIA FROST N9tiSEIM OF SCIENCE: (Ccorpira1c Sia! THE REPRESENTATIVES SENTATIVES OF MUSEUM OF SCIENCE. INC. () ) - V Date- ATTEST: lig Date: 13 ,‘ttachnivot .t City of Miami Beach Program Afterschool Enrichment Program at Biscayne Beach Elementary School and Miami Beach Fienberg-Fisher K-8 Schools Biscayne Beach Elementary School Miami Beach Fienberg-Fisher K-8 • 800 77 Street, Miami Beach 1420 Washington Ave, Miami Beach (305)868-7727 (305) 531-0419 Principal Karen Belusic Principal Maria Costa FROST SCIENCE Afterschool .FROST SCIENCE Educators must attend an orientation session on the first Friday of each semester. .FROST SCENCE Educators will be matched to an afterschool session depending on their course schedules. Educators Illness or Emergency .FROST SCIENCE Educators are expected to notify FROST SCIENCE and the corresponding school by 10:00am on the day they will not be able to make it to class due to illness. In case of an emergency, instructors are also expected to call before the session. In both cases,the session will be cancelled. FROST SCIENCE PRIMARY CONTACT Daniella Orihuela, MPH Director of Educational Programs Phillip and Patricia Frost Museum of Science dorihuela@frostscience.org Schedule The program runs in the Spring,from January 13'to May 22r°,2020. A background check of level II is required Mondays 3:15 p.m.—4:15 p.m. Fridays 3:15 p.m.—4:15 p.m. 14 ATTACHMENT HMEN - I; 411) MIAMI-DADE COUNTY PUBLIC SCHOOLS 2019-2020 SCHOOL CALENDAR ELEMENTARY AND SECONDARY July 2019 A st 2019 September 2019 M T _ W T F QQ M W T F 1 2 3 > 5 mI© 3 4 5 6 8 9 10 11 12 ©Q It iliV;i 9 10 11 12 13 15 16"17 ' 18 19 �LVAE1P7 [1) 16, 17 18 19 , 20 22 23 124 25 26 20 - 21 23 24 25 26 27 29 30 ! 31 ;31 _ 26 27 28 His � ' t October 2019 November 2019 December 2019 1 M T ' WjT ! F MT W T F MiT1W T F ' 1 2 + 314 1 2 3j4 5 6 7 8 +'`8, 10 11 5 6 7 8 9 : 10 11 12 13 14 15 16117 18 12 1311.4 15 16 '' 17 18 19 20 21 22 23 18 191 20 21 1 22 ►I/ _r►_ Ny . 29 30 31 _ 21126 a�_ January 2020 February 2020 March 2020 M T T F M T WiT F M TJW T F ; 3 4 5 6 7 2 3 ; 4 5 6 6 7 8 9 10 10 11 12 13 14' 9 10 11 12 131 13 14 15 18 1920 21 16 17t 18 19 21 , 22 23 24 24 251 26 27 28 _4107 10 27 28 ' 29 30 i 31 —1 31` AEiril 2020 May 2020 June 2020 M T W ' T1 F M : TW T F M T W T F ' 1 2 3 1 1 1 2 (.4::',,:` 5 6 7 8 9 14 4 5 1 6 + 7 8 °8 °9 10 11 12 13 14 15 16 , 17 11 12i 13 ' 14 15 15 16 17 18 19 20 211 22 231 24 18 191 20 21 22 22 23 24 25 26 27 28 ; 29 , 30 , r 26 1 27 28 29, _ 29 30.______ _1 No ralx Asea 771 a Grarc*Moa keys w Oai, Period e7mN 7N^rry 771-MD Opt P...., 1 46 7ie+c3-.ue oneometl qR 3or ID* 2 u 311 l-46 For onformaton on env oyer opt drys.phase refer to back of calendar 15 ATTACHMENT C City of Miami Beach Free After-School Enrichment Program Registration Form Grades 3-5 Only Biscayne Beach Elementary School one I rrrn l'.,Child i'ease all forms must he re?urned:o c:ak sl princiria k 1 rat.t)ecemher 13.20141 fod:a",Date: 4iudcnt-s(ira,le: Student's Last Name. Name. Name of Parent'Guardian I'arent(ias.ardian Here Numbs'r- I E Mail..!Print('learh _BISCAYNE BEACH ELEMENTARY' Monday Tuesday Wednesday Thursday Friday 3:15-4:15 13:15-4:15 ,2:05-345 '3:15-4:15 3:15-4:15 3-d Printing Logic aliMathGamest&2 PAT Scratch 1&2 Robotics 4+rte3i Reality Robotcs 2 Physics Puy Chemistry Fun Please se:cct your crass preference using a check mark(✓)next to ONE class below.as students will be enrolled in only one class per semester and c:ass enrollment is restricted to.16 students each(see chart above fbr day of the week): -[)Printing Virtual Reality Robotics Logical Math Games MIT Scratch Chernisty Fun Physics Play Snrine2020 Proeram Schedule Week I:January 13 Week of February 24: No Classes Week 10: March 30 %Ai eek 2:January 20(No class 20'") Week 7: March 2 Week 11: April 6 lro class Ise'') ll eek 3:January 27 W'eek S: March 4 Week 12: April 13 Week 4: February 3 Week 9: March :6 Week 13:April 20 Week February 10 Week of March 23:Spring Break Week 14: April 27 Week 6: February 17(no class 17") Accident•Health Insurance Please note that the Yearly Student Accident!Health Insurance is recommended to participate in City of Miami Beach After- School Enrichment Program. You may pay online at:w Vfr kl2studcntinsuraccc.com.7hc above insurance,or private accident insurance is the sok responsibility of the parent'guardian to purchase Pick in Students must he picked up at the end of class. Please indicate how your child will get home(select I only): ❑ Parent Pekup 0 Walks 1 tome❑City of Miami Beach NSYPC alter-school program ❑Return to Biscayne Aftercare • I understand that all students must adhere to the M-f)CI'S Code of Student Conduct. • I understand that this signature form will he kept in my child's file as an official document. • Contact Information Form must he coinpieted and signed(attached). Date: I'arentGuardian Signature Date: Parent:Guardian Name 16 MIAMI BEACH CITY OF MIAMI BEACH t I-Form CONTACT INFORMATION FORM:AFTER SCHOOL ENRICHMENT PROGRAMS 2019 2020 SCHOOL YEAR NAME OF SCHOOL. Biscayne Elementary LOCATION NUMBER. 0321 STUDENT NAME. REGISTRATION DATE: LAST MIST STUDENT ID#3: _ AGE GRADE: GENDER: NI❑ F ❑ BIRTHDATE: TEACHER: PARENT/GUARDIAN w--ME • LAST FIAT HOME ADDRESS: ADO ESZ L.T' STATE 2IP OOOE HOME PHONE. WORK PHONE: CELL PHONE: E-MAIL ADDRESS: PARENT/GUARDIAN Nr V- LAST FIRST HOME ADDRESS: ACHMESo LxTv STATE DP CODE HOME PHONE: WORK PHONE CELL PHONE: E-MAIL ADDRESS: PERSONS AUTHORIZED TO PICK UP ENRICHMENT STUDEN1 EMERGENCY CONTACT INFORMATION NAME: PHONE LAST — FIRST NAME: PHONE- T MIST PHYSICIAN. PHONE: LAST MST HOSPITAL IN THE EVENT NO ONE CAN BE CONTACTED, I GIVE PERMISSION FOR MY CHLD TO RECEIVE EMERGENCY MEDICAL TREATMENT? YES 0 NO 0 SPECIAL NEEDS/INSTRUCTIONS: SIBLINGS IN PROGRAM: PARENT/GUARDIAN SIGNATURE: DATE. MIAMI BEACH WAIVER & RELEASE FORM READ CAREFULLY BEFORE SIGNING set al- fj in r,(,',1• t•••ere,r,:..,:tle,"0"e• '0 of. 'Re cofc- +,e-eby exe;:..ste Ye-n•-o e•ose or:.tee owe 7.htre,-.1.7.,roc-orn Pfo-ry.o.rn ce oy 'he !Ity ty s:.oyee Beci4 ile—entcry Sct,00. o.cc ir C377 S-eet M ccn 4 nlve oc-eco 4cr;t-ey es est.o:Asheocyt,e Cy'f-sr ;." es -;;;vt , '•ore fie-se ^rW-re' S orre0toh e "y 1,os t',,C T,g"." 5 (.>, •e' - ogee ni3 o%-,re—ent o-ea Proli•ctr Re'eoss• wino-y -...;•• •:X•t.-C.1....r,• f!-c pe-scq or.c.:Pc'!y 1-c . • - ot,se ro- r ""0.:3,•.t•trr. "f".",Inc:er$crcec e Cc ::‘,- - Le-,o oz,z,we -re- eXe-_/0' ootr -, re,eose4 d -ft-eve! c.:,sc-o•''ies tre ry cc MiccinBeo,'= • - • C s : ct --e er:ted or,v: cccicc r-eO -es swcces!::,-; oss-2 !L' "=5 cc;:s c exoeeses ReleOSOf rinc c'IS- cc . " c-c n crly t‘t fc,•• :r- o-y Pfc,-.14-o,- • 4:•; t,;;;• tier „,::es yieii •I:4± ccc.c !Ws RELEASOR OF THE UNDERSIGNED exn•es-y og-ees ;hot fre =oreac-nr..: -e eoie ye' - - .•• : • : •tysi, 1"e t y • ' •, -,,e c..4•,:o cc-cc ei.ec• THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE RELEASE AND WAIVER OF LIABLITY AND INDEMINTY AGREEMENT, - • •- • PHOTOGRAPHIC RELEASE e•ez,y ze . 000 s o-:ents e ected Ltno Ce-:ci5. ciycP. ferese,. -ves oss w • teiev 210f-record rigs cc-;d/o' we te yse: wcrcce - ey ' ':j tow,5- Zndccc cse one s- the so—e si.rt cc oces cn i cmt-e 2.,-y c.:^1 c 5,4'M to he o: nenef-to so o ty. ,etet:y wcwe o-y rCifct-o• •-o/-.ove ,soec• opp-ove ,tioy useo cc 4e SciCcciC fl.se w1 ,1 rr,Jycc o:4) Dated this day of ,20 -c- -- - - : W c-ess Pr--1 .•4eeocc-c, - ec•tt ccci,cc c (.:1 Wo,e, No-ne Too•-•e - - -- — c'•ccWt•ess 18 (lass Dates Spring 2020 Semester Dates(14 weeks) Week 1: January 13 - 17 Week 9: March 16 -20 Week 2: January 21 - 24 Week of March: Spring Break (no Week 3: January 27 - February 1 classes) Week 4: February 3 - 7 Week 10: March 30- April 3 Week 5: February 10- 14 Week 11: April 6-9 Week 6: February 18 -21 Week 12: April 13 - 17 Week 7: March 2 -6 Week 13: April 20 - 24 Week 8: March 9 - 13 Week /4: April 27- May 1 19 City of Miami Beach Free After-School Enrichment Program Registration Form (;rades 3-8 Only Miami Beach Fienberg Fisher K-K One Foran Per Child Please (al:firms must he returned to. heol_prnnr ipal 7a fr d as,Dece,mh=r 13.2019) Ioday a Date: Student's(rade: Student-s Last Name. Fre Name: Name of Parent(iaaardrw:. Knenl(ivard data Phone Nurnbcrs:lime: Cell. E-Mail,4Print Clearly) FIENBERG FISHER* (Monday Tuesday 'Wednesday 1Teursday Friday 3:15 4:15 3:15-4:15 2:05-3:05 3:15 4:15 3:15-4:15 t?a3r9�.ici 2 Book Cluz 3 3 Printing NMIT Scraith I 3 2 {Hr.,a:tf:;Mc r.li4rb LOg calfMath Games 1&2 lag 9 s�otatall Lna>er r ddir4g Volleyball! Physics Play Che rastry F,,,n wiz 'class description attached Plea5e.select your class preference using a check mark(I)next to the two classes below one from Group A and one from(:roup B. as students will be enrolled inonly-two classes per semester and class enrollment is restricted to 16students each(see chart above for day of the week): Group A(select I t (.roup B(select I) 3D Printing Chemistry Fun Volleyball Logical'Mathematics Games Cheerleading Healthy Mc Club MIT Scratch Book Club Flag Football Robotics Jazz Physics Play Spring 2020 Program Schedule Week I.January 13 Week of February 24:No Classes Week 11: April 6(no class I0'`) Week 2:January 20(No class 20') Week 7: March 2 Week 12: April 13 Week 3:January 27 Week 8: March 9 Week 13: April 20 Week 4: February 3 Week 9: March 16 Week 14; April 2 Week 5: February 10 Week of March 23: Spring Break Week 6: February I?(no class 17*) Week 10: March 30 AccidentiHealth Insurance Please note that the l earn Student Accident/Health Insurance is recommended to participate in City of Miami Beach After- School Enrichment Program.You may pa+ online at:iso.w.kl2studentit'si:ranie.ci'm l he abuse insurance,or pr:%ae aceident iasxcnce:s the sale resi74)nsabits of the parent guardian to purchase, - Pick l."p Students must be picked up az the end of class.Please indicate how)our child will tet home(select I only i. ❑ Parent Pic.up 0 V.alks home OCits of Mian Reach :a iningo PAI,after-school prognen 0 Return to Fienherg fisher Aftercare • I understand that all students muse adhere to the tt-DCPS Code of Student Conduct • I understand:hat this signature litrm will he kept in nay child's file as an official document. • Contact Information Form must he completed and signed(a;:achcdj.20 Date: Parent"Guardian Signature Date: l'arent`(ivardian\ata:e. ,MAN BEACH CITY OF MIAMI BEACH CONTACT INFORMATION FORM AFTER SCHOOL ENRICHMENT PROGRAMS 2019 _ 2020 SCHOOL YEAR NAME OF SCHOOL' Fienberg F,;cier<A Center LOCATION NUMBER 0761 STUDENT NAME: REGISTRATION DATE IABP RAST STUDENT ID it AGE- GRADE GENDER M':] F BIRTHDATE TEACHER: PARENT/GUARDIAN N .AB' REST HOME ADDRESS ADZ an, STATE LP COOL HOME PHONE: WORK PHONE' CELL PHONE. E-MAIL ADDRESS: PARENT/GUARDIAN N HOME ADDRESS — - wuuss cif!. �niE va ust HOME PHONE WORK PHONE: CELL PHONE: E-MAIL ADDRESS: PERSONS AUTHORIZED TO PICK UP ENRICHMENT STUDENT EMERGENCY CONTACT INFORMATION NAME PHONE uaB' PRE* NAME PHONE LAE— PRET PHYSICIAN. PHONE Aar Rrr-:T HOSPITAL IN THE EVENT NO ONE CAN BE CONTACTED, I GIVE PERMISSION FOR MY CHILD TO RECEIVE EMERGENCY MEDICAL TREATMENT? YEs 0 NO 0 SPECIAL NEEDS/INSTRUCTIONS SIBLINGS IN PROGRAM: PARENT/GUARDIAN SIGNATURE: _ DATE AFERSChiCa E\RCHMEN- PRaCkA,Y„ WAIVER & RELEASE FORM READ CAREFULLY BEFORE SIGNING = ; • 2 - • ;e4-or core-.-Jlez c rC" VV uvef ri 4,e'eodre -; ; • ,r ' c"fre'•';,,f;-4-or-;/-e •s 5"..1“:7`Scrig..1 oy -he Cry F.t. och e <S. tc2c, W 1OOr Aven,,,e, Moo, r;,;:g..-3 rove ocree,-,c::to obey ri • by4rc ;Of i ' ;-_-,grbsn OC- ,1,17.S Orrtcflpor. To co 'rose'./he-s!e= 31:-.-...eptcble •-;e C y 11,e C-$y at be 'crt term onto hi or • zff- .1. .f..;o•e n ofr,-ement ore- r',o..c:o3- ensor 13.rees irs wove z-ct • koow- ...o<rowr de-,rt-Os or rt,•,y -0 the pe-snr or p-ooeoy ressAt cry eead- -g e rr&rurr The,,,r,-ders -ed cector 0r bea tt-ttase. cr -e-ie' risc or te^.;;Ilf ,tre ck.sve -ne exe:::dtc' svcce5s3-.1• rirx o=4 -ebreseve -e err; 'le Cry beau Dooe Scroo s SC,'er,ze --e r 5.•oi etro -ep•ece-Ict yes 705 711 'Llt -."(..1!•'5 or CtX:,:eriCt, pr.1,3y cc r-c:; wuy kr c• :b- ;ne -cc-Liooco •-lvel z.;; / -he • Re.ecor Jr,::eri-,-;-••., riot'",i wo ..o.es "rs :ouseo leg'::jerze or or orycc rorove bo-t•es RELEASOR OF THE UNDERSIGNED • or r.,-,;rces 4,u• t•:e reiecsr; wo ve( (2^r.: ve Os s by t' ow of tre C"?...1"40.fl cod rho'-4 cry perhc s tre, rs,t. .t urrn ' THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE RELEASE AND WAIVER OF LIABLITY AND INDEMINTY AGREEMENT, • • • orc . -c '-:-- ,• ' • • :; •-• - • w:-e-ogree—er- PHOTOGRAPHIC RELEASE IC .17Th srot -; : - '"ef:n4C,'1,5 er,-.4-qoyees s-c.cesio-s • tr;toke 'e ev=so,:eco-o,,gso ..;•• ,^, y -r.ey w sr rsrrj i t, p.JE7 ish fre sore races 31,5 CSc M• .Cr", 3efin, Ss sto/i ;:c :le:. to :;:e ci bet:e'st so 7. 'y re.reby wowe c"y- 'care -,;pect -4:wove'he tN:i-soy be aced here,,nder rte Dated this day of , 20 , • - • 2 . ear; 'csr ,5e Pc-cot Woness NI,:rno Auci•ess \A/,ress S "eez.,-one t-ess. 22 Class Dates Spring 2020 Semester Dates(14 weeks) Week 1: January 13 - 17 Week 9: March 16-20 Week 2: January 21 - 24 Week of March: Spring Break(no Week 3: January 27 - February 1 classes) Week 4: February 3 - 7 Week 10: March 30- April 3 Week 5: February 10 - 14 Week 11: April 6 -9 Week 6: February 18 - 21 Week 12: April 13 - 17 Week 7: March 2 - 6 Week 13: April 20-24 Week 8: March 9- 13 Week 14: April 27- May 1 23