City of Sierra Madre Survey

1. What school(s) does your child (ren) attend? (check all that apply)

What school(s) does your child (ren) attend? (check all that apply) Sierra Madre Elementary School – Lower Campus

Sierra Madre Elementary School – Upper Campus

Field Elementary School

La Salle High School

Alverno High School

St. Rita’s Catholic School

The Gooden School

Highland Oaks Elementary School

Bethany Christian School

Pasadena High School

Other

2. Goals for my family include: (check all that apply)

Goals for my family include: (check all that apply) Teaching values, good work ethic, and community service

Providing an excellent education

Instilling in my child(ren) healthy eating habits and daily physical activity

Providing my child(ren) with financial resources for their future

Expanding my child’s world with a wide variety of enrichment activities

Identifying few key quality extracurricular activities

Allow my child(ren) to try many new activities to see which ones they really like

Other (please specify)

3. My child is enrolled in the child care program listed below:

My child is enrolled in the child care program listed below: YAC – Sierra Madre Community Center

YMCA Before and Afterschool Program

Private Child Care Provider

My child does not attend afterschool care

Other (please specify)

4. I am interested in the following program(s) for my child: (check all that apply)

I am interested in the following program(s) for my child: (check all that apply) After-School, Mon-Friday, 15 hours per week (3 hrs per day)

After-School, 1-3 days per week (1 hr per day)

Winter Break

Spring Break

Summer Break

5. If enrolled in an After-School program, my child would need care from:

If enrolled in an After-School program, my child would need care from: 2:00pm-5:00pm

2:30pm-5:30pm

3:00pm-6:00pm

6. For the academic portion of the After-School program, please check the areas of curriculum where your child needs assistance: (check all that apply)

For the academic portion of the After-School program, please check the areas of curriculum where your child needs assistance: (check all that apply) Homework Support Literacy Skills Math Skills	Science Skills One-on-One Tutoring
Other

7. I would be interested in the following enrichment programs offered at the Sierra Madre Community Recreations Center:

I would be interested in the following enrichment programs offered at the Sierra Madre Community Recreations Center: MUN: The California YMCA Youth & Government Model United Nations program is a simulation of the “real-life” United Nations Assembly. Participants in Model United Nations (MUN) will take part in some of the activities that the real U.N. participates in.

Youth and Government: The ML/C is a statewide youth educational program involving more than 2,300 high school freshman, sophomores, juniors, and seniors in a nine month “hands on” experience. Since its inception, the program has used a variety of activities to build, encourage, and strengthen those life assets and character traits that will help high school youth become involved responsible adults who are decent and respected citizens.

Intramural Sports: YMCA youth sports use athletic training and competition as a vehicle to teach group work, character development, teamwork, healthy living, and sport specific fundamentals.

Afterschool Enrichment Programs: YMCA Enrichment standards promote a focus on age appropriate academic, creative, social, and physical enrichment activities that will enhance each child; that means fun, exploration and a wide variety of interesting and challenging activities. There is a daily emphasis on homework and academic support in addition to organized enrichment activities. Cooking, Karate, Ceramics, Art, Social Media, Babysitting, CPR and First Aid. Program operates Monday-Friday from 3pm-6pm. Early release day 12pm-3pm in order to stay within the state guidelines of exempt programming.

Summer, Winter and Spring Day Camp: Each season the YMCA designs activities for youth that will allow them to explore their interests on and off site. Programs operate Monday-Friday from 7am – 6pm

8. For the enrichment portion of the After-School program, please check the areas that would be of interest to your child: (check all that apply)

For the enrichment portion of the After-School program, please check the areas that would be of interest to your child: (check all that apply) Social Skills Leadership Skills Performing Arts Visual Arts Dance Music Film/Video/Photography	Environmental Projects Computer Literacy Exercise/Physical Fitness Sports/Athletics Martial Arts Chess
Other (please specify)

9. What WEEKLY fee would you be willing to pay for after school care, Monday-Friday, 20 hours per week (4 hrs per day)? What WEEKLY fee would you be willing to pay for winter, spring and summer camps, Monday-Friday, 50 hours per week (10 hours per day)?

What WEEKLY fee would you be willing to pay for after school care, Monday-Friday, 20 hours per week (4 hrs per day)? What WEEKLY fee would you be willing to pay for winter, spring and summer camps, Monday-Friday, 50 hours per week (10 hours per day)? School Year

$60.00

$70.00

$80.00

Camps

$100.00

$125.00

$150.00

10. Comments / Suggestions:

Comments / Suggestions:

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