1. No category

Superintendent
Dr. Daniel J. Coles
Board Of Education
John C. Armstrong, President
Deby Dato, Vice President
Jonathan Feryance, Secretary
Kathleen Bianco
Carey McHugh
David Patterson
Brian Swanson
Go Mustangs!
3500 Darrell Road
P.O. Box 920
Island Lake Il 60042
Important Dates
1/4 - School Resumes
1/4 - Beginning of 3rd quarter
1/7 - 2nd quarter report cards
sent home
1/18 - Dr. Martin Luther King Day
NO SCHOOL
1/21 - School Spelling Bee
1/22 - Ski Trip to Alpine Valley
1/27 - Student Council trip to
Feed My Starving Children
1/29 - End of 3rd Exploratory
Rotation
Volume 9, Issue 5
January 2016
Students of the Month
Jack Baker, Paul Balingit, Erin Benson,Vincent D
Agostino, Gianna Fellino, Dylan Francisco, Corey
Freed, Liana Jacobson, Bri Kinney, Sarah Lochen,
Yessica Magallanes, James Marvel, Aiden McFadden,
Emily McGovern, Caden Miller, Elissa Pavlowski,
Taylor Phillips, April Ruiz
What’s Inside:
Important Dates………...…...2
School News………...……..3
Yearbook …….……………...4
2015 Illinois Report Cards for all schools in Wauconda
School District 118 are now available on the Illinois Report
Card website: https://illinoisreportcard.com/.
Letter to class of 2020……...6
Severe Winter Weather….....7
D118 events……..………...10
Community Events………...15
At this Illinois State Board of Education supported website, information may be found by browsing each individual school or
district report card.
Preschool Screening………16
Breakfast Menu…………....18
Lunch Menu…………….….19
Please join us at our home
sporting events!
Girls’ volleyball
1/21 4pm
Wrestling :
1/9 @ 9am
1/12 @ 4:15pm
1/16 @ 9am
1/26 @ 4:15pm
1/28 @ 4:15pm
YEARBOOK! ORDER YOURS NOW!
The discounted price for Hoofprints the MMS Yearbook ends December
31. Purchase Hoofprints for $20 this month. The price will be raised to
$25 January 1. After that date the engraved nameplate and the current
events Our World insert will no longer be available.
YOU KNOW YOU WANT ONE!
Ski and Snowboarding Trips to Alpine Valley
Friday, January 22
Friday, February 5
Friday, February 19
Friday, March 4
Friday, March 11
Important Dates for Matthews Middle School
2015-2016 School Year
January
4
7
18
21
22
27
29
School Resumes
2nd Quarter Report Cards Sent Home
Dr. Martin Luther King Jr. Day – No School
MMS Spelling Bee
Middle School Ski Trip
Student Council Feed My Starving Children Trip
End of 3rd Exploratory Rotation
February
1
5
6
9
11
12
15
19
23
4th Exploratory Rotation Begins
Middle School Ski Trip
D118 Band Solo and Ensemble
3rd Quarter Midterms Sent Home
Parent Conferences – No Student Attendance
Institute Day – No Student Attendance
President’s Day – No School
Middle School Ski Trip
National Junior Honor Society Induction (at MMS) 7:00 p.m.
March
2
4
9
11
11
14
15
18
28
Spring Choir Concert (at WHS) 7:00 p.m.
Middle School Ski Trip
MMS Band Concert (at WHS) 7:00 p.m.
End of 3rd Quarter
Middle School Ski Trip
Beginning of 4th Quarter
3rd Quarter Report Cards Sent Home
Spring Break Begins Following Regular School Day
School Resumes
1
4
26
26
27
28
29
30
End of 4th Exploratory Rotation
5th Exploratory Rotation Begins
4th Quarter Midterms Sent Home
MMS Spring Musical Performance for Elementary School
MMS Spring Musical Performance for Elementary School
MMS Spring Musical 7:00 p.m.
MMS Spring Musical 7:00 p.m.
MMS Spring Musical 7:00 p.m.
April
May
1
MMS Spring Musical 2:00 p.m.
TBA Farewell MMS/WMS Choir Concert (at WHS)
TBA MMS Band Concert (at WHS)
24
Last Day of School if all Emergency Days Are Used
Matthews Middle School has adopted PBIS (Positive Behavior
Interventions & Supports) to help our students become responsible,
respectful, and safe citizens here at Matthews and in our community.
We are lucky to now have parents and students as a part of our PBIS
program. Your ideas make this program the best it can be!
We concluded the 2nd Quarter with an assembly, reinforcing the
positive behaviors seen throughout the 2nd quarter. Have a respectful,
responsible, and safe Holiday Season.
See you next year!!!
Congratulations and Keep Up the Great Work!!!!!!!
Congratulations to our 42 classroom qualifiers for
this year’s spelling bee. The winners celebrated
with a pizza party and ice cream. We also had an
optional meeting after school to practice with the
microphone and to learn some spelling bee tips.
We even had a mock spelling bee and the winner
won a $10 gift card to Starbucks. Both the pizza
party and mock spelling bees are sponsored by
Matthews Middle School Student Council. We will
be having two more optional practices after school
on January 8th and January 18th and and will have a
mock spelling bee with prizes as well.
Our
classroom winners will be competing in the school
spelling bee held in our school library on Thursday,
January 21st starting at 12:45 pm. So take some
time out of your buzzzy schedule and brush up on
your spelling words.
THEIR
FRIENDS.
THEIR STORIES.
LIKE
YEARBOOK!
WE’RE
IN
IT
TOGETHER.
ONE YEAR. ONE BOOK. LAST CHANCE TO PRESERVE IT ALL.
¡ELIJA EL ANUARIO!
OnE
BOOK.LAST
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chAncETO
tOPRESERVE
pREsERvEITItALL.
ALL.
ONE YEAR.
YEAR. OnE
ONE BOOK.
ORDER YOUR 2016 MATTHEWS MIDDLE SCHOOL YEARBOOK TODAY!
A yearbook is a priceless artifact of a school year. It includes
A
yearbook
is
aa treasured
capsule
of
Aall
yearbook
is aa keepsake,
keepsake,
treasured
time
capsule
of youth.
youth.
the memories,
triumphs,
defeats, time
friends
and experiences
It
transcends
distance
and
capture
Itwithin
transcends
distance
andItgenerations
generations
to
capture the
the
names
its pages
forever.
is a piece soto
permanent
—names
one that
and
faces,
and
places
that
make
year
and
faces, events
events
and
places
that
make
this
year memorable.
memorable.
students
may not
realize
the
true
valuethis
of until
they
open it
With
comes
aa discovery
of
With
the
future
comes
discovery
of the
the past,
past, and
and that’s
that’s when
when
five,the
tenfuture
or twenty
years
later.
photographs
photographs and
and stories
stories become
become precious.
precious.
It’s so easy to stay in touch with friends nowadays, thanks to
While
social
helps
stay
touch
with
friends
now,
While
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media
helps them
them
stay in
inmedia,
touch but
with
friends
now,
ever-evolving
technology
and social
the
yearbook
the
yearbook
will
them
those
friends—and
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will help
help
them
remember
those
friends—and
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out. Order
ORDER tOday!
TODAY!
Don’t
miss out. ORDER
ORDER & PAYMENT DUE BY: JANUARY 1, 2016*
*Order by January 1, 2016 to receive discounted pricing!
SCHOOL ORDER NUMBER: 8247
Please have this number handy when you order
by phone or online.
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MATTHEWS MIDDLE SCHOOL
3500 Darrell Road
P.O. Box 920
Island Lake, IL 60042
QUANTITIES ARE LIMITED,
BUY YOUR YEARBOOK TODAY!
• The price of the yearbook will increase by $5.00
after January 1, 2016. Yearbooks will be sold on a
first come, first served basis as long as supplies
last.
Please turn over if returning by mail.
• Our World and Name Plate options will no longer
be available after January 1, 2016.
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*Order by January 1, 2015 to receive discounted pricing!
ITEMS OFFERED IN YOUR PACKAGES:
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• The price of the yearbook will increase by $5.00 after January 1, 2016. Yearbooks will be sold on a first come,
first served basis as long as supplies last.
• Our World and Name Plate options will no longer be available after January 1, 2016.
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Yearbook Order Center
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Edwardsville, KS 66113-9029
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MATTHEWS MIDDLE SCHOOL
ISLAND LAKE
847-526-6210
Emergency Alerts and School Closings Now on Twitter
Follow Superintendent Dr. Coles on Twitter @Supt_D118
Dr. Daniel J. Coles, Superintendent of Schools will now be utilizing Twitter to announce emergency alerts and school
closings. The use of Twitter will be used in conjunction with our existing communication platforms such as our
SchoolMessenger Emergency Alert System (robocall) as well as postings on our District’s Website at
http://www.d118.org/. In order to get the emergency alerts and school closing “Tweets” from Dr. Coles, you must
have a Twitter account. To do so, use your smart phone to download the Twitter app or use your web browser on
your computer and go to: https://support.twitter.com/. Once you have a Twitter account, you may get the alert Tweets
by following Dr. Coles @Supt_D118. Please note that the purpose of this Twitter account will only be used for
notifying staff, parents and the community about emergency alerts and school closings.
WAUCONDA COMMUNITY UNIT
SCHOOL DISTRICT 118
Superintendent of Schools
Dr. Daniel J. Coles
555 North Main Street, Wauconda, Illinois 60084-1299, (847) 526-7690, Fax (847) 526-1019, www.d118.org
Wauconda Grade • Robert Crown • Cotton Creek • Wauconda Middle • Matthews Middle • Wauconda High
_______________________________________________________________________________________________________________________________
Associate Superintendent
Business Services, CSBO
William Harkin
Assistant Superintendent
Curriculum & Instruction
Dr. David Wilm
Assistant Superintendent
Human Resources
Cameron Willis
Assistant Superintendent
Special Services
Valerie Donnan
Assistant Superintendent
Technology Services
Scott Cittadino
Emergency Early Dismissal Procedures
Due to Severe Winter Weather
Dear Parents:
In the event of severe winter weather occurring during the school day, it may be necessary to dismiss the
students housed at Wauconda Middle School, Matthews Middle School and Wauconda High School
earlier than usual.
The reason this action would be taken is to allow the buses an opportunity to drop off these older students
in order to return in time to take the younger elementary students at Wauconda Grade School, Robert
Crown School and Cotton Creek School home according to their regular dismissal schedule.
If this early dismissal was not done, we would run the risk of buses being unable to return the Wauconda
Grade School, Robert Crown and Cotton Creek students to their homes, or very late drop off for these
same students. In addition, we hope to avoid buses driving in a snowstorm when it is dark.
Parents of students in grades six through twelve need to be aware of the possibility that this situation
could occur due to inclement winter weather. If it does, we would enact the SchoolMessenger Service in
an attempt to notify you that your sixth through twelfth grade student was coming home early. As a
result, we ask that you make appropriate arrangements with your sixth through twelfth grade student in
order for them to gain access to shelter after being dismissed early due to weather conditions. This type
of situation does not occur often, but if it does we wanted you to be informed of our actions so that you
and your students can be prepared.
Thank you for your cooperation.
Sincerely,
Dr. Daniel J. Coles
Superintendent of Schools
“Learning For Life – Building Partnerships For Success”
WAUCONDA COMMUNITY UNIT
SCHOOL DISTRICT 118
Superintendent of Schools
Dr. Daniel J. Coles
555 North Main Street, Wauconda, Illinois 60084-1299, (847) 526-7690, Fax (847) 526-1019, www.d118.org
Wauconda Grade • Robert Crown • Cotton Creek • Wauconda Middle • Matthews Middle • Wauconda High
_______________________________________________________________________________________________________________________________
Associate Superintendent
Business Services, CSBO
William Harkin
Assistant Superintendent
Curriculum & Instruction
Dr. David Wilm
Assistant Superintendent
Human Resources
Cameron Willis
Assistant Superintendent
Special Services
Valerie Donnan
Assistant Superintendent
Technology Services
Scott Cittadino
Procedimientos de Emergencia de Despido Temprano
Debido a Severo Clima de Invierno
Estimados Padres:
En la eventualidad de un clima severo de invierno durante el día escolar, puede ser necesario despedir a
los estudiantes alojados en la escuelas Wauconda Middle School, Matthews Middle School y Wauconda
High School más temprano de lo usual.
La razón para que esta acción sea tomada es el permitir a los autobuses la oportunidad de llevar a estos
estudiantes mayores a tiempo para volver y llevar a la casa a los estudiantes elementales más jóvenes en
las escuelas Wauconda Grade School, Cotton Creek y Robert Crown según su horario de despido regular.
Si este despido temprano no se hace, estaríamos tomándonos el riesgo de que los autobuses no puedan
llevar a sus casas a los estudiantes de Wauconda Grade School, Cotton Creek y Robert Crown, o que
estos estudiantes lleguen sumamente tarde. En adición, queremos evitar que hayan autobuses corriendo
en una tormenta de nieve cuando ya ha oscurecido.
Los padres de los estudiantes de sexto grado al grado 12 tienen que estar al tanto de la posibilidad de que
esta situación pueda ocurrir debido a las condiciones del clima de invierno. Si ocurre, nosotros no
podremos notificarles personalmente que su estudiante de sexto grado al grado 12 va a llegar temprano a
la casa. Como resultado, les solicito que hagan los arreglos apropiados con su estudiante de sexto grado
al grado 12 de manera que estos tengan acceso a un lugar donde estar después que hayan sido despedidos
temprano debido a las condiciones del clima. Este tipo de situación no ocurre muy seguido, pero si
ocurre, nosotros queremos que ustedes estén informados de nuestras acciones de modo que ustedes y sus
estudiantes estén preparados.
Gracias por su cooperación.
Sinceramente,
Dr. Daniel J. Coles
Superintendente de Escuelas
“Learning For Life – Building Partnerships For Success”
2016 Super Bowl Commercial Challenge
Film your own Super Bowl Commercial - great fun and friendly competition for teams,
businesses, charitable groups, musicians, individuals or families.
• You write, produce and edit it. (Use editing software like iMovie for Mac, or Windows Movie
Maker)
All proceeds benefit the
Bulldog Nation Foundation !
• The commercial can be serious advertising, funny spoofs, or a combination of both
• Submit your video to the Bulldog Nation Foundation by Wednesday February 3rd
• Acceptable formats include: Flash Drive, CD, DVD, or email – [email protected]
• Winners are chosen at the Foundation Viewing Party held at Middleton’s on Main on
Saturday February 6th – 6:00 p.m.
• The cost / donation to enter is easy to calculate - $30.00 buys you a 30 second spot,
$60 = 60 seconds, and so on.
Questions: Contact Mike Salisbury @ Lake County Watersports – 847-526-2211
Watch some of the previous entries with a QR Code reader
Acres Inc.
Bliss Wine Crew
Bulldog Nation
Wauconda HS Choir
www.bulldognationfoundation.net
Lake County Water Sports
2016 Super Bowl Commercial Challenge Registration Form
Name of Business or Organization __________________________________________
Address________________________________________________________________
Contact Person _________________________________________________________
Cell Phone ____________________ Email Address ___________________________
Length of Commercial (Circle One) 30 seconds
60 seconds
120 seconds
Donation Amount = Length of Commercial x 1.00
90 seconds
150 seconds
( 30 seconds = $30.00 ) _______________________
Make Checks Payable to the Bulldog Nation Foundation
Please drop off or mail registration form and donation to:
Lake County Watersports
530 South Rand Road
Wauconda, IL 60084
Attention: Mike Salisbury
[email protected]
847-526-2211
All proceeds benefit the Bulldog Nation Foundation !
www.bulldognationfoundation.net
District 118 PTO Presents
FAMILY BINGO NIGHT
Friday, February 5th
6:30pm-8:30pm
Wauconda H.S.
Admission: Adults $3.00
Children $2.00
*Free Bingo Card and Raffle Ticket with
each paid admission!
Pizza, hot dogs, chips, drinks and
goodies will be available to purchase.
Don’t forget to wear your PJs
We are looking for volunteers to help out on February 5th . Please complete
the information below and return to school in an envelope labeled ‘PTO
Bingo’.
Name: _____________________________________________________
Phone #: ___________________________________________________
Email: _____________________________________________________
Comments: _________________________________________________
Any questions please contact Beth Acosta [email protected]
Distrito 118 PTO
Presenta
NOCHE DE BINGO FAMILIAR
VIERNES, 5 DE FEBRERO 6:30pm ~ 8:30
Wauconda H.S.
Admisión
Adultos $3.00 Niños $2.00
*Con su boleto de admisión se le entregara una
carta para el bingo y un boleto para la rifa
Podrá comprar pizza, hotdogs, chips y
más.
No se te olvide
ponte tus pijamas y vente a jugar
Savethe Date
3·4·16
Wauconda High School
Bulldog Nation Foundation
Spring Dinner Dance
Starting in September,
the Library will offer a Homework Help center in our new
digital classroom. Students will be able to drop-in with
homework questions and get assistance from teachers on
Tuesday and Thursday from 4-6 p.m.
& Saturdays from 10 a.m. - 12 p.m.
Our monthly program calendars, available at www.wauclib.org
or in the library, will have specific dates.
Preschool Screening
2015-2016
Wauconda CUSD 118
Parents, if you have any questions or concerns
about your child’s emotional, social, cognitive, or
physical development and you live within Wauconda
CUSD 118 boundaries, please call 847-526-7950
x9205 for an appointment today.
Wauconda CUSD 118 offers Preschool Screening to all
children aged three to five years who live within the
district boundaries. The screening will provide
parents with information about their child’s growth
and development in the areas of cognition, motor,
speech, language, social, emotional, vision, and hearing.
Screenings are offered on the following dates:
Tuesday, August 25
Thursday, August 27
Tuesday, September 15
Tuesday, December 1
Tuesday, February 23
Tuesday, May 3
Don’t Delay! Contact the Special Education
Office at 847-526-7950 X9208 to schedule a
screening or for further information.
Examenes Pre-Escolares
2015-2016
Distrito 118 Comunidad de Wauconda
Padres, si tienen preguntas o preocupaciones sobre el
desarrollo emocional, social, cognoscitivo, o físico de su
hijo/a y viven entre los limites de Wauconda CUSD 118,
favor que llamar hoy 847-526-7950 x9205 para una cita.
Wauconda CUSD 118 ofrece los Exámenes PreEscolares a todos niños/as que tengan tres a cinco
años que vivan entre los límites del distrito escolar.
Los exámenes van a proveer los padres con
información sobre el desarrollo de su hijo/a en los
áreas de lenguaje, social, emocional, visión, audición, y
de motaras.
Están citas por los exámenes en las fechas abajas:
Martes, 25 de Agosto
Jueves, 27 de Agosto
Martes, 15 de Septiembre
Martes, 1 de Deciembre
Martes, 23 de Febrero
Martes, 3 de Mayo
Favor que llamar la Oficina de Educación
Especial lo más pronto como posible para hacer
una cita para una examen o para más
información al 847-526-7950 X9208
$PurchaseOrder.Id=46197
$PartName=WithBorder
Wauconda School District Breakfast Menu
BREAKFAST PRICE: $1.45 - REDUCED BREAKFAST PRICE
W/G STRAWBERRY POP TARTS
BLUEBERRY MINI PANCAKES
MINI MAPLE PANCAKES
FRESH BAGEL
CHEERIOS CEREAL BAR
FRESH APPLE AND/OR ORANGE
OR APPLE CINNAMON MUFFIN
OR BLUEBERRY MUFFIN
CREAM CHEESE
FRESH APPLE AND/OR JUICE
MILK
FRESH APPLE AND/OR JUICE
FRESH ORANGE AND/OR JUICE
FRESH BANANA AND/OR JUICE
MILK
W/G =
WHOLE GRAIN
MILK
MILK
MILK
1% WHITE MILK AND FAT FREE CHOCOLATE MILK OFFERED DAILY
GOLDEN GRAHAMS CEREAL BAR
FRESH APPLE AND/OR JUICE
MILK
CINNAMON MINI WAFFLES OR
BLUEBERRY NUTRIGRAIN BAR
FRESH ORANGE AND/OR JUICE
MILK
W/G CINNAMON POP TARTS
FRESH BANANA AND/OR JUICE
MILK
MINI CHOC CHIP FR. TOAST
OR APPLE NUTRIGRAIN BAR
FRESH ORANGE AND/OR JUICE
MILK
FRESH BAGEL
CREAM CHEESE
FRESH APPLE AND/OR JUICE
MILK
MINI FRENCH TOAST OR
BLUEBERRY NUTRIGRAIN BAR
FRESH ORANGE AND/OR JUICE
MILK
W/G STRAWBERRY POP TARTS
FRESH APPLE AND/OR JUICE
MILK
MENU IS SUBJET TO CHANGE
NO SCHOOL
MARTIN LUTHER KING JR.DAY
MINI MAPLE PANCAKES OR
STRAWBERRY NUTRIGRAIN BAR
FRESH APPLE AND/OR JUICE
MILK
CHERRIOS CINNAMON BAR
FRESH BANANA AND/OR JUICE
MILK
OUR MENU IS ALIGNED WITH THE USDA's HEALTHIER SCHOOL CHALLENGE
FRESH BAGEL
CREAM CHEESE
FRESH APPLE AND/OR JUICE
MILK
BLUEBERRY MINI PANCAKES
OR APPLE CINNAMON MUFFIN
FRESH ORANGE AND/OR JUICE
MILK
CINNAMON TOAST CEREAL BAR
FRESH BANANA AND/OR JUICE
MILK
MINI MAPLE PANCAKES OR
BLUEBERRY NUTRIGRAIN BAR
FRESH APPLE AND/OR JUICE
MILK
W/G CINNAMON POP TARTS
FRESH ORANGE AND/OR JUICE
MILK
WE WELCOME YOUR QUESTIONS OR COMMENTS. PLEASE CONTACT RICHARD I. REDER, GENERAL MANAGER AT: 847-487-9703.
Middle School Lunch Menu
MONDAY
January 2016
WEDNESDAY
TUESDAY
4
5
THURSDAY
6
4 FRIDAY
7
8
4
Mini Chicken Corn Dogs
Cheese Quesadilla
Chicken Parmesan w/Pasta
Beef Nachos
Bosco Stick w/Marinara Sauce
Green Beans
Tator Tots
Broccolo Florettes
Sweet Potatoes
Corn
Fruit
Fruit
Fruit
Fruit
Fruit
Milk
Milk
Milk
Milk
Milk
11
12
13
14
15
General Tso Chicken w/Rice
Beef Taco's
Cheesey Baked Pasta
Baked Potato w/Cheese & Broccoli
Oven Baked Chicken Leg w/Roll
Green Beans
Tator Tots
Carrots
Broccoli Florettes
Corn
Fruit
Fruit
Fruit
Fruit
Fruit
Milk
Milk
Milk
Milk
Milk
18
Martin Luther King Jr. Day
No School
19
20
21
22
Beef Nachos
Creamy Mac & Cheese
Chicken Pot Pie Bowl
Bosco Stick w/Marinara Sauce
Tator Tots
& Mozzarella Cheese
Sweet Potatoes
Corn
Fruit
Broccolo Florettes
Fruit
Fruit
Milk
Fruit
Milk
Milk
Milk
25
26
27
28
29
Penne Pasta with
Chicago Style Hot Dog
Baked Chicken Leg w/Roll
Marinara Sauce & Cheese
Sweet Potato Fries
Corn
Fruit
Broccoli Florettes
Fruit
Fruit
Milk
Fruit
Milk
Milk
Baked Mini Chicken Corn Dogs
Beef & Bean Burrito
Green Beans
Tator Tots
Fruit
Milk
t
Milk
31
Baked Chicken Nuggets w/Roll
LOCALLY GROWN ITEMS
Green Beans
ARE OFFERED
Fruit
WHENEVER SEASONALLY
Milk
AVAILABLE.
LUNCH PRICE: $2.75
MENU IS
SUBJECT
REDUCED LUNCH: $ .40
TO CHANGE
Wauconda High School Dance Team Presents:
A POM CLINIC & PERFORMANCE
Who: All students Kindergarten through 8th grade
When: Monday February 15th
Time: Monday February 15th from 10am-4pm
Where: Wauconda High School Competition Gym (Events Entry)
Cost: $45 per participant or $50 at the door
Attire: Comfortable clothing, Gym shoes, or Dance shoes
**Please bring water, snacks, lunch, energy, and a smiling face!
Each participant will receive a WHS t-shirt and the
opportunity to perform at the WHS Basketball
Halftime performance on February 19th, 2016.
Game time is 7:00pm
(Further details to be provided at clinic)
Questions? Email Coach Leveque at [email protected] or Coach
Masura at [email protected]
Please mail the bottom portion along with your payment to attn:
Coach Leveque or Coach Masura
Wauconda High School
555 N. Main
Wauconda, IL 60084
by January 29, 2016
Checks can be made out to the Wauconda Dance Team
–––––––––––––––––––––––––––––––––––––––––––
Wauconda High School Pom Squad Clinic
(One form per participant please)
Student’s Name: _________________________________________________
Address: _________________________________________________________
Phone Number: ___________________________________________________
Grade and School: ________________________________________________
Allergies: __________________________________________________________
T-Shirt size: Youth Small Youth Medium Youth XL/Adult XS
Adult S
Waiver of claims: I, as a parent or guardian, hereby give permission for my
child to participate in the 2016 Wauconda High School Pom Squad Clinic and
acknowledge the fact that she is physically able to participate in camp activities. I hereby authorize the camp director to act according to her best judgment in any emergency requiring medical attention. I acknowledge that I will
be responsible for any cost incurred due to sickness or injury to my daughter.
I hereby waive any claim I might have against the Wauconda High School Pom
Squad Camp and District 118.
Thank you for supporting
Wauconda High School
Signature of Parent or Guardian: ________________________ Date: _____________