2019 Summer Program Application
 
Welcome to the Aloha MAP summer program.  Aloha MAP - Meritorious Achievement Program, a Native Hawaiian Education initiative, is a federally funded grant project, fiscally sponsored by Friends of the Future, a Hawaii 501(c)3 non-profit corporation located in Waimea, Hawai'i.
 
Aloha MAP offers children and youth culturally-relevant academic and cultural learning opportunities designed to reduce summer learning loss, improve student proficiency in English Language Arts and Math and increase student knowledge in Hawaiian language and culture.
 
The Aloha MAP staff are excited to provide high-impact, motivational, energizing and stimulating learning experiences for all participants.  We appreciate the continued support of our Hawai'i Island communities and look forward to serving participating children, youth and families.
 
2019 Aloha MAP Summer Program Application
 
A primary caretaker/ legal guardian is required to complete and submit one online application per child/youth interested in consideration for acceptance into the Aloha MAP summer program.
 
All correspondence regarding this application will be directed via e-mail to the primary caretaker/legal guardian listed in the application.  Please ensure that a valid e-mail and phone  number for the primary caretaker/legal guardian are provided.  Aloha MAP will not be responsible for communication errors due to invalid e-mail or phone numbers provided in this application.
 
The primary caretaker/legal guardian will receive an acceptance letter and further admission instructions, by email, for the child/youth that is accepted to participate in the Aloha MAP summer program. 
 
Acceptance letters will be distributed until program capacity is met.
Aloha MAP will enroll up to 250 students per site.
Once program capacity is met, all other applications will be placed on a wait list.
 
Special Note:  Submission of this application does not guarantee acceptance into the Aloha MAP summer program.
 
Program Information:
 
Program Sites:
Kealakehe High School 
Konawaena Middle & High School 
 
Dates:  M-F, June 10, 2019 - July 5, 2019
 
Holidays: June 11, 2019 (Kamehameha Day) and July 4, 2019 (Independence Day)
 
Hours of Operation:  7:30am-3:30pm
 
Application Fee:  $0
Aloha MAP will requre a $20 fee per child/youth accepted and confirmed to participate in the Aloha MAP Summer Program.  The fee will provide the participant a program shirt and address Aloha MAP Ho'ike presentation attire requirements.
 
Aloha MAP Ho'ike:  July 5, 2019 at the Hilton Waikoloa Village Grand Ballroom
 
Eligibility:  Children/Youth over 4years and 8months and up to 17 years of age, enrolled in Ka'u, Konawaena or Kealakehe complex schools.
 
Ka'u Complex Schools
Ka'u High & Pahala Elementary School
Na'alehu Elementary School
Ka'u Learning Academy PCS
Volcano School Art/Sci PCS
 
Kealakehe Complex Schools
Holualoa Elementary
Kealakehe Elementary
Kealakehe Intermediate
Kealakehe High
Waikoloa Elementary & Middle
Innovations PCS
Kanu o ka Aina NCPCS
West Hawaii Explorations Academy PCS
 
Konawaena Complex Schools
Honaunau Elementary
Hookena Elementary
Kahakai Elementary
Ke Kula o Ehunuikaimalino
Konawaena Elementary
Konawaena Middle
Konawaena High
Kona Pacific PCS
 
Meals & Snacks
The primary caretaker/legal guardian may indicate and authorize in the Aloha MAP summer program application for their child/youth to participate in the National School Lunch Program Seamless Summer Option (NSLPSSO).  Contingent upon NSLPSSO application and approvals, USDA approved nutritious breakfast and lunch meals, serving children/youth through age 18, at no cost to families, may be provided at Konawaena and Kealakehe High School cafeteria.
 
The primary caretaker/legal guardian is responsible for providing a morning and afternoon snack and bottle of water daily for their child/youth who will participate in NSLPSSO.
 
In the event that NSLPSSO is unavailable or for the child/youth not participating in NSLPSSO, their primary caretaker/legal guardian is responsible for providing a breakfast, lunch, morning and afternoon snack and bottle of water daily.
 
The nutritional value and perishability of foods should always be considered.
 
Transportation
Transportation to and from the Aloha MAP summer program will not be provided.  Transportation arrangements are the responsibility of the primary caretaker/legal guardian.
 
Licensing
The Aloha MAP Summer Program has been proposed and is currently in process of becoming licensed under Hawaii Administrative Rules Title 17 Department of Human Services Subtitle 6 Benefit, Employment and Support Services Division Chapter 896 Licensing of Before and After School Child Care Facilities.
 
Aloha MAP Contact Information:
 
Lilinoi Grace - Aloha MAP Project Director
 
Address:
Aloha MAP
Attn: Lilinoi Grace
P.O. Box 394
Holualoa, HI 96725
 
Phone:  (808) 494-5044
 
E-mail:  notifyalohamap@gmail.com 
 
Website:  www.alohaproductions.org

Aloha MAP Summer Program Policies and Procedures

Aloha MAP Policies and Procedures:
Please read the Aloha MAP Summer Program Policies and Procedures before completing this application.
I have reviewed, understand and agree to comply with the Aloha MAP Summer Program Policies and Procedures.
 
(An Authorized Primary Caretaker/Legal Guardian shall acknowledge and give consent by typing his/her First Name, Middle Initial, Last Name and Date in the provided area below.)
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Aloha MAP Program Site Selection

Student

If the requested information is Not Applicable type NA.  If the requested information is Unavailable type UA.
School * 
 
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If you selected Native Hawaiian, can you provide documentation to prove Hawaiian ethnicity? *
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Language Spoken at Home *
 
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Does the student participate in any of the following educational programs? *
 
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Primary Caretaker

If the requested information is Not Applicable type NA.  If the requested information is Unavailable type UA.

Adults Authorized to sign-out the listed student

Provide information for adults at least 18 years of age other than the Primary Caretaker who is authorized to sign-out the student.
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Student's Additional Emergency Contact Information

In the event that the student listed above becomes ill or is injured and I cannot be contacted, Aloha MAP authorities have my permission to contact and release the student to the custody of one of the following:
1. Emergency Contact 
During the past 12 months has a doctor or other health professional informed that the student listed has or had any of the following conditions? (check all that apply) *
 
The student listed above receives regular care for the following medical conditions: *
 

Emergency Facility Release

If the student listed above needs to be taken to an emergency facility, he/she will be taken to the nearest one.  I give my consent for Aloha MAP authorities to take appropriate action for the safety and welfare of the student listed above.
 
 
(An Authorized Parent/Legal Guardian shall acknowledge and give consent by typing his/her First Name, Last Name, Middle Initial and Date in the provided area below.) 
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Father/Legal Guardian

If the requested information is Not Applicable type NA.  If the requested information is Unavailable type UA.
 
Father/Legal Guardian Information:
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Language Spoken at Home *
 

Mother/Legal Guardian

If the requested information is Not Applicable type N/A.  If the requested information is Unavailable type U/A.
 
Mother/Legal Guardian Information:
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Language Spoken at Home *
 

Aloha MAP Liability Release

Please Read Carefully
 
In exchange for participation in Aloha MAP program activities, under the fiscal sponsorship of Friends of the Future, I agree to the following:
 
1.  AGREEMENT TO FOLLOW DIRECTIONS.  I agree to observe and obey all posted rules and warnings, and further agree to follow any oral instructions or directions given by Aloha MAP and/or Friends of the Future staff.
 
2.  ASSUMPTION OF THE RISKS AND RELEASE.  I recognize there are certain inherent risks associated with Aloha MAP activities and I assume full responsibility for personal injury to myself and further release and discharge those parties named in the first paragraph of this document, whether caused by the fault of myself or presence upon the premises, whether caused by the fault of myself, the organizations named above or other third parties.
 
3.  INDEMNIFICATION.  I agree to indemnify and defend the organizations named above against all claims, causes of action, damages, judgements, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my presence on the premises.
 
4.  FEES.  I agree to pay for all damages to the premises caused by any negligent, reckless or willful action by me.
 
5.  APPLICABLE LAW.  Any legal or equitable claim that may arise from participation in the above activty shall be resolved under Hawaii law.
 
6.  NO DURESS.  I agree and acknowledge I am under no pressure or duress to sign this Agreement and I have been given reasonable opportunity to review it before signing.
 
7.  ENFORCEABILITY.  The invalidity or unenforceability of any provision of this Agreement whether standing alone or as applied to a particular occurrence or circumstance, shall not affect the validity or enforceability of any other provision of this Agreement or of any other applications of such provision, as the case may be, and such invalid or unenforceable provision shall be deemed not to be a part of this Agreement.
 
8.  DISPUTE RESOLUTION.  The parties will attempt to resolve any dispute arising out of or relating to this Agreement through friendly negotiations amongst the parties.  If the matter is not resolved by negotiation, the parties will resolve the dispute using the mediation and arbitration services accepted as general practice in the State of Hawaii.
 
I have read this document and understand it.  I further understand by signing this release, I voluntarily surrender certain legal rights.
 
(An Authorized Parent/Legal Guardian shall acknowledge and give consent by typing his/her First Name, Middle Initial, Last Name and Date in the provided area below.)
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Personal Information Disclosure Statement

I certify that the information provided in this application is true and accurate to the best of my knowledge.  I understand that all personal information will be kept confidential and will not be disclosed without written consent from the listed primary caretaker/legal guardian.
 
I grant my permission and authorize Friends of the Future and Aloha MAP to use information provided in this application for the sole purpose of generating program performance/evaluative reports required by the federal funding agency, Friends of the Future and key stakeholders.  I understand that during the generation of any performance/evaluative reports, the applicant/primary caretaker/parent/legal guardian's personal information will always remain confidential.

I grant my permission and authorize my child's school to release his/her academic transcripts, special education diagnostic reports (if applicable) and any other documentation required on behalf of Aloha MAP for the purpose of assessing my child's progress in school and participation in the program.

(An Authorized Primary Caretaker/Legal Guardian shall acknowledge and give consent by typing his/her First Name, Middle Initial, Last Name and Date in the provided area below.)
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Aloha MAP Media Release

I hereby grant permission for Aloha MAP fiscally sponsored by Friends of the Future to publish, copyright, or use all films, photographs, computer-generated imagery, and printed and spoken words in which my son/daughter is included, whether taken by staff, students, or others. I further agree that Aloha MAP can use these photographs, films and words for evaluative/performance reports, exhibitions, displays, web pages and publications, without reservation or compensation.
I waive any inspection or approval of the media and release and agree to hold harmless Friends of the Future, Aloha MAP and partners from and against any and all claims including, but not limited to, invasion of privacy that I might ever have in any way relating to media.
 
(An Authorized Primary Caretaker/Legal Guardian shall acknowledge and give consent by typing his/her First Name, Middle Initial, Last Name and Date in the provided area below.)
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Aloha MAP Primary Caretaker/Legal Guardian Commitment

You are your child’s most important teacher and role model, and we are pleased to have the opportunity to share in the education of your child. Primary caretakers/legal guardians, teachers and students must combine efforts for your child to MAP their way to success.            

As a primary caretaker/legal guardian, I fully agree with and commit to the following:

  • I will make sure my child arrives at least fifteen (15) minutes before the start of each day and remains in program until the conclusion of the day.
  • I will require my child to complete all assignments.  I will read with my child every night.
  • I will communicate respectfully with volunteers and staff.
  • I will read all papers sent home, sign if necessary and return the next day.
  • I will participate in all meetings and conferences concerning my child.
  • I will be a role model for my child as I follow the rules, codes, policies and procedures established by the program.
  • I will pick my child up from program on time or accept the consequences or penalties.
  • I will notify program staff if my child is unable to attend.  I understand daily attendance is essential to student and program success.
  • I will ensure my child follows the school rules, codes, policies and procedures so as to protect the safety, interests and rights of all individuals in the classroom.  

Failure to adhere to these commitments may cause my child to lose privileges and may lead to my child’s dismissal from the Aloha MAP program. 

(An Authorized Primary Caretaker/Legal Guardian shall acknowledge and give consent by typing his/her First Name, Middle Initial, Last Name and Date in the provided area below.)
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Notes