Fields of Dreams After School Program 2026–27

Please fully complete this form. All fields marked with * must be filled. Completing this application does not guarantee a slot.

If you'd rather use a paper copy, ask at the school's front office (your school) or call Keith Stubbs at (240) 463-9904.

Questions about the program? Read the FAQ

What is the goal of the Fields of Dreams program?
The program is focused on academic enrichment, fitness & nutrition awareness, character education, and baseball knowledge and instruction. It is our hope to instill an interest in baseball and softball for D.C. youth. The fabric of our program is based on the values that guided the life of Jackie Robinson on and off the baseball field, as written about by his daughter Sharon in her book Jackie's Nine.

How will I know if my child has been accepted?
If your student is accepted to the after-school program, you will receive an email with orientation materials and will be asked to confirm your child's enrollment. Please do not assume your child has been accepted just because your application was received.

Who can join?
Children who are currently enrolled at the school in the 3rd through 5th grade.

Does my child need baseball experience?
No! We are a developmental program. We will teach any student, including beginners. All we ask is that your child comes with a positive attitude and a willingness to learn.

What activities will children participate in?
Academic & enrichment activities related to nutrition & health, character development, fitness, baseball knowledge and baseball instruction and other team sports. We will also take field trips. After-school snacks are included.

Holidays. The program will not operate when school is not in session.

More information: contact Fields of Dreams' Operations Director Keith Stubbs at (240) 463-9904 or keith.stubbs22@gmail.com. Paper applications may be handed in at the school office.

Student

Student's Name

Date of Birth

Address

City

State

Zip

Ward

Gender

Race / Ethnicity

Current School Attending

Grade (SY 2026–2027)

The program is for students in 3rd–5th grade in the 2026–27 school year.

Parent / Guardian

Parent / Guardian Name

Parent / Guardian Address (if different from student)

Home Number

Cell Number

Work Number

You'll receive a confirmation email here.

Emergency Contact

Emergency Contact Name

Relationship

Address

Phone Number

Alternate Phone Number

Pickup & Authorization

Does your child walk home?

Yes No

Will you or an authorized adult pick up by 5:30 PM?

Yes No

Authorized Adults — staff will not release your child to any adult not listed below without a confirmed parent note.

Authorized Adult #1 — Name & Contact #

Authorized Adult #2 — Name & Contact #

Medical

Any medical, physical, or mental health needs that require special attention?

Medications your child takes regularly

Food allergies

Do you consent for your child to receive medical attention in the event of an emergency?

Yes No

Fields of Dreams Connection

Has your child taken part in a Fields of Dreams program before (after school or summer camp)?

Yes No

Program Consents

Fields of Dreams reports attendance to the DC Office of Out of School Time Grants and Youth Outcomes (OST Office / Learn24). These two consents are recorded with your child's enrollment.

Youth Survey Consent — may your child complete a confidential program survey during the school year?

Yes No

FERPA Consent — do you authorize the school, DCPS Office of the Chief of Staff, or the Office of the State Superintendent to provide your child's education records for the current school year (enrollment, attendance, grades, assessment data, IEP information, demographic data, universal student ID) to Fields of Dreams and the DC OST Office? Full text is in the Parent / Guardian Statement below.

Yes No

Parent / Guardian Statement

Read the full statement

I hereby give permission for my child to participate in all activities conducted by the Fields of Dreams (FOD) After School Program, including educational activities at the school site, performing and visual arts activities at the school site, field trips to arts and educational activities away from the school site, and sports activities conducted in DCPS, DC Public Charter and/or DC Dept. of Parks and Recreation facilities.

I further grant permission for my child: (1) to appear in person and in voice, video, or photographic presentation for non-commercial radio, television, internet, or print media reports and/or media campaign(s) resulting from participation in this program and its activities, (2) to complete confidential or anonymous surveys, and (3) to participate in interviews for evaluation purposes.

By signing this application, I am certifying that my child is in normal health (or if there is a medical problem, it is indicated above) and able to participate in all FOD activities. By signing below, I am authorizing FOD staff to act for me in securing medical treatment for my child in the event of injury or sickness during the program. I assume all risks and hazards related to this program and absolve the Fields of Dreams' staff and volunteers of any liability for any injury to my child.

I also grant permission for my child to be transported to field trips of the program.

Family Educational Rights and Privacy Act (FERPA) Consent. I further hereby authorize and consent DCPS Office of the Chief of Staff, Office of the State Superintendent, or the school to provide information concerning the education of my child to Fields of Dreams and the DC Office of Out of School Time Grants and Youth Outcomes (OST Office). I further authorize the release of educational records of my child for the current school year to the parties listed above that include the following information: education transcripts, school/program enrollment information, universal student ID, address, demographic data, attendance data, credit history, grades, assessment data, IEP information, and graduation attainment (12th grade only). This authorization and release shall remain in effect from the date signed through my child's graduation from DCPS or a DC public charter school. By signing below, (1) I acknowledge and understand that I have the opportunity to review the records to be disclosed and the right to challenge the contents of such records, and (2) I am at least 18 years of age or I am signing this document on behalf of my child because he/she is not 18 years of age.

I have read and agree to the Parent / Guardian Permissions and FERPA Consent above.

Type your full name as signature

Your typed full name is your e-signature.

Date

Printed name of person signing

Relationship to child

Please check the box above accepting the Parent / Guardian Statement to submit your application.

After you submit, you'll get a confirmation email at the address you provided.

✓

Application received!

Thanks for applying to the Fields of Dreams After School Program 2026–27 at your school.

We've emailed a confirmation to —.

What's next: Program slots are limited (about 25 per school). If your child is accepted, you'll receive an email with orientation materials and you'll be asked to confirm enrollment. Please do not assume your child has been accepted just because your application was received.

Questions? Contact Keith Stubbs at (240) 463-9904 or email keith.stubbs22@gmail.com.

After School Program 2026–27

Which school is your child at?

Student

Parent / Guardian

Emergency Contact

Pickup & Authorization

Medical

Fields of Dreams Connection

Program Consents

Parent / Guardian Statement

Application received!