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East Lake Early Learning Academy

East Lake Early Learning Academy

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    • Afghanistan
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    • Jersey
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    • North Korea
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    • Liberia
    • Libya
    • Liechtenstein
    • Lithuania
    • Luxembourg
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    • Madagascar
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    • Malaysia
    • Maldives
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    • Marshall Islands
    • Martinique
    • Mauritania
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    • Micronesia
    • Moldova
    • Monaco
    • Mongolia
    • Montenegro
    • Montserrat
    • Morocco
    • Mozambique
    • Myanmar
    • Nagorno-Karabakh
    • Namibia
    • Nauru
    • Nepal
    • Netherlands
    • Netherlands Antilles
    • New Caledonia
    • New Zealand
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    • Niger
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    • Niue
    • Norfolk Island
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    • Poland
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    • Puerto Rico
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    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
    • Saint Kitts and Nevis
    • Saint Lucia
    • Saint Martin
    • Saint Pierre and Miquelon
    • Saint Vincent and the Grenadines
    • Samoa
    • San Marino
    • Sao Tome and Principe
    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
    • Sierra Leone
    • Singapore
    • Slovakia
    • Slovenia
    • Solomon Islands
    • Somalia
    • Somaliland
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    • South Sudan
    • Spain
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    • Timor-Leste
    • Togo
    • Tokelau
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    Check One
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    Pickup persons are individuals over 18 years, that have your permission for the Y to release your child to.
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    We will make all efforts to reasonably meet the needs of all children. For some accommodations, prior to acceptance and enrollment, parent meeting with Director must be scheduled. Please type N/A if field does not apply
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    My child is currently on medication(s) prescribed for long-term continuous use and/or has the following preexisting illness, allergies, or health concerns: Please type N/A if field does not apply.
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    590-1-1-.20(1) Parental Authorization. Except for first aid, personnel shall not dispense prescription or non-prescription medications to a child without specific written authorization from the child's physician or parent. Such authorization will include, when applicable, date; full name of the child; name of the medication; prescription number, if any; dosage; the dates to be given; the time of day to be dispensed; and signature of parent. I give East Lake Early Learning Academy, permission to apply one or more of the following topical ointments/preparations to my child in accordance with the directions on the label of the container.
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  • 28
    My child will participate in the following meal plan (check applicable meals and snacks):
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  • 29
    ELELA gives priority based on Drew Charter’s lottery priorities. **You must provide proof of your below selection (current utility bill)**
    • Villages of East Lake
    • East Lake / Kirkwood
    • City of Atlanta (Atlanta Public School Zone)
    • Other
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  • 30
    YMCA Scholarships are provided through the generosity of our members, donors, and community partners. These funds vary from year to year and are based on a families total household income. To be considered for a YMCA scholarship you will need to provide 2022 Income Tax Return 1040. Scholarships amounts are not guaranteed from year to year.
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  • 32
    All members in the household total income.
    • $100,000 or more
    • $75,000 to $99,999
    • $50,000 to $74,999
    • $30,000 to $49,000
    • Less than $29,000
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  • 33

    OUR PROMISE TO YOU

    The YMCA of Metro Atlanta endeavors to provide a safe environment and programs for you, your family and guests. The YMCA provides exciting, life-enhancing programs that involve exercise, travel, learning, and sports. These programs, however, necessarily have a certain amount of risk associated with them. The purpose of this Agreement is to secure your agreement to assume these risks, on behalf of yourself and any children or other minors for which you are legally responsible, and to ensure you are aware of and adhere to certain YMCA safety and other policies.

    ASSUMPTION OF RISK AND RELEASE OF LIABILITY

    I acknowledge and agree that use of any of the YMCA of  Metro Atlanta facilities, services, equipment or premises (the “Facilities”) necessarily involves risks of injury to my person and property, and to the person or property of any child or legal ward of mine (hereinafter “dependents”) that I have requested or allowed entry to or use of the Facilities. By engaging in such use, or permitting use by a dependent, I voluntarily accept and assume full responsibility for these risks.

    In consideration of the use of the Facilities, I agree that the Metro Atlanta YMCA and its directors, officers, members, employees, volunteers, and agents (collectively, the "YMCA”) will not be liable for any injury to my person or property or to the person or property of any dependent of mine.

    Further, on behalf of myself and my legal successors, I do hereby release, discharge and hold harmless the YMCA from any and all liability and claims arising from my use, or use of a dependent of mine, of the Facilities. I further covenant not to sue the YMCA with respect to, and I waive any and all claims that I may have now or in the future against the YMCA for any liability arising from the use of the Facilities. This waiver includes, but is not limited to, all liability and claims arising from personal injury (including death), accidents or illness and damage to, loss of, or theft of property.  I understand that, notwithstanding the foregoing, should I sue or file any claim against the YMCA, or threaten to sue or file any such claim, the YMCA may terminate my membership privileges and my involvement in any program or activity of the YMCA.

    BY SIGNING AT THE BOTTOM OF THIS AGREEMENT, I UNDERSTAND I AM RELEASING THE YMCA FROM ALL LIABILITY TO ME, AND MY DEPENDENTS, FOR ANY AND ALL LOSSES AND DAMAGE TO ME OR SUCH DEPENDENT, AND I FOREVER GIVE UP ANY CLAIMS THEREFOR ON ACCOUNT OF INJURY TO PERSON OR PROPERTY, WHETHER CAUSED BY THE NEGLIGENCE OF THE YMCA OR OTHERWISE.

    FOR YOUR HEALTH

    It is my responsibility, prior to engaging or permitting any of my dependents to engage in any YMCA exercise program or other activity involving physical activity, to consult with my physician to determine whether I and my dependents are medically able to engage in the program or activity.  It is my responsibility to monitor my own condition and those of any dependents throughout any activity and, should any unusual symptoms occur, to cease participation and inform the YMCA staff of the symptoms.

    I give permission to any YMCA staff person to administer first aid in the event of an emergency and to summon 911 response units for any medical treatment needed for me and my dependents. I understand that the staff will try to phone the emergency contacts in my YMCA household record, but is not required to do so before action is taken. I agree that any medical expenses incurred by me or my dependents will be my responsibility.

     FOR YOUR SECURITY

    I understand the YMCA premises, especially parking lots and locker rooms are provided for members' and guests' convenience while participating in YMCA programs. The YMCA is not responsible for vandalism, break-ins or thefts of personal property. I understand the YMCA recommends that valuables should not be brought to program activities or onto any premises. I agree to report any suspicious activity immediately to the staff. I understand that it is my responsibility to request, read, and after enrollment abide by the refund, cancellation and fee payment policies connected to specific membership and program involvement.

      YOUR CONDUCT

    I and my dependents will not bring weapons, controlled substances or alcohol on YMCA premises.   I understand that any form of solicitation is prohibited, and the use of violence, noise, force, coercion, sexual misconduct, threats, intimidation, unsafe conduct regarding children, fear, resistance, insults, or other conduct, intentionally or unintentionally causing disruption or preventing YMCA members' ability to enjoy their program activities, membership or YMCA staff's and/or volunteer's ability to conduct class or their job duties, is not acceptable behavior, is in conflict with YMCA values, and may result in my or my dependent's program withdrawal or termination. I am aware that the YMCA reserves the right, within its sole discretion, to withdraw program involvement and membership privileges to anyone for any reason that the YMCA, in its sole discretion, considers appropriate or in the interests of the YMCA and/or its patrons.

     SEX OFFENDER POLICY

    The YMCA conducts regular sex offender screenings on all members, participants, and guests. If a sex offender match occurs, the YMCA reserves the right to cancel membership of any member, end program participation, and remove visitation access.

     POLICY ON PHOTOGRAPHY

    I authorize the use and reproduction of any and all photographs or video footage of myself or my dependents for YMCA promotional purposes without compensation, and I understand that it is the personal responsibility of members and their guest(s) to avoid being photographed if they so desire.

     PARENTAL AUTHORIZATIONS & ACKNOWLEDGEMENTS

    Parental authorizations, including, but not limited to, written authorization for the Center to obtain emergency medical care for the child when the Parent is not available.

    Parental acknowledgment of their responsibility for keeping the Center advised of any significant changes in enrollment information concerning phone numbers, work locations, emergency contact, family physicians.

    Parental acknowledgment that when the Parent(s) or persons authorized by the Parent(s) pick up or drop off their child at the Center, they will not allow their child to enter or leave the Center without being escorted and that the Center will not permit the child to enter or exit the Center without an escort.

    The East Lake Early Learning Academy  agrees to obtain written authorization from me before my child participates in routine transportation, field trips, special activities away from the facility, and water-related activities occurring in water that is more than two (2) feet deep.

    I authorize the child care facility to obtain emergency medical care for my child when I am not available.

    I have received a copy and agree to abide by the policies and procedures...

    I understand that the facility will advise me of my child’s progress and issues relating to my child’s care as well as any  individual practices concerning my child’s special needs. I also understand that my participation is encouraged in facility activities.

    EMERGENCY MEDICAL AUTHORIZATION
    Should my child suffer an injury or illness while in the care of East Lake Early Learning Academy and the facility is unable to contact me (us) immediately, it shall be authorized to secure such medical attention and care for the child as may be necessary. I (We) shall assume responsibility for payment for services.

    The facility agrees to keep me informed of any incidents, including illnesses, injuries, adverse reactions to medications, etc., which include my child.


    By signing at the bottom of this agreement or electronically accepting this Agreement, I agree that I have read this entire Agreement and understand my responsibilities, and those of my dependents, for participation and conduct in YMCA programs and activities.

     

     

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