Parent/Guardian Signature Signature*
I give permission that my child(ren)name(s)*, may be given first aid/emergency treatment by the childcare licensee and/or staff at: Name of Licensee: Here We Grow Child Development Center Address of Licensee: 12243 South 700 West, Draper, Utah 84020When I cannot be contacted, I authorize and consent to medical, surgical and hospital care, treatment and procedures to be performed for my child(ren) by a licensed physician, health care provider, hospital or aid care attendant when deemed necessary or advisable by the physician to safeguard my child(ren)'s health. I waive my right of informed consent to such treatment. I also give permission for my child(ren) to be transported by ambulance to an emergency center for treatment. I certify under penalty of perjury under the laws of the state of Utah that this information is true and correct. Parent/Guardian Signature* Date*
RISK FACTOR ASSESSMENT
Review the list below. How many of these circumstances apply to your child?
Affirmation: I certify that the above information is true and accurate to the best of my knowledge.Parent/Guardian Signature: Signature Date: Date
Initial* I agree to release and waive any claim for accidents and/or injuries involving my child while under staff supervision. In the event of an emergency, the center has my permission to administer first aid and/or obtain medical treatment and transportation in the child's best interest. I agree to pay all medical expenses incurred due to an emergency involving my child.
Initial* I give permission for my child to participate in all Here We Grow field trips. I will be notified prior to all field trips on cost and time.
Initial* I grant permission for my child to be transported in the center vans. I grant permission for my child to be transported in staff's vehicles and/or volunteer's vehicles in the case of an emergency involving a group evacuation.
Initial* Here We Grow is open from 7:00am - 6:00pm. However, please be here by 5:45pm to pick up your child at the end of the day. This allows time for staff to help your child gather their daily work and backpacks, and wash their hands. If utilizing our curbside pickup, please call the center 10 minutes prior to your arrival and have your child's name card displayed in your front window to ensure a smooth, quick dismissal process.
Initial* Late Pick Up Policy: If your child is not picked up by closing (6:00pm) an additional charge of $1 per minute per child will be assessed. This fee is payable to the staff member staying with your child. Legal authorities will be contacted after all emergency contacts have been tried for the children left one hour after closing time.
Initial* I agree to pay as indicated on the tuition agreement and I will notify the center's director TWO WEEKS in advance of withdrawal from the program or pay the difference. Upon closing of childcare services, I agree to pay off the balance within two weeks. Should any amount on this account become delinquent, I agree to pay all interest, court cost, attorney fees and reasonable collection cost up to 50% of the amount owing. Accounts on which no payment is made in a 30-day period are subject to 18% annual interest charges.
Initial* A 10% discount will be offered to families who enroll multiple children from the same family into our program. The discount is applied to the oldest child. This discount is not applicable to part time programs.
Initial* A non-refundable Material Fee of $75 and the first week's tuition are due upon my child's enrollment.
Initial* I understand and agree that if my child is still in diapers, I need to provide diapers and diaper rash cream for my child. I understand and agree that if my child is running low on diapers, my child's teacher will notify me with a note sent home in my child's cubby. If my child runs out of diapers, I will be charged $1 per diapers used from HWG's extra diaper supply.
Initial* I understand and agree that I need to provide my child with a spare change of clothes to be kept in my child's classroom - I will make sure to change these clothes out according to weather. If my child is sent home in their extra clothes, I will return a new change of clothes to be kept in their classroom. I understand that if my child has an accident and is in need of new clothes, if HWG does not have extra clothes for my child I will be called to bring them extra clothes.
Initial* Parents are responsible for any tuition or fees not paid by third-party agency reimbursement. I also understand that it is my responsibility to communicate any charges that could affect my third-party reimbursement to the Center Director in order to avoid additional fees and charges.
Initial* If my child attends summer camp, there will be a separate Camp Registration Fee and Tuition Rate.
Initial* Any returned checks will be charged a $35.00 returned check fee.
Initial* I understand my account will not be credited for absences. Here We Grow is required to staff and incur operating costs even when my child does not attend. Tuition fees are still required and are not pro-rated for illness, holiday, vacations, or emergency closure of the center.
Initial* I understand and agree that the schedule I have selected for my child is the schedule that HWG is reserving for my child. I understand that these are the only dates and times my child may attend (unless approved by the director) so the school can maintain the correct student-to-teacher ratio. If we do permit your child to come for an extra day, please provide us with as much notice as possible so we can check the classroom availability. An extra day will be charged and added to your statement. I understand and agree that I may not choose a week-to-week schedule for my child. HWG schedules are set up on a monthly basis. If you select a 3 day schedule, your child may come for 3 days only and it must be the same three days every week. If you need to change your child's schedule, you may submit a written request and we will return a form to you with approval or denial of the schedule change. ALL SCHEDULE CHANGES MUST HAVE A TWO WEEK NOTICE.
Initial* If a child must be gone for a prolonged period of time, he or she may withdraw and then re-enroll by paying the enrollment fee; Here We Grow will not guarantee a spot if another child enrolls during the period of absence.
Initial* If your child attends an outside school and we normally pick them up, but you do not need them picked up that day, you must notify the center at least one hour before school lets out. If you fail to do so, a $10.00 fee will be assessed.
Initial* I have read the sick child guidelines in the Parents statement of service. To maintain the health of all children at the center, your child may not be allowed to attend the center if he/she has a fever of 100.4 or higher, or are showing other signs of illness. Your child should be free of symptoms for 24 hours without medication before returning to school.We DO NOT care for children who are ill. If your child becomes ill at the center, you will be contacted and asked to pick up your child within one hour of notification. If you are unable to pick up your child within the hour, someone listed on your child's emergency contact list should pick up your child. Our center will administer medication to a child ONLY when a medical release form from the parent/guardian has been received. If COVID-19 is confirmed in a child, family member, or staff member of HWG, they will be asked to self-isolate for 14 days, or 7 days post-symptoms, whichever comes first.
Initial* I have read the Child Admission and Release Requirements. Parents or other adults authorized for pick up are required to check their children in and out each day on the Procare App when dropping off and picking up their child. Failure to do so will result in a $5 fee. Children will not be released to persons. under the age of eighteen (18) including siblings, with the exception of minor parents. All pick-ups must show positive government-issued identification. In the event that parents request their child to be released to an unauthorized individual, a written authorization or phone call by the parent is required prior to the event.
Initial* I have read the Discipline Guidelines. It is Here We Grow's philosophy to redirect inappropriate behaviors by letting children know what behaviors are expected and offering assistance with expected behaviors. When a child is unresponsive to redirection, other strategies may be used to assist the child. These may include, but are not limited to problem solving together, assessing the goal of the misbehavior and addressing the need of the child, taking a break from the activity or environment, and allowing natural/logical consequences. All guidance techniques are designed to retain a child's self-esteem while helping them develop self-control. All harsh, physical, shaming and punitive approaches to discipline are strictly forbidden at Here We Grow.
Initial* I have access to the Parent Handbook (a copy is located in the front office or on the website).
ELECTRONIC FUNDS TRANSFER AUTHORIZATION FOR BANK ACCOUNT and
I (we) hereby authorize Here We Grow Early Learning Center to initiate credit card charges to the below-referenced credit card account (Section A) OR, initiate debit entries to my (our) checking or savings account, indicated below (Section B). To properly affect the cancellation of this agreement, I (we) are required to give 10 days written notice. initial* Credit union members: please contact your credit union to verify account and routing numbers for automatic payments. Check with the center for accepted credit card types. COMPLETE ONE SECTION ONLY (A OR B)
SECTION A (Credit Card)
Cardholder Signature Signature
SECTION B (Bank Account)
Authorized Signature Signature