Kids Day Off - Childcare at The OC

Kids Day Off - Childcare at The OC

Pre-registration form for childcare at The OC
Please note that this is NOT the registration for the After School Program at The OC, but is instead the registration for our full day childcare programs (kids days off, snow days, etc). For our after school program serving Ozark Elementary and Middle Schools, please visit Afternoon Kids Club at The OC

Thank you for your interest in our Day Out Childcare at The OC! With changes to local school disctrict schedules and state licensing requirements, as well our billing software, all day out particpation requires this form to take part in the program. Day of registration is no longer possible. Please note that snow days are only offered based on the cancellation of Ozark R-VI school district as well, and will be offered based on severity of weather, enrollment and interest, and staffing availability.

Billing options are available:
- Daily for students attending all local school disctricts, available during scheduled days off at $30 for families with an annual membership at The OC, or $35 for those without.
If you wish to save your form and continue later, please click Save in the bottom right hand corner, and follow the prompts given.
Are you an OC Annual Family Member?*

YESNO
How will you be utilizing this program?*

On an as needed basis as an Ozark student, billed daily - must sign up for specific dates in advance. A separate (simpler) registration form will have to be filled out after this one whenever I would like to select a date.
Please note - if you are registering for a recently announced snow day January 28th is currently full and has a waitlist, keep in mind that this registration may not be processed or a spot held for your child, as it can take up to two business days. Registration for a snow day will happen within ProCare Connect via message after pre-registration has been processed.
Would you like to select your dates today?*

Yes, I would like to select the dates my child will be attending and be invoiced for them. Payment of this invoice via ProCare Connect will hold my child's spot.No, I would not like to select dates and be invoiced today. I recognize a spot will not be held for my child until I do so, on a separate form.
Do you attend Ozark R-VI school district or one of the outlying districts with a four-day school week?*

Ozark R-VI School District (or other local district with five day schedule)
Registration Dates*
Childcare through Ozark Parks and Recreation utilize ProCare Connect for billing. As a part of our tuition and billing being a part of ProCare Connect for all of our programs, tuition will be drafted automatically on the fifth day of the billing period. Additionally, payment will only be accepted via major credit card in ProCare Connect. Upon registration and acceptance into the Ozark Parks and Recreation program, your ProCare connect account will be set up, and your invoice created*

Yes, I would like to auto-draft my after-school paymentsNo, I will make payments online through the self service portal, and recognize it is my responsibility to deactivate the auto-pay function.

Parent/Guardian Information
Parent 1:*

First NameLast Name
Cell Number*

Area CodePhone Number
Home Number

Area CodePhone Number
Work number

Area CodePhone Number
Employed by or school attending:*
Normal work/school days and times*
Parent 1's Work Address (per State of Missouri Childcare Licensing)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
Follow up emails will be sent to this address.
Parent 1 - address the same as child's:*

YesNo
Parent 1 Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 2:

First NameLast Name
Cell Number

Area CodePhone Number
Home Number

Area CodePhone Number
Work number

Area CodePhone Number
Employed by or school attending:
Normal work/school days and times
Parent 2's Work Address (per State of Missouri Childcare Licensing)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Parent 2 - address the same as child's:

YesNo
Parent 2 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Information

Below should be individuals OTHER than the primary guardians listed above. Primary guardians will be contacted first in the event that communication is required. If they are unavailable, The OC will then contact the individuals listed below.
Emergency Contact 1's Name*

First NameLast Name
Relationship*
Phone Number*

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
Emergency Contact 1 Address (Required per State of Missouri)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact 2's Name*

First NameLast Name
Relationship*
Phone Number*

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
Emergency Contact 2 Address (Required per State of Missouri)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Physician's Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Physician's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred Hospital*
Hospital Phone Number*

Area CodePhone Number
Hospital Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please upload a copy of your child's immunizations records as a part of our licensing requirements.*

Browse Files

Cancelof
Please upload a copy of your child's immunizations records as a part of our licensing requirements.*
Person(s) authorized to pick child up from the Ozark Parks and Recreation Program:*

Parents should examine the attached PDF to develop an understanding of our Parent Guardian Contract, which all individuals will be held to. Please note that while there may be one signature on this sheet, all parents and guardians/authorized pick-ups of the child listed below will be held to these standards. You can sign for both of these documents in the box below.

Parent Guardian Contract

Childcare Parent Handbook
By signing in the box below, I certify that I have read and acknowledge all of my responsibilities as laid out in the parent contract above.*

Clear
By completing this registration form, I am authorizing Ozark Parks and Recreation to invoice me for the complete cost of my child's tuition for these Day Out programs. I recognize that the policies and procedures of these programs were provided to me with my full registration previously submitted, and that I must abide by these policies. I recognize that a space is not held for my child until payment has been made, and that my registration may be cancelled any time after two business days of invoicing if payment is not received.*

Clear
Ozark Parks and Recreation's Cancellation Policy:
1. Program fees offset the cost to plan, schedule, and staff programs. When you sign up for a program, we depend on your enrollment for that program to succeed. Please plan your schedule carefully, as we cannot accept responsibility for your personal circumstances.
2. If you must cancel from the childcare program, please submit in writing or via email a cancellation to Recreation@OzarkMissouri.com ten business days prior to the start of your selected program. You will not be charged for the following month.
3. You will be notified if a program is cancelled due to insufficient registration.
4. Refunds take 2 to 3 weeks, and you must fill out a request for refund form and may be subject to a refund fee of $10.
5. There will be a $25.00 fee for all returned checks.
By typing your name in the box, you are declaring that you understand the Ozark Parks and Recreation cancellation policy.*

The City of Ozark Parks & Recreation Department

ASSUMPTION OF RISK & RELEASE OF LIABILITY AGREEMENT
In consideration of participating in ALL City of Ozark Parks and Recreation Department activities, regardless of location, and use of ANY of its facilities and/or properties every individual must fill out and sign this document. For participants under eighteen (18) years of age, parent(s) or guardian(s) must sign below.
Name (of individual participating)*

First NameLast Name
Birth Date*

MonthDayYear
Address (Address, City, State)*
Zip Code*
Cell Phone *

Area CodePhone Number
Home Phone

Area CodePhone Number
Email*
example@example.com
Emergency Contact*

First NameLast Name
Emergency Phone Number*

Area CodePhone Number
In consideration of access to and use of the City of Ozark Parks and Recreation Department facilities and participating in any of its activities and after carefully reading this document, I acknowledge, appreciate, and agree that:

I am at least eighteen (18) years of age and am of sound mind. I have carefully read this document and understand that it contains information regarding my responsibilities, assumptions of risk, and includes a release of liability, indemnification, and surrenders certain legal rights.

It is my responsibility to determine my physical condition, and the physical condition of any minor I am responsible for, and I acknowledge that it is safe for me and/or said minor to participate in the use of the Ozark Parks and Recreation Department facilities and activities, including, but not limited to: sports, swimming pool, rock wall, weight machines, track, trail, gymnasium, fitness classes, free weights, jump/bounce houses, etc.

I, on my own behalf and on the behalf of any minor accompanying me, agree to abide by and follow the rules, regulations, and policies of the City of Ozark Parks and Recreation Department at all times while using its facilities and/or participating in its activities.

I, on my own behalf and on the behalf of any minor accompanying me, am aware of the inherent risk of injury associated with the activities involved including the potential for permanent disability and death. It is my responsibility to consult with a physician prior to physical activity if I deem it necessary.

I, on my own behalf and on the behalf of any minor accompanying me, hereby release, hold harmless, and covenant not to sue the City of Ozark, with respect to any and all injury, disability, death, or loss or damage to person or property, whether caused by the negligence of the released party, its employees, and/or agents, or otherwise.

I, on my own behalf and on the behalf of any minor accompanying me, knowingly and freely assume all such risks of any loss, damage and injury that may occur in relation to any activity offered by City of Ozark, even if arising from the negligence of those persons released from liability herein, and I assume all responsibility for myself and any minor accompanying me.

I further agree to defend, hold harmless, and indemnify City of Ozark from any and all claims made by third parties against the City of Ozark for losses or causes of action of any kind or type, including but not limited to those for personal injury, including death, and/or property damage or loss, out of or in connection with the use of facilities operated by and/or activities organized by the City of Ozark Parks and Recreation Department by myself and/or a minor that I am responsible for.

I agree and understand that this release of liability and assumption of risk agreement covers each and every time I and/or a minor in my custody attend and/or participate in the City of Ozark Parks and Recreation facilities and activities.

I authorize the City of Ozark employees and/or staff to obtain or provide medical care for me and/or a minor in my custody and to call for and/or transport me and/or a minor in my custody to a medical facility. I authorize medical personnel to render such treatment they deem necessary for the health of me and/or a minor in my custody. I agree that the City of Ozark has no responsibility for medical care provided to me and/or a minor in my custody and I agree to pay all costs associated with such medical care and transportation.

I agree that this Agreement and all other aspects of my relationship with the City of Ozark are governed by Missouri law and venue shall be appropriate in Christian County, Missouri. Any portion of this Agreement deemed unlawful or unenforceable shall not affect the enforceability of the remaining provisions of this Agreement and the remaining provisions shall continue in full force and effect.

I have carefully read, understand and voluntarily sign this Agreement and acknowledge that it shall be effective and binding upon myself and my family and my heirs, executors, representatives and estate.
Participant Printed Name*

First NameLast Name
If on behalf of minor, name of guradian:*

First NameLast Name
Signature*

Clear
Should be Empty:

Kids Day Off - Childcare at The OC

The City of Ozark Parks & Recreation Department