TEGA 2024-25 Supplemental Enrollment Information: After School Care

TEGA Childcare Supplemental Enrollment Information - After School Care 2024-25 School Year

This information is required for your child to attend TEGA's After School Care program for the academic year 2024-25. Form must be filled out separately for each child that will be attending prior to their first day of care.
Student Information
Member ID
Student's Name*
Nickname
Student's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

MonthDayYear
Date
Entering Grade in 2024/25 School Year*
School Student Attends*
School Address*
School Phone Number*

Area CodePhone Number

Parent/Guardian Information

Parent/Guardian 1
Parent/Guardian 1*

First NameLast Name
Relationship to Child*
E-mail*
Primary Phone Number*
Secondary Phone Number
Parent/Guardian 2
Parent/Guardian 2

First NameLast Name
Relationship to Child
E-mail
Primary Phone Number
Secondary Phone Number

Emergency Contacts/Authorized Pickup

Parents cannot be listed as emergency contacts. List the name of at least one person who can be contacted in the event of an emergency or illness if you cannot be reached. Any person listed should be able to assist in contacting you. At least one person listed must be within one hour of TEGA, able to take responsibility for the child in case the parent/guardian cannot be contacted and should be at least 18 years of age. The first emergency contact must live no more than 1 hour away and be over the age of 18.
Emergency Contact #1
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Secondary Phone Number
Relationship to Child*
This person is authorized to pick up my child from TEGA:*

YesNo
Emergency Contact #2
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Secondary Phone Number
Relationship to Child*
This person is authorized to pick up my child from TEGA:*

YesNo
Please list the name, relation, and phone numbers of any additional people who are authorized to pick up your child from TEGA:

Child Behavior Assistance and Safety Plan

We want to ensure all students can thrive at TEGA. We understand that children may experience frustration, anxiety and struggle with behavior in different environments. However, we take the safety of all our children very seriously. If at any time a child harms another student or staff member or runs away from their group leaving them without supervision, parents will be phoned and the student will be excused for the day.
What behaviors might we encounter while caring for your child? Please explain.*
In your experience, what triggers these behaviors?*
What are the best options to redirect behavior?*
Help us understand what does NOT work for your child.*
Does your child lash out physically when upset?*
Discipline Contract
To ensure a cooperative, safe, and caring environment, as well as guarantee that ALL students enjoy their day, the following policies will be enforced by the staff of TEGA Kids. Please read, and with acknowledgement that you understand and agree to comply with all that is listed below, sign at the bottom of the page.

Rules:
- Directions are followed the first time they are given.
- We keep our hands, feet, mouths, and objects to ourselves.
- We stay with our group at all times.
- We make proper use of all the facilities including the restrooms.
- We use materials, supplies, and indoor and outdoor equipment properly and as instructed.
- We always treat others with respect and never use foul language, call names, tease or bully others.
Appropriate Behavior:
TEGA staff use a wide variety of rewards and privileges to recognize, acknowledge, and support the student’s use of “good behavior”.

Inappropriate Behavior:
Examples of inappropriate and unacceptable behaviors include, but are not limited to: leaving assigned areas without permission, use of foul language, threatening the health or safety of others, hitting/ kicking/ scratching/ biting/choking others, throwing rocks, dirt, sticks, etc. at others, stealing, damaging or destroying property, general disrespect or defiance, non-cooperation.

If a child is deemed to be out of control, the parent/guardian will be called to immediately come to pick up the child for the remainder of the day.

Children who have repeated difficulty behaving appropriately will be suspended for two weeks, at the parent’s expense. Upon return from suspension if the student continues to have disruptive, harmful or distracting behavior that student will be dismissed from the program permanently.

The following steps may be applied for inappropriate behavior:
- Step One: Child is given a verbal warning and is given instructions on how to correct his/her behavior.
- Step Two: Child is given a set “time-out” from the current or a future activity, away from the others.
- Step Three: The Director/General Manager will be informed and the child will be required to talk to the director/manager about the situation and the parents/guardian will be called or told at pick-up. Parents are expected to discuss the inappropriate behavior with their child and to work with the TEGA staff to stop the misbehaviors. Depending on the seriousness of the behavior, time-outs may be given immediately as determined by the staff. If the director/manager decides it is necessary to remove a child from the program, the above steps may be bypassed and his/her parent will be called to pick up their child immediately
Suspension or Termination
In addition to the situations listed above, students may also be suspended or terminated based on parents/guardians:
- Repeatedly being late in picking up children from the facility.
- Repeatedly being late and/or for non-payment of fees.
- Inappropriate behavior towards staff or other TEGA employees, use of inappropriate language, being verbally or
  physically threatening or intimidating, any physical aggression and/or damage to property.
- Disregard of or the refusal to follow the TEGA procedures and guidelines.
I have read the Discipline Contract and agree to discuss the policies with my child. I agree to abide by this contract and to support the TEGA staff as it may pertain to these rules and expectations.
Date* today's date
Signature*

Statement of Understanding
Sign Document (use mouse if on computer)*
Date Signed*

MonthDayYear
Camp Director Name and Contact Info
TEGA Kids (After School Care)
4525 Milwaukee Ave, Ste #500
Lubbock, TX 79407

TEGA Kids (Instructional Gymnastics, Ninja & Swim Classes)
4525 Milwaukee Ave, Ste #800
Lubbock, TX 79407

806-866-9765
www.tegakids.com
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TEGA Childcare Supplemental Enrollment Information - After School Care 2024-25 School Year

Student Information

Parent/Guardian Information

Emergency Contacts/Authorized Pickup

Medical / Health Information

Emergency Medical Treatment Authorization

Child Behavior Assistance and Safety Plan

Discipline Contract

Transportation, Release, and Special Activities

Statement of Understanding