Ozark Community Center - Afternoon Kids Club Registration

Afternoon Kids Club Registration
For more information about the format and schedules for our After School Program, please see our website at OzarkMissouri.com. You can also email Recreation@ozarkMissouri.com or call 417-581-7002 ext 2004 for more information.

Initial registration for August costs $65 for non-members, and $55 for Annual Family Members. After August, AKC costs $140 per month for non members, and $120 for Annual Family Members (except in December). Afternoon Kids Club families received priority registration for Camp (Summer, Spring, and Holiday), early access to our kids night in and kids day off programming, as well as the ability to sign up for a snowday via our Procare Connect app. For more information, please find our info sheet, or our parent handbook, on our website (both will be mailed automatically upon application completion).

If you wish to save your form and continue later, please click Save in the bottom right hand corner, and follow the prompts given.

Please note that we are unable to provide transportation from Ozark West Elementary
Are you an OC Annual Family Member?*

YESNO
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 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.

Child's Information
Child's Name*

First NameLast Name
Birth Date*

MonthDayYear
Grade in Fall 2025*
Put 0 for Kindergarten
Gender*

MaleFemale
School child currently attends:*

Ozark SouthOzark EastOzark NorthOzark Middle School
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Comments on child’s development (note allergies, habits, special needs, etc.)*
Please select the box that applies to your child.*

My child is in good health, and is able to participate in group care, has no special health or medical requirements.My child is able to participate in group care, but has special needs or medical requirements as listed below.
Description of special needs or medical requirements*

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
Employ 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:*

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 AKC program, please submit in writing or via email a cancellation to Recreation@OzarkMissouri.com ten business days prior to the next month's tuition. 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.*
Please type your name in the box.

Bus Consent Form
This form authorizes Ozark Parks and Recreation Department to pick up my child from school or the School Bus. If my child has not been arranged to be dropped directly off at The OC by Ozark School district, Ozark Parks and Recreation's bus will pick my child up at the rendezvous location each day and transport him/her to The OC for the Afternoon Kids Club.
My child will attend: (Please check one)*

North Elementary SchoolSouth Elementary SchoolEast Elementary SchoolOzark Middle School
Parent's Name*

First NameLast Name
Date*

MonthDayYear
Date
Parent Signature

Clear

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:

Afternoon Kids Club Registration

Bus Consent Form

The City of Ozark Parks & Recreation Department