Giant Steps Registration Supplemental Forms 2025

Giant Steps Registration Supplemental Forms 2025 - 2026
Parent / Guardian Full Name*

First NameLast Name
Parent / Guardian Email *
example@example.com

Please complete the following form for each child you are registering to attend any Giant Steps Program.

Please indicate YES or NO to give consent or acknowledge receipt of the information listed under "Consents and Acknowledgements".

Afterwards please complete the annual Health History Update for your child. This information is shared with 911 providers in case of emergency.

If your child takes medication during program hours please submit a medication authorization form for EACH medication taken.

Medication Authorization forms must be filled out for medication authorized to be administered at each program. (For example, one form for Day School and one form for Riley Center)

Thank you for taking the time to complete the online supplemental registration forms.
Child's Name*
Program*

Day SchoolCanopy Adult Day ProgramChristine's Dream
Birthdate*

MonthDayYear
Date
Grade*
Gender Identity
Sexual Orientation
Parent / Guardian Phone Number*
Please enter a valid phone number.
Language spoken at home*

Consent and Acknowledgements
Consent for use of Photography/Videography/Original Work on Social Media platforms:

Students/Participants and student/participant work may occasionally appear in photographs and recordings taken by Giant Steps staff members, other students/participants, or other individuals authorized by the Giant Steps administration. Giant Steps may use these pictures and recordings, without identifying the student/participant, in various publications, including the Giant Steps website, and Giant Steps social media (e.g., Giant Steps Facebook page, Canopy Facebook page, Christine's Dream Facebook page, Instagram page, Twitter feed and all other Giant Steps affiliated social media platforms).

At times, Giant Steps may want to identify a student/participant or student/participant work in a publication. For example, Giant Steps may wish to acknowledge students who participate in a school activity or deserve special recognition, including in a news release or a Giant Steps-sponsored material, publication, recording, website, social media. In order for Giant Steps to publish a picture or recording of a student/participant or of a student’s/participant's work while the student/participant is enrolled at Giant Steps, the student’s/participant's parent/guardian must sign this consent form below.

By electronically signing below, I understand that I am granting Giant Steps consent to use my child’s first name, photographic or video image, voice, statements, work, or writing; identify my child; and identify the school/program my child attends in any Giant Steps-sponsored material, publication, recording, website, or social media. I understand that I may revoke this consent at any time by notifying the Director of Special Education or Canopy Program Administrator in writing. I further understand that, while Giant Steps limits access to school/program buildings by outside photographers, it has no control over news media or other entities that may publish a picture of a named or unnamed student/participant from a school/program event.

This consent is valid only for the school/program year in which it is signed. Consent must be given annually.
Do you give consent for use of Photography/Videography/Original Work on Social Media platforms?*

YesNo
Consent for Internal Use of Photography/Videography/Original Work:

Students/Participants and student/participant work may occasionally appear in photographs and recordings taken by Giant Steps staff members, other students/participants, or other individuals authorized by the Giant Steps administration. Giant Steps may use these pictures and recordings, without identifying the student/participant, in various publications, including classroom yearbooks, classroom newspapers/newsletters, classroom or school yearbooks, school newspapers/newsletters, end of year PowerPoints, graduation PowerPoints for students moving to the next grade level or aging out of the transition program, and videos used for training new Giant Steps staff members. At times, Giant Steps may want to identify a student/participant or student/participant work in a publication. For example, Giant Steps may wish to acknowledge students who participate in a school activity or deserve special recognition in school newsletters or yearbooks. In order for Giant Steps to publish a picture or recording of a student/participant or of a student’s/participant's work while the student/participant is enrolled at Giant Steps, the student’s/participant's parent/guardian must sign this consent form below. By electronically signing below, I understand that I am granting Giant Steps consent to use my child’s first name, photographic or video image, voice, statements, work, or writing; identify my child; and identify the school/program my child attends.

This consent is valid only for the school/program year in which it is signed. Consent must be given annually. I understand that I may revoke this consent at any time by notifying the Director of Special Education or Canopy Program Administrator in writing.
Do you give consent for Internal Use of Photography/Videography/Original Work:*

YesNo
Consent for Emergency Medical Care: I give consent for emergency medical care to be secured for my child in the event of an emergency. I will be responsible for the emergency medical charges upon receipt of the statement.

YesNo
Consent for Community Based Instruction/Outing Transportation: I give consent for my child to participate in scheduled community based instruction and be transported via contracted buses or vehicles, Giant Steps approved vehicles (i.e. Day School utilizes minivans, Canopy Day Program and Rec Center access the following: 15 passenger van, 12 passenger van, Multi-Functional School and Activity Shuttle Bus, golf cart, mini-van, or other GS approved vehicle), and/or walking while enrolled at Giant Steps. I understand all such trips are under the supervision of Giant Steps staff members and that health and safety precautions are taken as appropriate.*

YesNo
Consent for Use of Fitness Equipment: I give consent for my child to participate in a physical fitness program that incorporates the use of fitness equipment (e.g., treadmills, elliptical, stationary bike, stair stepper, etc.). I understand that my child will only use the fitness equipment for which he/she has met the height and weight requirements. I further recognize that the use of fitness equipment involves the potential for injury even with the best instruction and equipment as well as strict observance of rules. I acknowledge that I have read and understand this warning. Furthermore, I release Giant Steps, its employees, and its agents from all liability for any injuries incurred by my child during or resulting from the use of fitness equipment.*

YesNo
Acknowledgement of Student and Participant Absence Procedures: I understand Giant Steps’ policy requiring me to notify the Day School or Canopy Program each day that my child will be absent. I understand that it is my responsibility to notify the school or the Canopy Program in a timely fashion by calling/texting the Day School at (630) 864-3899 or emailing student.attendance@mygiantsteps.org, or the Canopy Program at (630)864-3830 or emailing CanopyLeadership@mygiantsteps.org. I will leave a message including my child’s name, classroom teacher’s/program name, and reason for the absence. I understand that it is also my responsibility to notify my child’s transportation provider (e.g., bus company, cab company, etc.) each day that my child is absent.*

YesNo
Acknowledgement of Electronic Acess Usage:

Giant Steps has the ability to enhance your child’s education through the use of Giant Steps’ electronic network, including the Internet. Our goal in providing access is to promote educational excellence by facilitating resource sharing, innovation, and communication. Parents/guardians and their child must sign this Authorization form annually.

Giant Steps filters access on its electronic network to protect against pictures or videos that are obscene, pornographic, or otherwise harmful or inappropriate in the school setting. However, it is impossible to guarantee the filtering of all such material, and it is possible that a user may gain access to inappropriate material. Ultimately, parents/guardians are responsible for setting and conveying the standards that their child should follow and Giant Steps respects each family’s right to decide whether or not to authorize their student’s access to Giant Steps’ electronic network, including the Internet. With this educational opportunity also comes responsibility. The inappropriate use of Giant Steps’ electronic network, as defined in Giant Steps’ electronic network policy, and its implementing administrative procedures, rules, and regulations, may result in the loss of privilege to use this resource. All use of Giant Steps’ electronic network, including the Internet, shall be consistent with Giant Steps’ goal of promoting educational excellence by facilitating resource sharing, innovation, and communication. Remember that you are legally responsible for your child’s actions. The failure of any user to follow the terms of the Acceptable Use of Electronic Networks will result in the loss of privileges, disciplinary action, and/or appropriate legal action.

I have read and accept Giant Steps’ electronic network policy. Further, I acknowledge that I have reviewed the policy and procedures with my child. I understand that access is designed for educational purposes and that Giant Steps has taken precautions to eliminate any harmful or inappropriate material. However, I also recognize and agree that it is impossible for Giant Steps to restrict access to all harmful and inappropriate materials and that my child might access such material through the electronic network. I understand that any unacceptable use of the electronic network is grounds for suspending or revoking network privileges and may result in discipline, up to and including expulsion from school, as well as criminal or civil penalties. In addition, I agree to indemnify Giant Steps for any losses, costs, damages, charges, or fees caused or incurred by my child relating to or arising out of my child’s use of the electronic network or any violation of the Policy, procedures, rules, or other terms or conditions of electronic network access. In consideration for my child’s access to the electronic network, I hereby release Giant Steps and its individual Board members, officers, employees, agents, successors, and assigns from any claims and damages arising out of or related to my child’s use of, or inability to use, the electronic network.
Do you give acknowledge the access of the electronic access usage?*

YesNo
Are you registering a student for Day School?*

YesNo
Acknowledgement of Student and Parent Handbook: I acknowledge that I have received and read the 2025-2026 Student and Parent Handbook and that I have reviewed it with my child. I understand the policies, procedures, guidelines, rules, and expectations outlined in the Handbook are only a summary of all Giant Steps policies and rules, and that I am subject to and must abide by all Giant Steps policies. I also understand that a violation of any of Giant Steps’ polices and rules may lead to disciplinary consequences. I further understand that the Handbook may be amended during the year without notice.*

YesNo
Acknowledgment of Technology Tools: I have read about the the ability to create individual student accounts for any new technology tools in the Student and Parent Policy Handbook. Giant Steps Day School will create individual technology accounts for your child, we will notify you ahead of time to let you know which website or application is being used.*

YesNo
Consent for Distribution of Directory Information:

Some personal information contained in a student’s educational record is legally designated as public information and may be released at the discretion of the school unless a parent/guardian requests that information about his/her child not be released.

This “Directory Information” includes:
- Student name, address, and grade level
- Student photographs
- Parent/guardian names, addresses, and contact information
- Academic awards and honors received
- Information relating to school -sponsored activities, organizations, and athletics
- Period of attendance in the school.
The above information may be released to the general public, unless a parent/guardian submits a request to the Director of Special Education that it not be released. This consent is valid only for the school/program year in which it is signed. Consent must be given annually. I understand that I may revoke this consent at any time by notifying the Director of Special Education in writing.
Do you give consent to releasing Directory information?*

YesNo
Acknowledgement of Undesignated Epinephrine and Narcan: I understand that Giant Steps Day School houses undesignated epinephrine and Narcan as required by ISBE. In the event that your child is experiencing an emergency medical situation staff will utilize these resources as appropriate and contact Emergency Medical Services for additional support.*

YesNo
Are you registering a participant for Canopy Day Program?*

YesNo
Please answer the following questions for your Canopy Participant. If you are not registering a Canopy Participant than please select the "no" response
Electronic Billing Consent: Giant Steps utilizes electronic communication (e.g. email, Infinite Campus, QuickBooks, etc) to document and share information with participants, students, and families regarding fees for ancillary services. I give consent for Giant Steps to communicate with me regarding my child's fees for ancillary services (Canopy, Rec Center, Christine's Dream, etc) as needed to maintain accurate records*

YesNo
Rich Foundation Inc. and Giant STeps IL Inc.

RELEASE OF LIABILITY, HOLD HARMLESS AND INDEMNITY AGREEMENT

[Equine Activities]

BY SIGNING RELEASE OF LIABILITY, HOLD HARMLESS AND INDEMNITY AGREEMENT (THIS “AGREEMENT”) YOU ARE GIVING UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO RECOVER DAMAGES IN THE EVENT OF INJURY, DEATH AND PROPERTY DAMAGE.

WARNING

UNDER THE EQUINE ACTIVITY LIABILITY ACT, EACH PARTICIPANT WHO ENGAGES IN AN EQUINE ACTIVITY EXPRESSLY ASSUMES THE RISKS OF ENGAGING IN AND LEGAL RESPONSIBILITY FOR INJURY, LOSS, OR DAMAGE TO PERSON OR PROPERTY RESULTING FROM THE RISK OF EQUINE ACTIVITIES

DESCRIPTION OF RISKS

Each Participant understands that there are risks that are an integral part of equine activities and otherwise dealing with horses and ponies, including but not limited to:

• The propensity of an equine to behave in dangerous ways that may result in injury to the participant.

• The inability to predict an equine’s reaction to sound, movements, objects, persons, or animals.

• That hazards of surface or subsurface conditions including, but not limited to, surface or subsurface conditions.

1. Participant has read, understood, and freely and voluntarily enter into this Agreement with RICH FOUNDATION Inc. and GIANT STEPS IL Inc. (the “Company”), its staff, employees, officers, managers, and owners.

2. Participant understands that this Agreement is a waiver and release of any and all liabilities associated with or arising from my participation in or viewing of equine activities at the facilities owned or operated by the Company, its staff, employees, officers, managers, owners, J.R. Investments, LLC, Jerome A. Rich, and anyone else directly or indirectly connected with the Company. This Agreement is provided in consideration of Participant’s use and enjoyment of the property, stables, facility and services of the Company.

3. Participant understands and acknowledges that there are risks inherent in dealing with equines (including horses, ponies, mules, donkeys, and hinnies) and participating in, viewing and engaging in equine activities. Participant hereby expressly and unconditionally accepts all of those risks and the potential dangers and liabilities arising therefrom and expressly waives any and all claims for any injury, loss, damages to person or property and death arising therefrom.

4. Understanding these risks, potential dangers and liabilities, Participant hereby releases, holds harmless and indemnifies the Company, its staff, employees, officers, managers, members, owners, J.R. Investments, LLC, Jerome A. Rich, and anyone else directly or indirectly connected with the Company from any and all liability, accident, claim, injury, death, demand, cause of action, damage, theft, judgment, and expense, including without limitation all reasonable attorneys’ fees, which may in any way arise from, incurred or in any manner be connected with Participant’s use of or presence upon Company’s facilities or otherwise arising from or incidental to participation in equine activities, including without limitation electing to mount and ride a horse, or being a spectator at equine activities at the Company’s facilities.

5. Participant represents and warrants that this Agreement, is being voluntarily and intentionally signed and agreed to, and that in signing this Agreement, Participant knows and understands that this Agreement further limits the liability of equine professionals.

6. Participant agrees that Participant has been given sufficient time to read, and understand and ask questions, if any, concerning that nature and scope of this Agreement.

7. This Agreement may not be altered, amended, or modified except in writing and signed by both parties. This Agreement shall be governed by the Laws of the State of Illinois. Venue for any litigation involving Participant and the Company, including its staff, employees, officers, managers, members, and owners shall be in Kane County, Illinois.

8. Participant hereby grants permission and authority to the Company, its officers, staff and employees to act for Participant in executing verbal instructions (if I am unable to do so) to act for Participant in dealing with physicians, available ambulance companies and hospitals, to obtain prompt medical attention for the Participant in the event of any perceived medical emergency. Participant hereby releases and holds harmless the Company, its officers, staff and employees from any liability or expense connected with obtaining prompt medical attention for the Participant.

For purposes of this Agreement, the word “Company” shall include, without limitation the facilities owned or operated by Rich Harvest Farms Co., as well as its staff, employees, officers, managers, members, owners, J.R. Investments, LLC, Jerome A. Rich, and anyone else directly or indirectly connected with the Company.

If the Participant is a minor, the undersigned represents and warrants that the undersigned is the parent or legal guardian of the Participant. The undersigned has read this Agreement and in consideration of the Company allowing the Participant entry onto its premises and/or allowing Participant to engage in equine activities, hereby agrees that all of the terms and conditions contained herein shall apply to such Participant and shall be binding upon the undersigned and the Participant.

The undersigned, being the parent or legal guardian of the Participant, hereby grants permission and authority to the Company, its officers, staff and employees to act for Participant in executing verbal instructions (if unable to contact us) to act for us in dealing with physicians, available ambulance companies and hospitals, and to obtain prompt medical attention for the Participant in the event of any perceived medical emergency. The undersigned hereby covenants and agrees to release, hold harmless from and indemnify the Company, including its officers, staff, employees and owners and the owner of the stables and property from any liability or expense connected with obtaining prompt medical attention for the Participant.
I have read the above Liability, Hold Harmless and Indemnity Agreement for Rich Foundation Inc & Giant Steps IL Inc.*

YesNo
Christine's Dream Release and Hold Harmless Agreement

WHEREAS, the UNDERSIGNED acknowledges the inherent risks involved in riding and working around horses, these risks include bodily injury from using, riding or being in close proximity to horses, among other risks, and further, that both horses and rider can be injured in normal use or in competition and schooling.

IN CONSIDERATION, therefore, for the privilege of riding and/or working around horses at Christine’s Dream, the undersigned does hereby agree to hold harmless and indemnify Giant Steps and further release them from any liability or responsibility for accident, damage, injury, or illness to the Undersigned or any horse owned by the Undersigned or to any family member or spectator accompanying the Undersigned while on the premises and that except in the event of this stables gross and willful negligence, I shall bring no claims, demands, actions and causes of action, and/or litigation, against this stable for any economic and non-economic losses due to bodily injury, death, and/or property damage sustained by me and/or my minor child or legal ward in relation to the premises and operations of this stable, including while riding, hauling, lessons, adopting horses, shows, activities, trailering, etc.
I have read the above Christine's Dream Release and Hold Harmless Agreement*

YesNo
Christine's Dream Liability Release

Under the Equine Activity Liability Act, each participant who engages in an equine activity expressly assumes the risks of engaging in and legal responsibility for injury, loss, or damage to person or property resulting from the risks of equine activities. Under Illinois law, an equine activity sponsor or professional shall not be liable for any injury to, or the death of a participant in equine activities resulting from the inherent risk of equine activities. I acknowledge the risks and potential for risks of horseback riding and related equine activities involving equines and/or farm animals. However, I feel that the possible benefits to myself/my son/my daughter/my ward are greater than the risk assumed. I hereby, intending to be legally bound, for myself, my heirs, and assigned executors or administrators, waive and release forever all claims and damages against Canopy, Giant Steps, their board of directors, instructors, therapists, aides, volunteers, boarding facilities, boarders, and/or property owners, and/or employees for any and all injuries which I/my son/my daughter/my ward may sustain while participating in the Christine’s Dream equine activities program.
I have read the Christine's Dream Liability Release*

YesNo
Caravan Waiver & Rider Expectations
1. The participant will be traveling in a motor vehicle driven by an adult and they are to wear their safety-belt while traveling;
2. The participant is expected to respect their peers, the vehicles they ride in, and the people they travel with during the trip;
3. Riding in a motor vehicle may result in personal injuries or death from wrecks, collisions or acts by riders, other drivers, or objects; and
4. Participants are to remain in their seats and not be disruptive to the driver of the vehicle.
5. Modified seat belts, additional locks or safety harnesses cannot be accommodated by Caravan service.
The participant or assigned guardian has read and understands the above. These expectations apply to all shuttle usage throughout the program day.*

YesNo
Caravan AM/PM Expectations

The AM/PM pick up and drop off service that is provided by the Canopy staff and program from the 2500 Cabot Drive, Lisle, IL to 264 S Main St, Sugar Grove, IL is known as Canopy Caravan. The Caravan service is provided as an option for participants pending availability of seating and fit of participant. Caravan service is not guaranteed for participants enrolled in the Canopy Program and has separate qualifications for participants to have continued use of the services once they are enrolled in Caravan.
In order for participants to access the Canopy Caravan, participants must be able to:
1. Ride safely for up to 30 minutes each way, including wearing a safety belt and remaining seated in the designated assigned seat.
2. Modified seat belts, additional locks or safety harnesses cannot be accommodated by Caravan service.
3. Sit in close proximity to peers and staff with minimal assistance to maintain safe riding behaviors and conversational volume while on the vehicle. This includes, at times, sitting directly next to a peer or staff.
4. Enter and exit the vehicle in a regulated state with minimal prompting or physical assistance
5. Have reliable transportation arranged for pick up and drop off from the Lisle location at each end point of the Caravan trips
6. At any time Canopy staff reserves the right to request that Parent/Guardian/Care givers transport the participant to/from programming due to behaviors exhibited by the participant.
I have read and understand that if at anytime my child is unable to follow these expectations that impact the Caravan's ability to safely make the round trip to and from Sugar Grove I will be asked to drive my child to/and from programming and my child's eligibility for this service will require further discussion with Canopy Leadership Team.*

YesNo
In the event that a rider on the Caravan is not regulated at the time of pick up or the last hour of the day prior to leaving Sugar Grove, is exhibiting physical aggression, signs of heightened agitation or anxiety that may cause disruption or impact the safety of the other riders or driver on the vehicle, or is ill (has a known fever, diarrhea, or is vomiting) the participant will not be able to utilize the Caravan services for that leg of transportation. The family or other designated emergency contact will be responsible for arranging transportation to or from Canopy programming for the day.*

YesNo
Shuttle Bus Recording Policy

Electronic video and audio recordings (“Recordings”) may be recorded on any bus providing transportation for Canopy participants (“Participants”). Recordings may be viewed (i) to investigate an incident reported by Canopy bus drivers, Canopy administrative personnel (“Administrators”), supervisors, Participants or other persons; or (ii) at random.

Only Canopy Administrators and law enforcement personnel may view or listen to Recordings, and such individuals may only do so for the following reasons: (i) law enforcement, security or safety; or (ii) a need to investigate and/or monitor the conduct of passengers, including Participants, or Canopy bus drivers. Neither the Participants’ families nor non-Administrators will be granted access to any Recordings. Canopy will maintain a written log, which will, at a minimum, identify each individual who accessed a Recording and the date and time of such access.

Recordings may be reused or erased after 30 days unless they are needed for administrative or legal purposes.

This Policy will be (i) clearly posted on the front door and interior of each bus providing transportation for Participants; (ii) provided to Participants and their parents/guardians; and (iii) included in Canopy handbooks or such other similar documents.
I give permission for my child to be recorded in accordance with Canopy's Shuttle Bus Recoding Policy, this consent is valid for one year unless terminated by me in writing.

YesNo
Acknowledgement of Electronic Completion: By electronically completing these acknowledgement(s), I swear that I am the parent/guardian of the child, I have the authority to complete and execute this document, and the information contained in this document is accurate to the best of my knowledge.*

YesNo

Giant Steps Registration Supplemental Forms 2025 - 2026

Consent and Acknowledgements

Please answer the following questions for your Canopy Participant. If you are not registering a Canopy Participant than please select the "no" response

Annual Health History