EMERGENCY MEDICAL RELEASE: If emergency medical care is necessary and I cannot be reached, I authorize the NJ Promise After School to act in my behalf in granting permission for my child to receive emergency medical treatment. Parents are responsible for all expenses incurred as the result of medical treatment. Please fill out the information below, check Parent Agreement List, and sign and date.
PLEASE NOTE: NJ Promise After School does not provide transportation
back home after the program.
All are required to be answered. If there is an issue or disagreement, pleaseprovide reason to the director.
Dear Parents/Legal Guardian,
We thank you for considering NJ Promise After School as your child(ren)’s primary after school program. Our program strives toprovide the following:
1. Students will be provided with comprehensive enrichment and targeted assistance in their own academic curriculums fromqualified educators and staff members.2. Students will be given an opportunity to participate in extra curricular actives. We offer music, art, and dance.3. Students will be guided in developing life-long skills such as communication, teamwork, character growth, and relationshipbuilding.
NJ Promise After School program will run from the beginning of September when school starts (September 5, 2017) untilschool is out in June.
• Hours of operation: 3:00pm—6:30pm, Monday through Friday.• For more information, please contact Joseph Kim (201) 461-2600 or email him email@example.com.• Check with staff regarding holidays as we will be closed on certain holidays.• Parents must pick their child(ren) up by 6:30pm or a late fee will be assessed after 6:30pm.• NJ Promise After School is open early for all Bergen County Early Release Days.• Snacks will be available for each child daily; however, students may bring their own snacks.• Please remember that NJ Promise After School is not a babysitting service. Children are expected to interact with otherchildren. Additionally, they are required to participate in all activities as instructed by the staff.• Failure to follow the rules can result in your child being expelled from the program.• Disrespect of the staff, refusal to follow instructions, fighting, bullying of any type, are ground for immediate dismissal.• A registration fee of $350 per child per school year is charged for the program. The entire $360 is due regardless of thenumber of months the child attends the program.
HOLD HARMLESS RELEASE
I hereby waive, release, absolve, indemnify, and agree to hold harmless the NJ Promise After School, its directors, officers, organizers, sponsors, supervisory staff, participants, and any other affiliates; for, from, and against all liability because of any bodily injury, or property damage, known or unknown, which may occur or result from the participation of the below named child in any and all activities whether the result of negligence or for any other cause of the NJ Promise After School. I individually, and as a parent/ guardian for my child, have read this release and understood all the terms. I execute it voluntarily and with full knowledge of its significance.
Positive attitudes keep the After School program fun. Below aresome guidelines participants are expected to follow:
• Respect yourself and the NJ Promise After School staff.• Play fairly and be honest.• Applaud the efforts of others.• Avoid inappropriate language.• Eat and drink in designated areas.• Say only good things about others.• Follow the instructions of the staff.• Resolve disagreements in a positive way.• Running is not allowed inside, but only outside.• Listen during appropriate times and assemblies.• Be respectful of other members and their property.• Tobacco, drugs, alcohol, and weapons are prohibited.• Take care of the NJ Promise After School facility,grounds, and equipment.• If you make a mess, you clean it up.
Bullying/harassment/fighting has no place at NJ Promise AfterSchool. Bullying/harassment/fighting means more than beatingup or pushing people around.
Violation of this policy includes:• Physical assaults• Threats• Harassment• Name-calling• Racial slurs• Intimidation• Sexual harassment—physical or verbal• Spreading rumors• Extortion• Foul language• Taunting• Making insulting remarks about another student’s familymembers.• Using the internet to harass, threaten, verbally abuse,intimidate, or spread rumors.
Violation of the intent of this policy by a student participating inNJ Promise After School will not be tolerated. Review of thepolicy serves as your warning.