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FunZone and Camp Authorizations for Signature
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11
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1
Child's Name
First Name
Last Name
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2
Signer's Name
First Name
Last Name
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3
By signing below, I give consent to Young People’s Learning Center to call the local emergency care facilities, our physician or our dentist as listed on our registration form for medical or surgical care for my child should an emergency arise. It is understood that a conscientious effort will be made to reach parents ASAP in any situation where medical services are needed.
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4
Signing below authorizes Young Peoples Learning Center to pick up my child from their public school and to transport them during particiation in our program
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5
By signing below, I grant permission of any photographs or digital images taken of my child while at YPLC to be used in future printed or digital publication or websites. My child will not be identified by name and no compensation will be expected.
This is not a required signature.
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6
We often find lotion a useful tool for calming children and also to be helpful in preventing some skin irritation issues at times. We will never put lotion on a child’s skin if it is cracked or the lotion is being used as “treatment” without a doctor’s permission. Signing below authorizes us to use lotion on your child's skin if we feel it is helpful.
This is not a required signature
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7
By signing below, I grant Young Peoples Learning Center permission to use sunscreen and bug spray on my child as necessary. Use the box on the next 2 screens to give us any special requests or notes on usage for your child.
*
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Please note that we MUST apply sunscreen to your child at the necessary intervals. If you do not want your child to use sunscreen or if they refuse, they will be required to wear long sleeves, pants and a sunhat in order to participate in activities.
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8
Will you provide a specific sunscreen for your child?
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Please only use sunscreen provided by me (child will miss the activity if this box is checked and no sunscreen is provided)
Prefer to use sunscreen provided by me, but ok to use other sunscreen if none is provided
My child may use any sunscreen (SPF 30 and above and without oxybenzone) provided for the group. We ask each parent checking this box to contribute a bottle of sunscreen meeting the above stndards at the beginning of each program to be used by the group.
Other
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9
Please use the box below to provide any more direction about sunscreen and bug spray and your child.
We rarely apply bug spray, but want the option in case we are in a particularly "buggy" area. You may opt out of this by saying "no bug spray" in the box below.
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10
By signing below, I give permission for my child to go on field trips, whether by vehicle or by foot, to public parks, the library, pet stores, etc., with proper supervision and to go to out-of-town locations such as the Children’s Museum, the Denver Zoo, etc. with proper supervision and prior notice. All field trips will be announced on schedules and sign-in clipboards.
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11
Please read the financial policies carefully, they are available on the website or by following the link below.
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