It is our general policy that parents/caregivers remain in the building while children participate in activities, classes, open play, and/or special events. In special cases, we may make arrangements to supervise your child for short periods of time in our open play space or while in a non-adult participation class.  

These services are typically provided for an additional fee and require both advance notice and advance payment to make sure we are appropriately staffed. When these services are reserved, parents/legal guardians need to complete and sign this “Unaccompanied Child Information & Waiver Form” to include emergency information for each child left in our care.  

Each child left in the care of Marblehead Parenting LLC will be required to wear a wristband and/or name tag, and must be checked in and signed out with our staff before entering or exiting the space.  

Marblehead Parenting LLC is not legally responsible for the care or supervision of children beyond the end of the class,  agreed supervised play timeframe, or close of business. If you have an emergency we will do our best to work with you and contact the appropriate emergency contacts on your list.  

Additional charges will be incurred at a rate of $50 per half-hour, per child, for any care extended beyond the agreed-upon duration or after the close of business. If we are unable to reach a parent/guardian or any of the emergency contacts for more than 30 minutes past the scheduled pick-up time, the local authorities will be contacted.  

State Guidelines & Licensing Notes 

Marblehead Parenting, LLC is an independent, privately-owned business. We are not licensed by the MA Department of  Early Education & Care or any other state agency.  

Occasional Child Care: According to state guidelines each child may not attend without a parent/guardian in the building more than 4 hours a day and no more than 6 days per month. 

Instructional Classes: Unaccompanied children attending classes must be properly registered for the class and retrieved at the end of each class period.

Marblehead Parenting LLC: 40 Tioga Way, suite 350, Marblehead, MA 01945  

(w) MarbleheadParenting.com (p) 781-990-5254 (e) marbleheadparenting@gmail.com

Please complete a separate form for each child. This detailed information only needs to be completed once and will be kept on file for a maximum of 5 years. You may be asked to provide updated information or to complete a new form annually, in that case, all prior documents will be deleted. Please notify us if changes need to be made or if you would like us to delete your child's information from the system. 

Alternate Emergency Contact(s) 

In the event, my child is under the care of Marblehead Parenting LLC and I cannot be reached, my child is authorized to leave the facility with any of the adults listed below. These named adults are also authorized to respond on my behalf regarding emergency medical treatment and transportation to a medical facility.  

Medical Treatment Authorization and Consent 

In my absence, I hereby authorize Marblehead Parenting LLC teachers or staff, to administer basic first aid deemed best under the circumstances and I consent for my child/children. I also authorize Marblehead Parenting LLC, to treat, seek, obtain and consent to emergency medical care and treatment for my child/children as deemed necessary. If my child needs to be transported by ambulance, I hereby authorize Marblehead Parenting, LLC to make necessary arrangements to transport him/her to the closest emergency facility deemed appropriate by the dispatched first responders.  

All such transportation and medical treatment will be at my sole cost and expense. If I cannot be reached, I understand that Marblehead Parenting, LLC will attempt to notify the person(s) I have named as our emergency contact(s) in the order listed.  

Please list below the names of people who may pick up your child in the event of an emergency or when you cannot get here in time (these may be the same or different than your medical emergency contact and might be a neighbor, babysitter, friend, etc.).

Please keep this form current. Make sure Marblehead Parenting LLC staff are told at the time of drop-off and noted on the check-in form that someone else will be picking up your child. If your child doesn't recognize the other person (such as “Hi Grandma!”) then that individual will need to show us a form of identification.  

In your absence, Marblehead Parenting LLC will take every precaution to ensure the safety of your child, however,  accidents happen. Even when every precaution has been taken to avoid any injuries, any time a child participates in any  physical activity, there is a chance of injury and Parents/Guardians should be aware of this fact. 

To the extent permitted by law, Parent/Guardian hereby agrees to release and covenants not to sue, and to hold harmless MHP and its members, managers, employees, contractors, and agents, along with other participants and guests, from any and all liability, actions, causes of actions, claims, expenses, and damages, on account of illness or injury to the undersigned and the undersigned family members, including the named child/children, or any of their property which such person(s) now has or may have in the future in connection with the undersigned’s participation in any activities associated in any way with MHP activities. 

THIS AGREEMENT CONTAINS A GENERAL RELEASE WHICH INCLUDES A RELEASE OF CLAIMS FOR DAMAGES FROM  INJURIES OR MATTERS WHICH MAY NOT BE KNOWN BY THE PARTIES. 

Parent/Legal Guardian expressly agrees that this Agreement is intended to be as broad and inclusive as permitted by law and that all necessary information for the safety of your child has been addressed.