After School Program Application

In this document you will be asked to read and sign several releases, acknowledging your agreement and understanding. As the parent/guardian, you are responsible for all of the information contained in these documents. Please read each one carefully before you sign.

To help us better serve your child, please describe any special considerations for your child and/or accommodation(s) requested or being received elsewhere. Accommodations will be considered and met when possible. If none, type “none.”

I, {registeringAdult}, give me permission and consent for my child, {childsName305}, to participate in Mission 1:27's After-School Program in partnership with Walton Communities.

I agree and consent to the following:

1. All activities for the Adventure Center will take place at Walton Communities, with the exception of field trips, which will require a separate permission slip in order to participate.
2. I understand and give permission for my child to participate in all activities at the Adventure Center, except those specifically noted below:
   • {activityExceptions}
3. I agree to release and discharge Mission 1:27, its employees, volunteers, partner organizations, and Walton Communities from any action, suit, damages, claims or judgments that may result from any injury to my child while on the premises of Walton Communities’ property arising from my child’s participation in the Adventure Center After-School Enrichment Program.
4. Consent of Treatment: I authorize such physician or medical staff as the Adventure Center staff may designate to carry out minor medical or surgical treatment and/or medication necessary by them for the well-being of my child. It is understood, however, that if hospitalization or treatment of more serious nature is required, I will be contacted, if at all possible, by telephone for permission. The physician, organizers, directors, agents or employees of Walton Communities and Mission 1:27 are hereby released, acquitted and discharged from any claim for damage to person or property during the event or program, including transportation to or from the event and/or to any program. And in that regard, I hereby covenant that on my behalf and for the minor not to file a claim or bring suit with respect to any such injury or damage. I, the undersigned, am a parent (or guardian) of the above specified minor. I have read and fully understand the provisions of the above and release and have explained them to said minor. I hereby agree that said minor(s) and I will be bound thereby.

This release grants permission to Walton Communities, Mission 1:27, and its partner organizations to use my child’s picture, name, voice, likeness and biographical information in connection with the productions associated with Walton Communities, Mission 1:27 and/or any of its partner organizations, and any version thereof, and for any purpose of advertising and promoting said production and/or the exhibitors thereof, but not as an endorsement of any product.

Address:  {fullAddress}

Parent/Guardian Phone:  {cellPhone}

This release is made on {dateSigned}, by {registeringAdult} in favor of Walton Communities and/or Mission 1:27 (Video Projects herinafter known as the "Producer").

1. For good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, Guest (Parent/Guardian) grants the Producer the perpetual, worldwide right to make both visual and/or audio recordings and still images of him/her (collectively, the “Photography”) and to use his/her name, voice, likeness and biographical information in connection with the Producer’s production associated with Walton Communities and/or Mission 1:27, and any version thereof, and for the purpose of advertising and promoting said production and/or the exhibitors thereof, but not as an endorsement of any product. Guest (Parent/Guardian) further authorizes the Producer to incorporate and license others to incorporate any part or all of the Guest’s appearance in said production and/or the Photography in any other production. Guest (Parent/Guardian) agrees that the rights granted hereunder shall include the perpetual, worldwide right of the Producer to edit, telecast, cablecast, rerun, record, publish, reproduces, use, license, print, distribute or otherwise exploit, in any manner and in any medium or forum whether now known or hereafter devised said productions in whole or in part without any further compensation to Guest.
2. Producer shall be under no obligation to actually use Guest’s name, voice, likeness and biographical
   information.
3. That the rights granted herein shall inure to the benefit of the Producer, its licensees, successors and assigns.
4. Guest (Parent/Guardian) expressly waives and releases the Producer, its directors, employees, agents.
   Licensees and assigns from and against any and all claims which I or my heirs have or may have for invasion of privacy, defamation or any other claim or cause of action arising out of the production, distribution, broadcast, exhibition or uses of the Series and my participation.

The Adventure Center would like to collaborate with the teachers and faculty at your child’s Elementary School to partner in finding the best ways to help your child reach his/her full potential. By signing below, you are giving the Adventure Center team permission to talk to your child’s teacher about his/her progress, to obtain a copy of his/her report card, and to discuss academic needs and/or concerns.

Yes, I give the Adventure Center permission to speak to my child’s teacher about his/her progress, to obtain a copy of his/her report card, and to discuss academic needs and/or concerns.

I understand that the Adventure Center is a FREE after-school enrichment and summer camp program. I also understand that this is not a licensed program. Licensing of this program is not required by the State of Georgia.

The Adventure Center is a valuable amenity for residents at select Walton Communities, and a significant investment is made to provide teachers, tutors, and supplies.

I understand and acknowledge that when I register my child, the Adventure Center staff plans for them to be in attendance each day, and this comes with the expense of staffing, snacks, programming, and more. Children will not be able to attend the Adventure Center if they didn’t attend school that day(s). I acknowledge that I will support good attendance for my child and communicate with the Director when my child is not in attendance. Good attendance also includes hours of participation.

I understand that if my child does not maintain good attendance, they will be unenrolled from the program and placed on our waitlist. The Adventure Center Director has the discretion to make the final determination of what constitutes a good attendance record.

Your Contribution:

Your involvement and contributions to your Adventure Center takes our program from great to amazing! Here are a few simple ideas for being a friend to the Adventure Center:

1. Make a contribution each month of individually-wrapped snacks, cleaning supplies, school supplies or just $25.
2. Spend time weekly or monthly at the Adventure Center reading to or sharing your talents and hobbies with children at the Center.
3. Please keep the lines of communication open by using tools like Remind and Alaris, and by ensuring we have your most up-to-date phone numbers and email addresses. Like you, we want only the best for your child!

The Adventure Center is an amenity. We are not a “baby-sitting” service nor are we a daycare facility. We are not equipped to provide ongoing corrective discipline for children who consistently display disruptive behavior. Your partnership is essential in helping your child follow the rules, which are in place for their safety and the enjoyment of all participants.

As the parent or guardian, it is your responsibility to determine if your child is mature enough for this program. Please talk with your child about their attitude and behavior and make it clear that participation in the Adventure Center is a choice that comes with expectations.

We expect all children to show respect to staff, volunteers, and peers by listening and following instructions. Disrespectful behavior—such as fighting, defiance, or offensive language—will not be tolerated.

The Adventure Center follows the local school district’s dress code and enforces a zero-tolerance policy for weapons and drugs. Please refer to your school’s handbook for additional guidance.

Parents’ Responsibilities Regarding Behavior:

It is our belief that the parent has the primary responsibility of ensuring proper behavior of their child. If the occasion arises that you need to be informed of your child’s inappropriate behavior, please understand that we need your support. When the conduct of a student becomes such that the program is disrupted, the necessary measures will be taken to ensure the continued learning or recreational atmosphere for the other children in the program, up to and including suspension or expulsion from the program. Behavior problems will be reported to the Community Manager, and a report on this will be placed in the resident’s file.

Parents that are uncooperative or become abusive with staff or other children or parents may cause their children to be removed from the program.

I acknowledge that I have read and understand the policies and procedures for the Adventure Center that have been provided.

At the Adventure Center, we abide by this honor code. We strive to promote an environment that is emotionally safe for everyone. To help make the Adventure Center a fun and exciting place where each child feels welcomed and loved, everyone is expected to do their part in promoting this type of community. Infractions to the honor code will be handled with consequences as appropriate.

Because I want to honor God, Love Others and Walk In Truth, I will:

Be Honest.      Be Positive.      Be Respectful to others and property.

Be Honest – Speak and live in a truthful way.

Be Positive – Build others up, never put them down. Have a good attitude about all people, activities, and yourself. Contribute to a positive and safe environment by practicing good sportsmanship and the golden rule and avoiding negative behavior and talk.

Be Respectful – Speak to and about others in a respectful way. Obey authority and treat others how you’d like to be treated. Never physically harm, make fun of or bully someone. Use property in only appropriate ways, never stealing or damaging that which doesn’t belong to you.

We expect children to be modest and conservative in their dress. The Adventure Center complies with a similar dress code as that of our schools.

• No spaghetti straps will be worn and no midriffs showing, even when the arms are raised. Tight shirts are
  not allowed.
• Short-shorts are not permitted. Also, tight-fitting shorts, jeans and pants are not permitted.
• Males are required to wear shirts at all times unless they are in the pool.
• No underwear should be showing and there will be no sagging with shorts or pants.
• Regarding swimwear, modest one-piece bathing suits only are allowed for girls. Boys are required to wear swim trunks (no cut-offs or shorts). Only items specifically made for swimming are allowed to be worn in the pool (no t- shirts, athletic shorts, etc.)

I acknowledge that my child(ren) and I have read, understand and agree to abide by the Adventure Center Behavioral Expectations, Discipline Procedures, Honor Code and Dress Code.

Eligibility: All activities are limited to children enrolled in Kindergarten through 5th grade. The program is designed for Walton Communities residents who are listed on the lease only.

Cell Phones/Electronic Devices: The Adventure Center is a NO PHONE ZONE. Cell phones, iPads, Kindles, and other electronic devices are not allowed. This is for the protection of your child’s property, as well as to eliminate unnecessary distractions while at the Center. If your child must have a cell phone, it must be turned off and kept in his/her backpack while at the Center, or it will be confiscated by the Adventure Center Director. The parent will be required to reclaim it if it is confiscated. Please be sure your child leaves ALL toys or electronic devices at home.

Contact Information: It is imperative that the Adventure Center Director always has your correct phone number and additional emergency contact information. If you change your phone number, you must let the Director know right away and update this information in your Alaris portal.

Remind: To stay informed of all activities it is important to be signed up to receive messages from the Remind service. It is imperative that you receive these messages. See your Director to get signed up for this important resource.

Dismissal: The Adventure Center will close at the end of the program time and children designated as “walker” will be dismissed from the Adventure Center. The Adventure Center is not responsible for the children after program time.

Children designated as “pick-up” must be signed out at or prior to the end of the program time. A late pick-up fee in the amount of $1.00 per minute after end of program time will be assessed in the case of late pick-ups. If there are recurring late pick-ups children may not be able to continue attending the Adventure Center.

We do not accept phone calls to dismiss students. Children who are designated as “pick-up” must be checked-out in person by a designated individual listed in your Alaris portal.

Emergency Procedures: In the unlikely event that the Center is severely damaged or declared unsafe, children will be evacuated to the Leasing Office to await parent’s arrival. Should such an emergency occur, the Director will attempt to notify parents as soon as possible, so please be sure your Center Director always has up-to-date contact information.

Illness: Please partner with us in having a healthy community and do not send sick children to the Adventure Center. If your child is exhibiting any signs or symptoms of illness while at the center, you will be notified and expected to pick your child up right away.

Medication: Staff of the Adventure Center will not administer any medication to any child, for any reason unless so directed by emergency medical personnel during an actual emergency, if a parent or guardian is unable to be reached.

I have fully read and understand the Adventure Center After-School program procedures and consent to and agree to follow them.

I understand that space is limited at the Adventure Center and my child’s daily attendance and good behavior are essential to them being able to remain enrolled in the program.

Most messages will be sent via Remind. To receive messages from Remind, you must download the Remind app and be added to the class. Additionally, sometimes we will send messages via Alaris. By opting into Text/SMS updates, you agree to receive periodic text messages from Mission 1:27. There is no obligation, and you can opt out at any time by replying with the word "STOP" to any text message received. Standard message and data rates may apply. Your privacy is important to us, and we will never share your information with 3rd party individuals.