After School Care Waiver & Policies

Parent Name *

First Name

Last Name

Assumption of Risk & Liability *

Participants voluntarily engage in program(s) at The Center at their own risk, assuming all related risks, both known and unknown. The Center is not liable for any damage to clothing or personal belongings, and all risks of damage or loss are assumed by the participant. Additionally, the Center is not responsible for children before they arrive on the premises or after the program has ended.

I have read and agree to the terms above

Medical Responsibility *

In the event that medical care or treatment is required, participants are financially responsible for any associated costs. It is recommended that individuals carry their own health insurance.

I have read and agree to the terms above

Damage & Liability for Property *

Any damage to equipment or facilities resulting from willful actions, neglect, or recklessness by a participant or their family will be the financial responsibility of the individual responsible. The Center is not responsible for lost, stolen, or damaged personal belongings, including electronics.

I have read and agree to the terms above

Refund & Credit Policy *

A full refund will only be issued if The Center cancels the program due to low enrollment. Deposits and payments may be credited toward another camp, class, or lesson but will not be refunded.

I have read and agree to the terms above

Code of Conduct *

Participants are expected to behave respectfully toward staff, peers, and camp property. Bullying, aggressive behavior, or inappropriate language will not be tolerated and may result in dismissal without a refund.

I have read and agree to the terms above

Pick-Up Policy *

Only authorized individuals (with prior written consent) may pick up a child. You can submit authorized individuals below.

I have read and agree to the terms above

Early Dismissal & Absences *

If your child needs to leave After School Care early, please email written permission to admin@musicartdance.org before class begins. For recurring early dismissals (same day each week), one written notice is sufficient and will be kept on record. Early dismissals must be communicated in advance (before class begins that day); we’re unable to release students without prior notice. Early Dismissals will be begins at 5p unless we have been communicated with otherwise. If your child is absent due to illness, please let us know by phone or by emailing us at admin@musicartdance.org. Sick days are not eligible for refunds or make-ups

I have read and agree to the terms above

Instructor Illness or Emergencies *

I understand that the Center cannot guarantee that the program will operate every day. In the event of instructor illness or other unexpected emergencies that prevent the Center from operating, families will be notified by text no later than 8:00 a.m. Refunds are not provided for program closures.

I have read and agree to the terms above

Photography & Media Release *

Photos and videos may be taken during camp for promotional purposes. Parents/guardians may opt out.

Yes, my child can be photographed and used in promotional material on Social Media

No, I wish to opt my child out of being used in promotional material on Social Media

Pick-Up Details: *

Please select one option:

My child has permission to walk or bike home at the end of the day.

My child has permission to walk or bike home but needs to leave earlier than the designated dismissal time.

My child does not have permission to walk or bike home at the end of the day.

Emergency Contact #1 *

First Name

Last Name

Emergency Contact #1 Phone Number: *

(###)

###

####

Emergency Contact #2 *

First Name

Last Name

Emergency Contact #2 Phone Number: *

(###)

###

####

Does your child have any allergies we should know of? *

Yes

No

Does your child need any medications administered while attending camp? *

The Center is not responsible for giving medications with the exception of an epi-pen.

Yes

No

Any Dietary Restrictions The Center should be aware of? *

Yes

No

Any behavioral issues The Center should be aware of? *

Yes

No

Non-Prescription Medications *

The Center has non-prescription medication stocked and can be used on an as needed basis to manage illness and injury. Please check the medications you would allow:

Acetaminophen (Tylenol)

Benadryl

Anti-Itch Creams

Ibuprofen (Advil)

Throat Lozenges

Antibiotic Cream

Aloe

None of the Above