Emergency Medical Release. This is to certify that I voluntarily furnished medical and insurance information on the above designated child to Tiny Turtles Preschool of Jupiter. I hereby request that in the event that I, or the people I designate for an emergency, cannot be reached in a timely manner, that an official representative of Tiny Turtles Preschool of Jupiter will seek first aid or emergency medical care for my child including transporting them to the nearest emergency facility available. I further give my consent to any emergency facility and physician to administer necessary medical treatment to my child if I am unable to be reached or the situation necessitates immediate treatment. I also understand that any medical expenses of the above designated child are the sole responsibility of the parents/guardian. Physician Insurance Company Physician’s Phone Group/Policy No DISCIPLINE POLICY: Conscious Discipline: At Tiny Turtles Preschool of Jupiter it is our belief that the goal of discipline is to help the young child identify their feelings and gain inner self-control so they become aware of what is acceptable behavior. Developmentally appropriate guidance and classroom management promotes positive social skills, fosters mutual respect, strengthens self-esteem and supports a safe environment. Corporal punishment is NEVER permitted at Tiny Turtles Preschool of Jupiter. If a child displays an unprovoked act of aggression, kicking, punching, hitting, etc. toward another child or staff member, we will immediately contact a parent and you may be asked to remove your child from the premises, and/or disenrollment/terminate enrollment may be necessary.
Emergency Medical Release. Must be filled out COMPLETELY with no NA or Same as Above. No scratch out, cross offs or white out allowed on this form.
Emergency Medical Release. This is to certify that I voluntarily furnished medical and insurance information on the above designated child to Home Away From Home. I hereby request that in the event that I, or the people I designate for an emergency, cannot be reached in a timely manner, that an official representative of Home Away From Home will seek first aid or emergency medical care for my child including transporting them to the nearest emergency facility available. I further give my consent to any emergency facility and physician to administer necessary medical treatment to my child if I am unable to be reached or the situation necessitates immediate treatment. I also understand that any medical expenses of the above designated child are the sole responsibility of the parents/guardian. Physician Insurance Company __ Physician’s Phone Group/Policy No DISCIPLINE POLICY: Conscious Discipline: At HAFH it is our belief that the goal of discipline is to help the young child identify their feelings and gain inner self-control so they become aware of what is acceptable behavior. Developmentally appropriate guidance and classroom management promotes positive social skills, fosters mutual respect, strengthens self- esteem and supports a safe environment. Corporal punishment is NEVER permitted at HAFH. If a child displays an unprovoked act of aggression, kicking, punching, hitting, etc. toward another child or staff member we will immediately contact a parent and you may be asked to remove your child from the premises, and/or disenrollment may be necessary.
Emergency Medical Release. Permission is granted for emergency medical treatment if necessary…… SIGNATURE OF PARENT/GUARDIAN: DATE: PLEASE PRINT PARENT/GUARDIAN NAME: _DATE: PICK-UP AUTHORIZATION Listed below are people authorized to drop-off and pick-up your child. Your child will not be released to anyone unless they are listed below. PLEASE LIST YOURSELF, relatives, guardians, friends etc. In an effort to ensure the safety of your child, you or whoever is picking up the child may be asked to show a picture I.D. Please make sure to inform the individual picking up your child of this policy to avoid any confusion or frustration at the time of pick-up. Thank you for your cooperation. NAME: _ RELATIONSHIP: PHONE: _CELL: _ NAME: _ RELATIONSHIP: PHONE: _CELL: _ NAME: _ RELATIONSHIP: PHONE: _CELL: _ NAME: _ RELATIONSHIP: PHONE: _CELL: _ NAME: _ RELATIONSHIP: PHONE: _CELL: _ PLEASE NOTE: Pick-up Authorization only applies to programming with pre-registration. If your child is participating in a drop-off program, such as the roller skating program or open gym activities, it is your responsibility to ensure your child is safely dropped off and picked up from these programs. Eureka Recreation staff will not be responsible for your child’s whereabouts once they have left the drop-in program and they will not verify the identity of any individuals picking the child up.
Emergency Medical Release. This is to certify that I voluntarily furnished medical and insurance information on the above designated child to Prosperity Day School. I hereby request that in the event that I, or the people I designate for an emergency, cannot be reached in a timely manner, that an official representative of Prosperity Day School will seek first aid or emergency medical care for my child including transporting them to the nearest emergency facility available. I further give my consent to any emergency facility and physician to administer necessary medical treatment to my child if I am unable to be reached or the situation necessitates immediate treatment. I also understand that any medical expenses of the above designated child are the sole responsibility of the parents/guardian. Physician _____________________________ Insurance Company________________________ Physician’s Phone ________________________ Group/Policy No________________________ DISCIPLINE POLICY: Conscious Discipline: At Prosperity Day School it is our belief that the goal of discipline is to help the young child identify their feelings and gain inner self-control so they become aware of what is acceptable behavior. Developmentally appropriate guidance and classroom management promotes positive social skills, fosters mutual respect, strengthens self-esteem and supports a safe environment. Corporal punishment is NEVER permitted at Prosperity Day School. If a child displays an unprovoked act of aggression, kicking, punching, hitting, etc. toward another child or staff member, we will immediately contact a parent and you may be asked to remove your child from the premises, and/or disenrollment/terminate enrollment may be necessary.
Emergency Medical Release. This is to certify that I voluntarily furnished medical and insurance information on the above designated child to Home Away From Home. I hereby request that in the event that I, or the people I designate for an emergency, cannot be reached in a timely manner, that an official representative of Home Away From Home will seek first aid or emergency medical care for my child including transporting them to the nearest emergency facility available. I further give my consent to any emergency facility and physician to administer necessary medical treatment to my child if I am unable to be reached or the situation necessitates immediate treatment. I also understand that any medical expenses of the above designated child are the sole responsibility of the parents/guardian. Physician Insurance Company __ Physician’s Phone Group/Policy No PHOTO RELEASE: I _ do/ do not give permission for my child to be photographed at HAFH. I understand these pictures may be displayed at certain school wide events, decorations, advertising/website and promotional reasons.
Emergency Medical Release. Return Completed Form To: 181471 Ontario Inc. (“Producer”) 00 Xxxxxxxx Xx., Suite 400 Toronto, Ontario M6J 2R9 IN CASE OF EMERGENCY, I, by signing below, authorize Producer, Endemol Argentina S.A.., each of their respective parent, subsidiary and affiliate companies, and each of their respective agents, employees, representatives, and contractors, to arrange for and/or provide such medical assistance to me as any of them determines to be necessary. I also authorize any physician, other medical/paramedical provider, and/or medical facility to provide any medical/surgical care and/or hospitalization to me, including anesthetics, which any of them determine to be necessary or advisable, pending receipt of a specific consent from me. DATE: SIGNED: Print Name: Emergency Contact Name: Relationship: Their address: City: Province: Postal Code:
