Guardian Signature Date. Acknowledgement of Electronic Completion By electronically completing these acknowledgement(s), I swear that I am the parent/guardian of the participant, I have the authority to complete and execute this document, and the information contained in this document is accurate to the best of my knowledge. Acknowledgement of Canopy Policy and Procedures Handbook I acknowledge that I have received and read the 2018-2019 Canopy Policy and Procedures Handbook and that I have reviewed it with my child. I understand the policies, procedures, guidelines, rules, and expectations outlined in the Handbook are only a summary of all Canopy policies and rules, and that I am subject to and must abide by all Giant Steps policies. I also understand that a violation of any of Giant Steps’ polices and rules may lead to disciplinary consequences. I further understand that the Handbook may be amended during the year without notice.
Guardian Signature Date. Consent for Community Transportation I give consent for the participant to participate in scheduled trips to and from the Lisle and Sugar Grove location, scheduled community outings and be transported via Giant Steps owned vehicles (including mini-vans, 10, 12, and 15 passenger vans), and shuttle buses), as well as contracted buses or vehicles, and/or walking while enrolled at Giant Steps/Canopy. I understand all such trips are under the supervision of Giant Steps staff members and that health and safety precautions are taken as appropriate. Acknowledgement of Participant Absence Procedures I understand Giant Steps’ policy requiring me to notify Canopy each day that the participant will be absent. I understand that it my responsibility to notify the program in a timely fashion by calling (000) 000-0000, extension 3 as well as emailing the Program Manager and Service Liaison. I will leave the following information in a voicemail and email: the participant’s name, program name, and reason for the absence. I understand that it is also my responsibility to notify the participant’s transportation provider (e.g., bus company, cab company, etc.) if applicable each day that the participant is absent. Consent for Use of Sunscreen/Bug Repellant I give consent for Giant Steps/Canopy staff to apply sunscreen and/or bug repellant to the participant when going out into the community (e.g. parks, playgrounds, swimming pools, walking and community trips, etc.,) with their discretion to the needs of the weather at the time of the community trip. Giant Steps/Canopy staff will make every effort to ensure that health and safety precautions regarding sun exposure are taken as appropriate, but they are not liable for sunburns or exposure for the participants. Authorization for Electronic Access Giant Steps has the ability to enhance each participant’s programming through the use of Giant Steps’ electronic network, including the Internet. Our goal in providing access is to promote diversity of and enhanced programming by facilitating resource sharing, innovation, and communication. Participants and/or their parents/guardians must sign this Authorization form annually. Giant Steps filters access on its electronic network to protect against pictures or videos that are obscene, pornographic, or otherwise harmful or inappropriate in the Canopy setting. However, it is impossible to guarantee the filtering of all such material, and it is possible that a user may gain access to inappro...
Guardian Signature Date. Consent for Emergency Medical Care I give consent for emergency medical care to be secured for the participant in the event of an emergency. I will be responsible for the emergency medical charges upon receipt of the statement.
Guardian Signature Date. I, the student, give permission for publishing my work on the World Wide Web.
Guardian Signature Date. I, the student, give permission for the use of text messaging, instant messaging and/or social media for school related matters.
Guardian Signature Date. In case of an injury to my child while in the care, custody, or control of the School, I will hereby waive all claims against CCNS, its Directors, Facilitators, Teachers, Volunteers, and Members of all responsibility for any injury, loss, or damage which my child might sustain while participating in any CCNS activity. CCNS assumes responsibility for the child once the parent(s) or guardian(s) make eye contact with the teacher and the child has been greeted. The School’s responsibility ends when the responsible adult arrives to pick up the child. All children must be signed in upon arrival and must be signed out at the end of the day. This is for liability purposes.
Guardian Signature Date. Mother/Guardian Signature Date____________
Guardian Signature Date. Student Agreement
Guardian Signature Date. Child's Name Date Please read the following release statements and indicate with an "x" the statements you approve. Sign at the bottom. Cooperative Preschool field trips. Yes No Parents will be notified in advance of all field trips. videotaped in scheduled preschool activities. Yes No Such photographs/ videotapes may be used by SCP for publicity or educational purposes. Anyone who does not have permission to pick up my child:
