Screening Permission Participant(s):
1. I agree to have the temperature taken of my child(ren) arriving at the building with a temporal thermometer.
2. I agree to remove my child from care if a fever is identified upon arrival to the site.
3. I agree to limit contact and will drop off and pick up my child(ren) at the door.
4.I agree to practice social distancing in the best way possible.
5.I agree to pick up my child(ren) promptly if my child(ren) develops a fever during the day.
6. You will get a code to pick up for child- only those who are authorized to pick up will know this code.
7. Masks are optional unless otherwise directed by the Health Department.
Numbers to save to call for pick up-
> pick-up, any questions/concerns and to make a payment over the phone the number is (239)207-5078
General Details and Late Fees
1. Pick-up starts at 4:30 (No earlier than that) If your child has a doctor's appointment we will need to be informed ahead of time. If they leave early 3 times a week (before 4:30) they will be terminated from our program.
2. Your child can only miss 2 days a week.
3. If your child is not going to be attending after school for the day please inform us ahead of time- failure to do so your child may be suspended or terminated from the program.
4..Chilld must bring their own headphones with their name on them if needed to use.
5..After school starts August 10 (We follow CCPS we will end a week before school ends.)
6. Only those authorized here can pick up your child or if they know their code. Call us if you need to add someone last minute.
7. Children must bring their own snacks if they have any allergies. If you have a special circumstance in which you need snacks to be provided to your child, please contact us directly.
8.Please be sure all your child's clothes are marked with their name and they must bring a water bottle every day.
9. Hours of operation are until 6:30 PM Monday through Friday. After 6:30, a late fee of $1 per minute will be charged. Fees double after 6:45. If you are late more than three times, your child may be suspended or terminated from the program.
Sign below to indicate that you acknowledge and agree to the above payment policy and program details.
Enrollment and Payments
Submitting this application doesn't guarantee enrollment. We have a maximum number of students allowed per school. After you submit this application, we will email or call you to notify you of your status.
Upon acceptance, you must pay 2 weeks upfront, totaling $80.
(If you need financial assistance, please show proof of your income tax)
1.Weekly tuition is $40 per week for the first student, with a $5 discount for any additional students. This fee includes weeks that are shortened by a holiday.
2.Tuition is due on a weekly and is payable by card, check, or money order only-no cash, please. Payment must be received by 6 pm each Wednesday. Weekly fees must be paid, whether your child is present or not.
3.Accounts paid in full by Wednesday at 6 pm for the upcoming month will receive a $5 monthly discount.
4.If payment is not received on time, an additional late fee of $5.00 will be charged per day.
5.If your account is past due, your child may be suspended from the center until the account is brought up to date. Failure to keep the account up to date could result in your child being dropped from our center.
6.If you want to remove your child from the program, please give us at least two weeks' notice.
Activity Responsibility Agreement
I understand that during this period my child/ward may take part in activities such as, but not exclusive to, chapel activities, Vacation Bible School, performing arts class, athletics, art classes, and STEM classes, and other activities consistent with the purposes of the unit/program.
I, the undersigned, understand that there are risks and dangers inherent in participating in
Fran Cohen Youth Center Summer Camp, hereinafter "Activity", may include transportation, swimming, field trips, indoor and outdoor games and other activities consistent with the purposes of the unit/program for a time period of up to one year. I also understand that to be allowed to participate in this Activity and associated Activities, I must agree not to hold The Salvation Army liable for any injury or damage which I may suffer while participating in any Activity or going to/from any Activity.
Knowing this, and in consideration of being permitted to voluntarily participate in any Activity, and recognizing the charitable nature of The Salvation Army, I hereby voluntarily release The Salvation Army from any and all liability resulting from or arising in any manner whatsoever out of any participation in any Activity.
I understand and agree that I am releasing not only The Salvation Army, but also its officers, agents, and employees. I understand and agree that this waiver/release will have the effect of releasing, discharging, saving, and forever relinquishing any and all actions or causes of action that I may have or have had, whether past, present, or future; whether known or unknown, and whether anticipated or unanticipated by me, whether through acts or omissions by The Salvation Army's personnel or other unrelated third parties or other participants.
I understand and agree that this waiver/release will be binding on me, my spouse, my heirs, my personal representatives, my assignees, my children, and any guardian ad litem for said children.
I understand and agree that by signing this waiver/release, I am assuming full responsibility for any and all risk of death or personal injury, or property damage suffered by me while participating in any Activity, including but not limited to health care expenses.
I understand and agree that by signing this waiver/release, I am agreeing to release, indemnify and hold The Salvation Army, its officers, agents, or employees harmless from any and all liability or costs, including attorney's fees, associated with or arising from my participation in any Activity.
I understand and agree that I am signing this waiver/release on behalf of my minor child, that I will be giving up the same rights for said minor as I would be giving up if I had signed this document on my own behalf.
I acknowledge that I have read this waiver/release agreement and that I understand the words and language in it. I understand there are potential dangers incidental to participating in any activity and going to/from any activity. I execute it voluntarily and with full knowledge of its meaning and significance.
I UNDERSTAND THAT THIS IS A LEGAL DOCUMENT.
First Aid or Medical Treatment
I recognize that there may be occasions where the child named above or I if I am a participant, may require first aid or emergency medical treatment as a result of an accident, illness, or other health condition or injury. I do hereby give permission for agents of The Salvation Army to seek and secure any required medical attention or treatment for the child named above or me if I am a participant, including hospitalization if in the agent's opinion such need arises. In doing so, I agree to pay all fees and costs arising from this action to obtain medical treatment.
I give permission for attending physician(s) and other medical personnel to administer any required medical treatment, including surgery. I agree to pay for the medical treatment.
Electronics Policy
It is preferred that students do not bring any electronics to the FCYC.
However, I understand that my child is allowed to have an electronic device with them for emergencies only. Children are not allowed to play on their devices unless prior approval has been given. No social media is allowed.
I will not hold Salvation Army liable for any loss, theft, or damage to personal belongings including electronic devices.
I will not hold Salvation Army accountable for any social media interactions happening between students in our care.
Video Consent
I give consent for my child to view non-violent movies that are rated G or PG are and provided by The Salvation Army as well as local movie theatres.
Consent to Publication
I certify that I am at least 21 years of age, my birth date being ____________________ and having the right to contract in my own name and on the behalf of my child/children and to the extent herein set forth.
I hereby irrevocably grant to The Salvation Army, its successors and assigns, its agents and those by whom it is commissioned, the absolute, unrestricted and unlimited license, right, permission, and consent to use and reuse, disseminate, copyright, print, reproduce, publish and republish, for any and all trade purposes or commercial or other advertising or public purposes, and in any and all advertising, publicity, display, publication or media, my child's name, signature and likeness, and any portraits, pictures, photographic prints or other representations of my child, or in which my child may appear, or any reproductions or sketches thereof or parts thereof, photographic or otherwise, with such additions, deletions, alterations or changes therein as you in your discretion may make, either separately or together with my child's name or a fictitious name, or the name of another person, with or without any statements or testimonials made by my child, or authorized by me which you may, in your discretion, prepare for use in connection therewith. I warrant that I have not limited or restricted the use of my child's name or photograph to the use of any organization or person.
I hereby grant unrestricted use of audio tracks or text by The Salvation Army for such purposes as The Salvation Army may deem appropriate.
I understand and acknowledge that are no financial payments for use of my child's likeness.
I hereby release and discharge The Salvation Army, its successors, assigns, and agents from any and all claims and demands arising out of or in connection with the use of any of the foregoing, including any claims for defamation, invasion of privacy, or violation of any statutory right.
I understand that The Salvation Army is not responsible for private individuals placing photos on Facebook or other such media.
Code of Conduct
For all participants, leaders, and parents in attendance at all Salvation Army activities, whether on-site or away from our facility for field trips, educational outings, residential camp programs or retreats, the following behaviors are expected:
1.We will respect the individual's personal space and will not tolerate bullying, an act of violence, or threat of bodily harm.
2.We will remain calm in every situation and will not use vulgar language or gestures.
3.We will respect the leader(s) and obey their direction. Leaders will respect all youth and observe all the guidelines of our "Safe from Harm" program.
4.We will respect the facility and conduct ourselves in an orderly fashion. We will reverence the sanctuary while participating in worship or instruction. We will not tolerate the destruction of our facility and its furnishings/equipment.
5.We will maintain all food and drink in the designated dining area only and observe all health code guidelines.
6.We will respect other people's personal property, never taking anything that does not personally belong to us.
7.All children will remain under the direct supervision of at least two leaders throughout the duration of the program and are only dismissed to leave with parents or an approved adult, or on the provided transportation.
8.We expect all participants, leaders, and parents to wear appropriate attire for activities, keeping in mind personal safety, weather conditions, and activity requirements.
9.All incidents of misbehavior will be reported to the parent/guardian and we will discuss appropriate disciplinary actions.
10.I agree to participate in the functions and activities of The Salvation Army and to cooperate with the leaders and other young people. I promise to respect myself, respect other persons, and respect property. I understand that my continued participation in Salvation Army activities depends on my support of this agreement.
Food Related Activity
I understand that my child will participate in food-related activities such as snack, lunch (if specifically requested by parents), and cooking class, and garden club that include food consumption. The Salvation Army ensures proper food storage, safety, and preparation for all food. I understand that it is my responsibility to inform youth center staff of any food allergies or special diet pertaining to my child. If I have chosen to have The Salvation Army provide lunch to my child, I can view the menu posted at the facility. If I have not chosen for The Salvation Army to provide lunch for my child, I agree to provide a nutritional meal for my child.
Parent/Guardian Release
I am the parent or legal guardian of the minor and I am signing this waiver/release on behalf of said minor.
