YOUTH DEVELOPMENT PROGRAM APPLICATION Pleas lease complet complete all blanks blanks on this form. Incomple Incomplet complete enro nrollme llment forms cannot cannot be accept accepted. ed. According to the minimum standards put forth by the Commonwealth of Virginia, we are unable to care for your child until all required paperwork is submitted. CHILD HILD’S INFORMA FORMAT MATION: ION: Child’s Full Name (Last, First, Middle)
Nickname
Address City
State
Zip
School
Home Phone
Grade Entering
Age
Gender
Male
Female
Date of Birth
School and Child Care Centers Previously Attended
Other Schools/Programs Concurrently Attending
Custodial Guardian Informa formation: mation: In the event of an emergency, please number, in order of priority (1–6), which phone to contact. Guardian’s Name
Relationship to Child
Address
Cell Phone
Priority
Home Phone
Priority
Place of Employment
Work Phone
Priority
Guardian’s Name
Relationship to Child
Address
Cell Phone
Priority
Home Phone
Priority
Work Phone
Priority
City
City
State
State
Zip
Zip
Place of Employment
Emer mergen gency Contact Names, ames, Address ddresse resses and Phone Numbers mbers of TWO LOCAL ADULTS to be called alled in the the event that hat we cannot cannot reac reach ach eithe ither guardian: guardian: Emergency Contact Name
Relationship to Child
Address
Primary Phone
City
State
Zip
Alternate Phone
Emergency Contact Name
Relationship to Child
Address
Primary Phone
City
State
Zip
Alternate Phone
Authorized uthorized Person for PickPick-up, up in addition to Emergency Contacts Authorized Person’s Name for Pick-up
Relationship to Child
Authorized Person’s Name for Pick-up
Relationship to Child
Authorized Person’s Name for Pick-up
Relationship to Child
Authorized Person’s Name for Pick-up
Relationship to Child
School Year:____-____ Staff Initials:____
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Persons NOT Authorized to PickPick-Up; Up; appropriate custody papers must be attached if a parent is not allowed to pick-up a child Person’s Name NOT Authorized for Pick-up
Relationship to Child
Addition Additiona itional Information: Information: Are there any allergies, intolerance to food, medication, and any other substances? What are the symptoms and action to be taken, if any?
To ensure the best possible experience, tell us about your child (include any emotional, behavioral, physical or developmental challenges and any special accommodations needed).
My child's swimming level is:
Beginner
Intermediate
Advanced
Doctor’s Name
Doctor’s Phone
Medical Insurance Provider
Policy #
E-mail Address(es), for registration confirmation, fliers, newsletters, invoices and all other communications (other than the occasional phone call) E-mail address(es)
Which Youth Development programs are you interested in?
Before-School
After-School
Camp
The following Statements of Understanding and Authorization, Releases and Agreements are important for the safety and protection of your child. Please read this information and sign on the last page of the application. STATEMENT OF UNDERSTANDING 1. I understand that it is my responsibility to sign my child in upon arrival in the morning (Before-School Enrichment and Camp) and sign my child out before leaving in the afternoon. There must must be an exchange of respon responsi ponsib sibility ility from from one adult adult to staff, staff, not from from a child hild to staff. ff. I understand that I am not to leave my child at the Y or Y program site unless a Y staff is present to receive and supervise my child. (See the YMCA Parent Handbook for more information.) 2. I understand that my child will not be allowed to leave the program with an unauthorized person. Any person authorized to pick-up my child must be listed with the YMCA of Greater Richmond. Additional authorization will only be accepted in writing from the Custodial Guardian(s). 3. I understand that, should a person arrive to pick-up my child who appears to be under the influence of drugs or alcohol, for the child’s safety, staff may have no recourse but to contact the police. 4.
For or BeforeBefore-and AfterAfter-School Enrichment Programs, Programs, one week’s week’s fee may be due for each chil child ild and, and, for camp, $50 is due for each session. session These fees are nonnon-refundable and nonnon-transferable. The fixed weekly payment is due each Monday thereafter prior to the week services are rendered, whether an enrolled child is in attendance or not. Automatic Draft is the preferred method of payment. Drafts are continuous and will occur every Monday. I understand that additional fees will be assessed for late payments, late pick-up of my child, returned drafts and when schools are closed for inclement weather or emergency reasons.. I understa understand stand that after after two unres unresolved lved draft servi ervice vices ces to my account or two unpaid weeks, my chil child’s d’s participation in Enrichment Programs or Camp C amp w ill be t ermi erm i n ated at ed. . (See the YMCA Parent il ed Handbook for more information.) a.
Late Payment fees: A $15 late fee is charged for payments made after the Monday the payment was due. If payment is not made by Friday prior to the start of the next week, you risk losing your child’s space in the program.
b.
Late Pick-up fee: A late fee of $1.00 per minute, per child, will be charged for any child not picked up by the scheduled end of day. It must be paid, by draft of account or by check, the Monday following the late occurrence.
c.
Returned Draft fees: Should my bank or credit card issuer for any reason not honor my draft, a $25 return payment fee will be assessed on the account in addition to the program payment due. This is also in addition to any service fee your bank may charge. Your account will be automatically re-debited on the next drafting cycle
School Year:____-____ Staff Initials:____
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for payment of a draft not honored. d.
Inclement Weather – Schools Closed fee: If you choose to bring your child to the Y branch for care, the additional fee of $15 per day will be drafted from your Youth Enrichment Program account that is on file, in addition to the normal rate.
5. I understand that this draft will remain in effect until all payments have been made for the enrolled program, or for the time my child is a participant. I understand that if I wish to terminate or change my draft, I must give the Y 14 days written notice before my next draft date. date Questions regarding your draft should be addressed to the Office Manager as soon as possible. Any error must be identified no later than 60 days from the posted bank or credit card statement date. The Y is not responsible for errors occurring later than 90 days from the date of the initial error. If I become a member of a YMCA of Greater Richmond facility (as compared to a Y Program Participant only), I understand that I must notify the branch Office Manager so that my Youth Enrichment Program or Camp rate will be adjusted accordingly within two weeks. 6. For safety reasons, it is extremely important to be able to reach the parent(s)/guardian(s) or emergency contact(s) for a child in our program. I understand that failure to update the parent(s)/guardian(s) and emergency contact(s) information may result in withdrawal from the program. 7. I understand that Y staff and volunteers are prohibited from babysitting children with whom their only relationship is through Y programs at any time outside of the Y facilities or program(s). I also understand that Y staff and volunteers are prohibited from transporting children in their personal vehicles. 8. I agree to arrange to have my child picked-up as soon as possible, and no later than two hours, after the Y notifies me that my child is ill. (See the YMCA Parent Handbook for more information.) 9. I agree to inform the site within 24 hours or the next business day after my child, or any member of the immediate household, has developed a reportable communicable disease, as defined by the State Board of Health, except for life threatening diseases which must be reported immediately. 10. I understand that I can request the Youth Enrichment Program’s Emergency Preparedness Plan. 11. I understand that, by state law, the Y is mandated to report any suspected cases of child abuse or neglect to the appropriate authorities for investigation. 12. I wish to have my child participate in YMCA of Greater Richmond Youth Enrichment Program and Camp programs. I understand that even when every reasonable precaution is taken, accidents can sometimes happen. In consideration for my child being permitted to utilize the facilities, services, and programs of the YMCA for any purpose, including but not limited to observation or use of facilities or equipment, or participation in any program affiliated with the YMCA, without respect to location, for himself or herself and any personal representatives, heirs, and next of kin (the “Undersigned”): a.
The UNDERSIGNED HEREBY RELEASES, WAIVES, DISCHARGES AND COVENANTS NOT TO SUE the YMCA, its directors, officers, employees and agents (hereinafter referred to as "Releasees") from all liability to the Undersigned for any loss or damage, and any claim or demands therefore on account of injury to the person or property or resulting in death of the Undersigned, which is in any way associated with the Undersigned’s presence in, upon, or about the premises or any facilities or equipment therein, or participation in any program affiliated with the YMCA, without respect to location.
b.
The Undersigned hereby agrees to indemnify, save and hold harmless the Releasees and each of them from any loss, liability, damage, or cost they may incur which is in any way associated with the Undersigned’s presence in, upon, or about the YMCA premises or in any way observing or using any facilities or equipment of the YMCA or participating in any program affiliated with the YMCA. The Undersigned hereby assumes full responsibility for and risk of bodily injury, death, or property damage which is in any way associated with the Undersigned’s presence in, about, or upon the premises of the YMCA and/or while using the premises or any facilities or equipment thereon or participating in any program affiliated with the YMCA.
c.
The Undersigned further expressly agrees that the foregoing RELEASE, WAIVER OF LIABILITY AND INDEMNITY AGREEMENT is intended to be as broad and exclusive as permitted by law of the state of Virginia and that if any portion thereof is held invalid, it is agreed that the balance shall, not withstanding, continue in full legal force and effect.
d.
THE UNDERSIGNED HAS READ AND VOLUNTARILY SIGNS THE RELEASE, WAIVER OF LIABILITY AND INDEMNITY AGREEMENT, and further agrees that no oral representations, statements, or inducement apart from the foregoing written agreement have been made.
School Year:____-____ Staff Initials:____
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e.
The UNDERSIGNED acknowledges that the YMCA of Greater Richmond is a charitable non-profit organization under the laws of the State of Virginia and nothing in this RELEASE, WAIVER OF LIABILITY AND INDEMNITY AGREEMENT shall be construed as a waiver of charitable non-profit status and/or benefits under Virginia law.
STATEMENTOF AUTHORIZATION 1. My child has permission to be transported by a Y vehicle and to participate in all Y program activities and related field trips. 2. I have read and understand the Swimming/Wading/Boat Rules found in the Parent Handbook. My child has permission to participate in swimming activities. 3. I give the YMCA of Greater Richmond permission for my child to be given cardiopulmonary resuscitation (CPR) and First aid treatment by a qualified staff member of the YMCA of Greater Richmond. I also give permission for my child to be transported by ambulance or aid car to an emergency center for treatment. I authorize the YMCA of Greater Richmond to obtain immediate medical care and give consent to the hospitalization and performance of necessary diagnostic test(s) upon, the use of surgery on, and/or the administration of drugs to his/her child or ward if an emergency occurs when he/she cannot be located immediately. It is also understood that this agreement may cover only those situations which are true emergencies and only when he/she cannot be reached. I understand that the provider will take every effort to contact me and/or my designated emergency contacts. I understand that I will be responsible for payment of medical expenses. 4.
I understand and support the Y’s procedures to encourage appropriate behavior of my child and to discipline inappropriate behavior in order to provide a safe and fun environment for all program participants. (See the YMCA Parent Handbook for more information.)
5. I authorize the Y to survey my child regarding his or her feelings about the Y program and what they are learning. I understand that my child’s participation in the surveys are voluntary and strictly confidential.
CHALLENGE COURSE AGREEMENT Children in Youth Enrichment Programs and Camp programs have the potential to enjoy a challenge course experience at three of our local facilities: Camp Thunderbird, Shady Grove and Tuckahoe. As a result, we require that all Youth Enrichment Programs and Camp participants acknowledge and agree to the following. I HEREBY ACKNOWLEDGE AND AGREE on behalf of my child that the use of the Challenge Courses have inherent risks. I have full knowledge of the nature and extent of all the risks associated with the use of the Challenge Courses, including but not limited to: 1. All manner of injury resulting in falling off the Challenge Courses; 2. Rope abrasion, entanglement and other injuries resulting from activities on or near the Challenge Courses such as, but not limited to, climbing, belaying, rappelling, lowering on rope, rescue systems, and any other rope techniques; 3. Injuries resulting from falling climbers or dropping items, such as, but not limited to, ropes or climbing hardware; 4. Cuts and abrasions resulting from skin contact with the Challenge Courses; 5. Failure of rope, slings, harnesses, climbing hardware, anchor points, or any part of the Challenge Courses’ structures. I further acknowledge that the above list is not inclusive of all possible risks associated with the use of the Challenge Courses and that the above list in no way limits the extent or reach of this release and covenant not to sue. I accept full responsibility for my child’s safety while in the Challenge Course area. I agree to instruct my child to abide by, and to help enforce, the following Challenge Course safety policies: 1. Roped climbers and belayers must wear helmets and harnesses appropriately. 2. Participants cannot have gum or candy in their mouth while participating. 3. Participants must have appropriate footwear. No open toed shoes. 4. Participants must follow all commands and instructions. 5. Participants must report immediately all accidents or equipment damage. 6. Shady Grove Ropes Course’ additional safety policies: a. LOW ROPES: All participants must be 5 years old. A spotter is required. b. HIGH ROPES: All participants must be 11 years old. To belay for high ropes you must be at least 16 years old. c. Climbers must be roped and belayed through a belay plate. Belays must be anchored. d. Lead climbers must use adequate protection to eliminate the possibility of a ground fall at all times. 7. Tuckahoe Rockwall additional safety policies: a. Climbers must be roped and belayed through a belay plate. Belays must be anchored. b. Lead climbers must use adequate protection to eliminate the possibility of a ground fall at all times. School Year:____-____ Staff Initials:____
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c. No unbelayed climbing above the bouldering line. 8. Camp Thunderbird Alpine Tower and Dual Zip Line additional safety policies: a. All participants MUST be at least 8 years old. b. All participants must have the physical and mental ability to climb a 50 ft tower. c. All participants with long hair must have hair tied up underneath the helmet. d. Participants on the ground must wear helmets while in the “drop zone” underneath the platform. The Y reserves the right to withdraw the participation of any child for failure to follow the Challenge Course Safety Policies, or for any conduct that is viewed as unsafe or inappropriate. In consideration of the use of the Challenge Courses, I acknowledge that I have read and agree on behalf of my child to abide by the Challenge Course Safety Policies.
MEDICATION AND SKIN PRODUCTS AUTHORIZATION 1. I desire to authorize the application of sunscreen and/or insect repellant for my child by Y staff. Yes
No
I understand that I may be required to provide the sunscreen and/or insect repellant.. If Yes, please request an authorization form from the Y.
2. I desire to authorize staff to administer over-the-counter medication to my child.
Yes
No
If Yes, please request an authorization form from the Y.
3. I desire to authorize staff to administer prescription medication to my child.
Yes
No
If Yes, please request an authorization form from the Y. The authorization form must be completed by the parent/guardian and signed by a physician prior to the Y staff’s administration of medication.
PHOTO AND VIDEO RELEASE The YMCA of Greater Richmond requires your consent for the use of photographs or digital images of your child in any printed/filmed material for promotions. Please check below to indicate whether you give the YMCA of Greater Richmond consent or not. Note: If this selection is left blank, “Yes” will be selected for you. I consent to authorize the YMCA of Greater Richmond to use photographs or digital images in any printed/filmed Yes No material for promotions. I have read and understand the statements above regarding YMCA policies and procedures and, where authorization is required above, I give my consent (or have indicated otherwise). otherwise).
I have received a copy of the YMCA PARENT HANDBOOK and understand that it is my responsibility to be aware of all policies therein. I have provided a copy of my child’s PHYSICAL and IMMUNIZATION RECORDS, as well as PROOF OF IDENTITY, along with this form. Blank copies of the PHYSICAL and IMMUNIZATION forms (pages 2 & 3) can be found at http://www.vdh.virginia.gov. Search School Health Forms. The PHYSICAL and IMMUNIZATION RECORDS provided may be no older than 2 years prior to the date of this application. A copy of the child’s PROOF OF IDENTITY can include: a Birth certificate, report card, Birth registration card, passport, copy of the placement agreement or other proof of the child’s identity from a child placing agency(foster care and adoption agencies)
For office use only Form of Identity Verification Place of Birth
Date of Birth
Document Id. No.
Received By (staff name and date)
Billing Information in DAXKO? YES
Date Child Entered Care
Date Child Withdrew from Care
School Year:____-____ Staff Initials:____
Date Issued NO
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PARENT HANDBOOK Objectives The YMCA of Greater Richmond Youth Enrichment Programs and Camp Staff welcome you and your child! We desire to make this a happy and safe experience. The Y is the largest nonprofit profit child care provider with a history of stability built on the core values of CARING, HONESTY, RESPECT, and RESPONSIBILITY. Youth Enrichment and Camp Programs seek to help each child: • Develop an appreciation for himself/herself, family, school, community, country and other cultures. • Develop knowledge, interests and skill in his/her school through homework support and outdoor-related activities. • Develop and improve personal skills such as neatness, originality, patience and dependability. • Develop and improve social skills: acceptance of others, cooperation, and responsibility. • Develop healthy living and safety practices. • Have FUN!
Admission The YMCA of Greater Richmond recognizes and celebrates the growing diversity of our community. At the Y, everyone belongs. The YMCA of Greater Richmond Youth Enrichment and Camp program serves children 2-12 years of age and does not discriminate on the basis of race, color, religion, sex, or national or ethnic origin in administration of its personnel and admissions policies. The Y will address physically challenged and special needs children on a per request basis with the hope that we can serve all children who come to us.
Application and Immunization All parent(s)/guardian(s) must fill out the Youth Development Program Application form provided and return it before the first day of the program. These information sheets must be accompanied by a copy of the Commonwealth of Virginia’s physical form and the child’s proof of identity. The Commonwealth of Virginia’s physical forms must be signed by your physician. Regulations by the State Board of Health for the immunization of children requires documentation of all age appropriate immunizations prior to each child’s admission to a licensed child care center. The Y cannot accept your child into Youth Enrichment Programs or Camp without this documentation. The guardian (s) must also provide proof of a child’s identity prior to admission. Proof of child’s identity and age may include a certified copy of the child’s birth certificate, birth registration card, notification of birth (hospital, physician or midwife record), passport, copy of the placement agreement or other proof of the child’s identity from a child placement agency, record from a public school in Virginia, certification by a principal or his designee of a public school in the U.S. that a certified copy of the child’s birth record was previously presented, or an adoption/foster care placement agreement. Viewing the child’s proof of identity is not necessary when the child attends a public school in Virginia and the Y assumes responsibility for the child directly from the school (i.e. after school child care) or the Y transfers responsibility of the child directly to the school (i.e. before school child care). Otherwise, licensing standards mandate that child care staff see and record the ID number of your child’s proof of identity. If the guardian fails to provide needed documentation within seven days of initial attendance, the Y is required to notify the local law enforcement agency. While programs are not required to keep the proof of the child’s identity, documentation of viewing this information must be maintained for each child. Please bring it at the time you register. It is the responsibility of the guardians to keep proper registration information and current phone numbers in the child’s permanent records. Services may be withheld if this information is not updated in a timely manner.
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Payments For Youth Enrichment Programs, Programs, one week’s week’s fee is due for each chil child ild or, for Camp, Camp, $50 is due for each session upon enrollment. enrollment These fees are nonnon-refundable and nonnon-transferable. The fixed weekly payment is due each Monday thereafter prior to the week services are rendered, whether an enrolled child is in attendance or not. After school Enrichment Program payments are based on 180-day school calendar and divided equally into weekly payments. Few of the operating costs of the facility are eliminated when a particular child is absent; we are prepared for each child, each day, whether the child attends or not. Because of the aforementioned, there will not be any refunds, pro-rated fees, vacations, nor free weeks for days absent. Automatic Draft is the preferred method of payment; some YMCA of Greater Richmond branches only accept draft payments. Drafts are continuous and will occur every Monday. Additional fees will be assessed for late payments, late pickup of participants, returned drafts and when schools are closed for inclement weather or emergency reasons. After After two unres unresolved lved drafts servi ervice vices ces to an account or two unpaid weeks, a chil child’s ild’s participation in Youth Enrichment Programs or Camp Camp will be termi erminated ated. ed. •
Late Payment fees: A $15 late fee is charged for payments made after the Monday the payment was due. If payment is not made by Friday prior to the start of the next week, you risk losing your child’s space in the program.
•
Late Pick-up fee: A late fee of $1.00 per minute, per child, will be charged for any child not picked-up by the scheduled end of day. It must be paid, by draft of account or by check, the Monday following the late occurrence.
•
Returned Draft fees: Should your bank or credit card issuer for any reason not honor your draft, a $25 return payment fee will be assessed on your account in addition to the program payment due. This is also in addition to any service fee your bank may charge. Your account will be automatically re-debited on the next drafting cycle for payment of a draft not honored.
•
Inclement Weather – Schools Closed fee: If you choose to bring your child to the Y branch for care, the additional fee of $15 per day will be drafted from your Youth Enrichment account that is on file, in addition to the normal rate. I understand that this draft will remain in effect until all payments have been made for the enrolled program, or for the time my child is a participant. I understand that if I wish to terminate or change my draft, I must give the Y 14 days written notice before my next draft date. Questions regarding your draft should be addressed to the Office Manager as soon as possible. Any error must be identified no later than 60 days from the posted bank or credit card statement date. The Y is not responsible for errors occurring later than 90 days from the date of the initial error. If I become a member of a YMCA of Greater Richmond facility (as compared to a Y Program Participant only), I understand that I must notify the branch Office Manager and that my Youth Enrichment Program or Camp rate will be adjusted accordingly within two weeks. If you choose to pay via a personal check, please note that the YMCA of Greater Richmond converts check payments to a onetime electronic funds transfer. Electronic check conversion is a process by which your check is used as a source of information for the check number, your account number and the routing number identifying your financial institution. The information is then used to make a one-time electronic payment from your account; funds may be withdrawn from your account as soon as the day after we receive your check. The check itself is not the method of payment. If you don’t want your check to be used for electronic check conversion, you will need to provide another form of payment (i.e. money order, debit card or credit card).
Financial Assistance The YMCA of Greater Richmond wants to provide services for everyone and does not want to turn anyone away due to his/ her inability to pay for programs. It is the YMCA of Greater Richmond’s policy to provide services for any youth who desires to participate in a Y program. Through the generosity of the YMCA of Greater Richmond’s annual giving campaign we are able to offer a limited number of financial assistance spaces. This requires the parent/guardian to complete an “Open To All” application accompanied by proof of income (to include, but not limited to, no less than two check stubs and a copy of your most recent year’s 1040’s) and/or assistance. Once the Y determines the discounted amount you are able to pay, you must pay the amount granted on a timely basis or the assistance may be cancelled. For additional information and the aforementioned forms, please contact the Office Manager.
Hours of Operation Please contact the branch for the regularly scheduled hours of Youth Enrichment Programs and Camp operation. On days when school is closed (teacher work days & other holidays), the program is closed at the school location your child normally attends. However, care is available (for a limited number of children) at the corresponding branch. Please contact the branch for these hours. 8
During early dismissal for regularly scheduled half-days, Youth Enrichment Programs will be available at the schools and/or the branch. Please contact the Youth Program Director for more details.
Holidays All Youth Enrichment sites will be closed Thanksgiving Day and the day after Thanksgiving, Christmas Eve, Christmas Day, New Year’s Eve, New Year’s Day, Memorial Day, Labor Day and July 4. There will be no reduction in program fees during the weeks in which these holidays occur. Care on scheduled early release days and full days is included in the weekly fee. Please see the school calendar for a list of those dates. An additional fee will be charged for any unplanned closure of schools due to inclement weather or emergency reasons.
Inclement Weather If county schools have a delayed opening of 1 or 2 hours, the Y will not provide care for children before school but will have normal After-School Youth Enrichment Program hours. If there is a delayed school opening followed by a school closing (and the Y branch is open), then the Y will open Youth Enrichment Programs one hour after the closing is announced. If county schools close early due to inclement weather, the Y After-School Programs will provide transportation only to children that normally receive care at a Y branch and only if county school transportation is also running. For offsite Child Care locations, parent(s)/guardian(s) must pick-up their children from the offsite locations within two hours of school closure and, if they choose, may transport their child to the Y branch when the Y program chooses to remain open until the regular closing hour. If schools are closed and the Y is open, Youth Enrichment Programs will be available at the regularly scheduled full day time unless the branch opens later. If the branch decides to open later, then branch Youth Enrichment Programs will open when the branch opens; offsite Youth Enrichment Program locations will open when the school facility opens. If the Y facility is closed, no Youth Enrichment Programs will be provided at the facility or at the off-sites.
Staff The Youth Director, Site Supervisors and Counselors hold each child’s safety and well-being at heart. Employees have been selected based on their educational background, experience and commitment to working with children. Pre-employment drug testing is required for all new employees and random drug testing is also conducted on a regular basis. Criminal background checks and TB tests are performed for all staff as well. Continual training is provided throughout the duration of employment including, but not limited to CPR, First Aid and Daily Health Observation. We maintain a direct staff to child ratio that meets or exceeds licensing standards. In addition, staff members strictly adhere to a Y code of conduct. Staff members will act in a caring, honest, respectful, and responsible manner, portraying a positive role model for youth. Staff members will respond to parent(s)/guardian(s), children, and each other with respect and consideration and treat all children equally regardless of sex, race, religion, disability, color, national origin, or any other characteristic protected by federal, state, or local law. If you have reason to believe that a Y staff member is not abiding by the Y’s core values, please contact the Youth Director or branch Executive Director to report your concerns.
Authorization To PickPick-Up Your children may be picked-up by authorized guardians only. Other arrangements may be made in writing to inform the Y of an additional authorized guardian. Staff will question those persons with whom they are unfamiliar and check authorization before releasing a child. Identification will be requested of anyone that we do not know. Authorized persons must have a valid driver’s license or identification card from the DMV. In addition, the Y requires a copy of any legal documentation that restricts another parent/guardian’s access to your child. We will restrict access as required by the legal documentation only. If a parent/guardian who has been denied such access to a child attempts to enter the Y program, or otherwise access the child actively participating in the Y program, the Y will contact local law enforcement. Without legal documentation, the Y cannot restrict access. 9
Should an authorized person arrive to pick-up your child and appear to be under the influence of drugs or alcohol, Y staff members will take necessary measures to ensure the safety of the child, including contacting the police. Please do not put staff in a position where they have to make this judgment call.
Sign In/ Sign Out Upon arrival for the Before-School Youth Enrichment Program or Camp, the parent, guardian or authorized person must accompany his/her child into the site to sign him or her into the program. A Y staff member must be present when you drop your child off for Youth Enrichment Programs or Camp; do not leave your child if no staff member is present. We cannot be held responsible for your child if we are uncertain of his/her presence. Children are to be picked-up and signed out by a parent, guardian or authorized person. All who pick-up must be approved before leaving the site.
Late PickPick-Up We understand that a late pick-up may occur on a rare occasion. If your child is not picked-up by the end of his/her program, a late fee will be charged and collected at that time. If it is 6:01pm (by our clock), you are late and a late fee will be assessed. THE FEE IS $1 PER MINUTE INTERVAL (per child). This fee is used to pay the staff who remain with your child. If you know you are going to be late, call us. We do understand that things come up and traffic can be challenging even in the best of times. We tend to worry about your safety just as much as your child does. Please be considerate. If we have not heard from you by 15 minutes after closing time and we cannot reach you by phone, emergency contacts will be called. If a child has not been picked-up one (1) hour after closing, Child Protective Services will be called. The YMCA of Greater Richmond has found that it is necessary to have an excessive late pick-up policy, which could result in you being asked to remove your child from our program. Many of our staff go to school or have other positions within the Y which requires them to be on time for those duties. Removal from the program is up to the discretion of the Youth Director.
Appropriate Dress Children should wear comfortable and appropriate clothing for indoor and outdoor activities. Especially for Camp, we strongly recommend that you send your child in serviceable clothes, not “party” best. We do not reimburse for clothing rips, stains or normal wear and tear. ClosedClosed-toed shoes must be worn at all times. times Open-toed shoes or heelies are not allowed. Open-toed shoes can be a safety hazard to your child. If you send your child in open-toed sandals or in “flip-flops,” you will be called and asked to bring different shoes for your child.
Personal Items We have plenty of equipment and activities to keep your child busy. Please do not allow any toys, video games, iPods or cell phones to accompany your child. This eliminates fights, theft and/or lost items. The Y is not responsible for lost or stolen items.
Snacks/Meals All meals and snacks will meet the nutritional needs of children as established by the U.S. Department of Agriculture. USDA guidelines for healthy menus can be found at www.cnpp.usda.gov. Menus will be posted weekly for parental/guardian notification. Children will not be permitted to use the vending machines during program hours. Food portions are appropriate for the age of the child. Children will be encouraged, but not forced, to try new foods. The Y serves food family style, meaning the child will serve themselves from common bowls with limited help from adults. It is the parent/guardian’s responsibility to provide their child with a lunch on a full day. The lunch must be in a sealed container and clearly labeled with the child’s name and date. Please do not include any items that need refrigeration or heating in a microwave, as these appliances are often not available. On half days, if school does not provide lunch prior to dismissal, the parent/guardian must provide a lunch following the guidelines stated above. Licensing does not allow sugary snacks or empty calories, so please do not allow your child to bring candy, gum or other junk food. (Even though we understand that they taste the best!) For the protection of all children, the Y does not allow children to share foods they bring from home. Parent(s)/guardian(s) may provide special food for their children on the basis of religious, medical or dietary reasons. A written 10
letter must be submitted by the parent/guardian identifying the reason for the special diet and the parent(s)/guardian(s) are responsible for complying with the USDA nutritional guidelines. Food must be delivered in airtight containers or the original container. We will not keep leftovers. With prior approval, parent(s)/guardian(s) may bring food or beverages for celebrations. The Y does not allow any sweetened beverages, fried foods, or any “junk” foods for parties or holiday events. If you want to bring food for a special celebration, we ask that it be healthy. We suggest food items such as raisins, popcorn, pretzels, vegetables and dip, or frozen yogurt.
Vehicle Conduct Whenever the Y transports children, the Y takes every precaution to ensure your child’s safety. Children must follow the below Y basic safety rules while being transported. With the first infraction, a parent/guardian will be notified and asked to discuss proper behavior with his/her child. With the second infraction, transportation services may be denied for a minimum of two days, and the parent/guardian will be notified. With the third infraction, transportation services will be terminated. • No fighting, swearing or abusive behavior. • Must remain seated properly with seat belt on at all times. • Cannot have any part of his/her body out of the vehicle. • No eating or drinking on the vehicle. • May not throw anything out the window. • Must be respectful to and listen to the bus driver. • The children will be expected to keep their hands to themselves. No rough-housing will be tolerated at any time. • All other potentially dangerous actions will not be tolerated. Our Y drivers are instructed to: load and unload the children only when the vehicle is pulled up to a curb, the side of the road, or in a driveway; to not discipline and drive at the same time; and take precautions to never leave a child alone in a vehicle. If you have concerns about the safety of our drivers and/or buses, please contact the branch Youth Director.
Field Trips In order to reduce paperwork and waste, the signed Youth Enrichment Program Application authorizes the Y to take your child on all field trips for the school year and summer with notice. You have the right to refuse permission for your child to go on a particular field trip. Just let us know in a timely fashion, not that day! Preschoolers under the age of 4 must have car seats; please remember to drop your car seat off the day of the field trip.
Swimming/Boating Swimming/Boating Rules Since your child may participate in Swim Lessons and or free swim time, it is of the utmost importance that you know and understand our Swimming and Boating Rules. • All children must pass the swim test in order to participate in free swim. • No running, pushing or dunking. • No abusive language or rough play will be allowed. • The lifeguard has the right to dismiss anyone who is careless or dangerous to others. • No diving in shallow water. • No food or drinks in pool area. • No unauthorized flotation devices.
Sick Child Procedures The HEALTH and SAFETY of your child is a matter of major importance to all of us. In order to protect the children in the program who are well, we have very stringent rules about sick children. These rules are in compliance with all Commonwealth of Virginia licensing regulations. Staff members will observe the health of each child, each day, as they enter the program, noting any fever, bumps, bruises, burns, etc. We will notify you if your child shows symptoms of an illness. For the below common illness and injuries, the child must be removed from participation with other children and the child’s parents/guardians are required to pickpick-up the child immediately. immediately. A late fee may be applied if your child is not pickedpicked-up within the 2 hours after notification of illness. • Vomiting or diarrhea (Child can return when symptom free for 24 hours.) • Severe bleeding • Allergic reaction • Possible sprain or break 11
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Head lice (Child can return once it has been treated. Must be checked by a staff member prior to the student returning.) Ring worm (Must be treated and area must be covered; if it cannot be covered, we will need a doctor’s note for the student to return.) Child’s temperature > 1000 (Child can return when fever free for 24 hours.) Contagious Illness, e.g. sniffles, reddened eyes, sore throat, constant cough, heavy nasal discharge, headache, etc.
The parent/guardian will inform the site within 24 hours or the next business day after his child or any member of the immediate household has developed a reportable communicable disease, a defined by the State Board of Health, except for life threatening diseases which must be reported immediately.
Medication If a child requires medication while at the program: • An “authorization to give medication” form must be completed by the parent/guardian. • Medicines must be in original containers, with the child’s name on it. • The medication must be prescribed by a doctor; it cannot be an over-the-counter drug unless it has been prescribed by the doctor (we must have a note to that effect). • Authorization is good for one week only and then must be filled out again. (The only exception to this is long-term medications for such things as asthma, ADHD, epi-pen, etc.) All medication will be kept in a locked box. We are not required by law to administer medication and only do so as a service to the parent/guardian. Please understand that it may not always be possible to administer medications as requested. (Whenever possible, for After-School Youth Enrichment Programs, we will ask the school nurse to administer medicine needed before the close of the school day.) Only those Youth Enrichment staff who are certified “Medication Administrators” may dispense medications. Please consult the on-site supervisor prior to leaving any medication at the site in order to ensure all Department of Social Services paperwork requirements are met.
OverOver-thethe-Counter Skin Products Y staff will administer sunscreen, and/or insect repellent provided: • We receive written parental/guardian authorization noting any adverse reactions. • Products are in their original containers labeled with your child’s name. Note: Children under nine years of age may not administer their own sunscreen, according to licensing standards. Y staff will administer sunscreen, i.e. at the minimum, the staff person is in charge of taking the bottle of sunscreen and placing an appropriate amount of lotion in the child’s hand who in turn can apply his/her own lotion.
Injuries If your child has an injury that may require more than our First Aid skills allow, or your child has been bumped on the head of any kind, we will make an immediate attempt to contact you. If we are unable to reach you or the person you have designated in case of such emergencies, we will call the child’s physician. If necessary, we will call an ambulance. Please make every effort to keep the Y up-to-date on phone numbers, emergency numbers and other pertinent information. This is of the utmost importance because the hospital will not treat your child without you being there.
Emergency Preparedness The director and staff of each site are responsible for the safety of the children and have coordinated their facility emergency action plans with community public safety officials and the landlord’s security and facilities (when applicable). The intent of this plan is to assist the Youth Director and staff in responding to emergency situations and provides a basis for restoration of services. Parent(s)/guardian(s) are welcome to review this document at any site or branch location.
Child Abuse Prevention Throughout its history, the Y has been a strong advocate for the child and children’s rights; as a result, mistreatment or neglect of children and the resulting severe effects are of primary concern to the Y. To prevent the abuse of children in our care, the YMCA requires the following staff conduct and prohibitions: •
Staff and volunteers are prohibited from babysitting children with whom their only relationship is through YMCA programs at any time outside of the YMCA facilities or program(s). 12
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Staff and volunteers are prohibited from transporting children in their personal vehicles. Staff members shall never leave a child unsupervised. At no time during a Y program may a staff member be alone with a single child where others cannot observe him/her. As staff members supervise children, they should space themselves in a way that other staff can see them. Staff members should conduct or supervise the following private activities in pairs, if at all possible: putting on bathing suits, changing clothes, taking showers, etc. When this is not feasible, staff members should be positioned so they are visible to others. Staff members shall not abuse or neglect children. The following may be examples of abuse and neglect: o Physical abuse: strike, spank, shake, slap. o Verbal abuse: humiliate, degrade, threaten, yell. o Sexual abuse: inappropriate touch or verbal exchange. o Mental abuse: shaming, withholding love, cruelty. o Neglect: withholding food, water, basic care, etc. Staff members will respect children’s rights to not be touched in ways that make them feel uncomfortable and their right to say “no.” Affectionate touch and the warm feelings it brings is an important factor in helping a child grow into a loving a peaceful adult. The rule of thumb for staff is to not touch any areas that a bathing suit would cover, including swimming trunks. Staff members will make sure that suspicious or unknown individuals are not occupying the restroom before allowing children to use the facilities.
As a parent/guardian, parent/guardian, if you observe violations of these procedures or any other red flags, the Y asks that you bring your concern to the Site Supervisor/Director. Supervisor/Director. If you feel your concerns are not addressed appropriately, please bring your concern to the attention of the branch Executive Director. In addition, the Y is mandated by state law to report any suspected cases of child abuse or neglect to the appropriate authorities for investigation.
Parent/Guardian Communication We believe communication between parents/guardians and the Youth Enrichment/Camp programs is crucial in ensuring a positive, enjoyable experience for your child. Therefore the Y will provide written notices regarding changes in policy, scheduling or special events. It is the responsibility of the parent/guardian to check for any changes daily. In addition, for before and After-School Youth Enrichment Programs, semi-annual, written or verbal communication on your child’s development will be provided to you twice each school year.. From the parent(s)/guardian(s), we ask that you let us know if your child will be absent from Youth Enrichment Programs or Camp. Children may not receive personal phone calls at the Y except in emergency situations.
Behavior Management Y staff members strive to provide a safe and fun environment for all program participants, while holding its staff as well as its participants to its Core Values: Caring, Honesty, Respect, and Responsibility. As a result, the Y will not allow children who continually display disruptive behavior to hinder the safety or enjoyment of others. When a child engages in unacceptable behavior that hinders the safety and enjoyment of others, the below consequences for these behaviors may occur: • Participation in an activity will be denied for repeated poor behavior and the child will be directed to an alternate activity. The parent(s)/guardian(s) will be informed in writing about the poor behavior. • Unacceptable behavior notifications may be issued for children whom violate our Code of Conduct which includes, but is not limited to: • Engaging in physical aggression as a means to resolve a conflict. • Bringing weapons of any kind on Y property or into Y offsite programs at any time. • Stealing or defacing property. • Refusing to follow basic safety rules. • Exhibiting disrespect for staff members or other children. • Displaying an inability to follow established guidelines. • Acting in an unsafe or unacceptable manner as determined by staff members. To reinforce good behavior, staff members use positive techniques of guidance including redirection, positive reinforcement, 13
and encouragement. Physical discipline will not be used nor will food be denied as a punishment. We ask for your support in encouraging appropriate behavior of your children.
Biting Procedures Although it is developmentally appropriate for a toddler (16-30 mos.) to bite because of limited language and social skills, it is an inappropriate behavior in the Youth Enrichment Program and Camp environment. The Y will take the following actions for biting incidents: • If a child bites another child or adult and the skin is not broken: o When a child bites another child or adult, the parent/guardian of the biter is to be notified immediately. When the parent/guardian of the bitten child comes to pick-up their child, staff will inform them of the biting incident. A conference will be set up and actions will be discussed to curtail the problem. o If the child that did the biting bites again during the same day, the parent/guardian is notified that the child MUST be picked-up within ONE HOUR after notification. o The biter may return the next day, but if on the next consecutive visit the child bites again, even if no skin is broken, the Y reserves the right to immediately suspend or terminate the child’s participation in the program. • If a child bites another child or adult and the skin is broken: o Staff will remove the child from the program immediately and notify the parent/guardian that the child MUST be picked-up within ONE HOUR after notification. If the person bitten was a child, that parent/guardian is also notified immediately and staff will attend to the bite wound following proper First Aid procedures. o The biter may return the next day, but if on the next consecutive visit the child bites again, even if no skin is broken, the Y reserves the right to immediately suspend or terminate the child’s participation in the program.
Suspension If a child continues to display poor behavior, the parent(s)/guardian(s) will be informed by phone, in writing and through parent/guardian conferences. For repeated offenses or grievous misbehavior, suspension may result, at the discretion of the Youth Director. If the unacceptable behavior endangers another’s safety or the child’s safety, immediate suspension/termination may result. The parent/guardian of the child will be notified and the child MUST be picked-up WITHIN ONE HOUR after notification. If you are unable to pick-up your child immediately, please make other arrangements for someone to pick-up your child immediately. Failure to pick-up your child within ONE HOUR after notification may result in withdrawal from the program.
Termination The Y reserves the right to terminate Youth Enrichment Program or Camp services at any time. If your child has been terminated from any of our programs, s/he may not attend the same program at a different location. If your school age child is no longer enrolled in our program, your child’s school will be notified so that he or she can go home on the appropriate school bus.
Virginia Child Daycare Programs The Commonwealth of Virginia helps assure parents that child day programs that assume responsibility for the supervision, protection and well-being of a child for any part of a 24-hour day are safe. Title 63.1, Chapter 10 of the Code of Virginia gives the Department of Social Services authority to license these programs. While there are some legislative exemptions to licenser, licensed programs include child day centers, family day homes, child day center systems, and family day systems. The state may also voluntarily register family day homes not required to be licensed. Standards for licensed child day centers address certain health precautions, adequate play space, and a ratio of children per staff member, equipment, program and record keeping. Criminal records checks and specific qualifications for staff and most volunteers working directly with children are also required. Standards require the facility to meet applicable fire, health and building codes. Compliance with standards is determined by announced and unannounced visits to the program by licensing staff within the Department of Social Services. In addition, parents or other individuals may register a complaint about a program, which will be investigated if it violates a standard. If you would like additional information about the licensing of child day programs or would like to register a complaint, please contact the Regional Office of Social Services closest to you:
Central Regional Office 1604 Santa Rosa Road Richmond, VA 23229-5008 804.662.9743 14
