It is our policy to notify a parent when a child is ill or needs medical attention. In the event that we are unable to contact parent and need to get immediate help for the child, our procedure is to take the child to the nearest emergency center. Signing below gives us permission to take appropriate action on behalf of your child. In the event I cannot be reached by phone, I hearby give my/our consent for my/our child, if injured, to be taken to the nearest emergency center by the Wellspring Church staff when I/we cannot be contacted. I consent to an ambulance being called to transport the child, and allow them to make medical decisions in the best interest of my/our child, if necessary. I authorize an adult, in whose care the minor(s) has/have been entrusted, to consent to any X-ray examination, anesthetic, medical, surgical or dental diagnosis or treatment, and hospital care, to be rendered to the minor under the general or special supervision and on the advice of any licensed physician or dentist. The undersigned shall be liable and agrees to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child/children pursuant to this authorization. I (we) hereby release Wellspring Church and any of its employees or agents from any liability as a result of their exercise of any power conveyed under this Consent. In the event it becomes necessary for that person to give consent for us, I/we agree to hold such person free and harmless of any claims, demands, or suits for damages arising from giving such consent so as the treatment is administered by or under the supervision of a licensed physician. In this regard, it is understood that any medical, hospital and/or surgical expenses which may be incurred as a result or treatment recommended by any such doctor will be borne by me/us.
I hereby grant permission to Wellspring Church to use photographs and/or
video of my child taken at camp in publications, news releases, online,
and in other communications related to the mission of Wellspring Church.
Please sign or initial:
I understand that my child will be part of a loving and encouraging environment while cared for at Wellspring Church All of our staff is background checked prior to employment. To keep our classrooms a fun, welcoming and uplifting atmosphere, we do not allow unkind words or unkind hands. We want to ensure teachers and volunteers are treated with respect at all times. Our policy for children who have some difficulty during their class time will be walked through the following steps in this order:
A verbal reminder of the classroom expectations. Ex: “In this space we use only kind hands.”
A private discussion with a teacher about behavior including positive reinforcement & ideas to replace the behavior. Ex: Child is taken aside during activity and told, “I love the way you are participating in our game, but I do need you to make sure you are using kind words with your friends. What are some kind words we could use instead of the words that may hurt our friend’s feelings?”
Parent is called. Child, parent and director will then meet and establish a plan for the following day and remainder of the week. During this meeting, we come up with a plan as a group and encourage child in how loved and valuable he/she is in their classroom.
An exception to this procedure is dangerous behavior that could cause harm to others. In this instance a child will be removed from the classroom and immediately begin at step 3 of this contract.
In appropriate scenarios depending on age and behavior Steps 1 and 2 may be repeated.
I understand that this is the medical policy and behavior policy while my child is being cared for at Wellspring Church. I consent the policies as outlined on this document by signing below.
Please sign or initial:
