Medical Information

Each child's medical information is strictly for the use of Creature Klub facilitators and will be kept private and confidential. Please indicate by name if your child(ren) has any of the following in order to help us ensure the safety and comfort of your child during the academic school year:

medical condition (including the need to take medication)
allergies (food, topicals (sunscreen, soap, sanitizer), animals, insect bites, etc.)
special dietary requirements

Please write 'NONE' if your child(ren) have no such conditions

Emergency Contact Information

The parent/guardian listed above is the first person we will contact if your child has a medical emergency, needs to talk to you, or is late being picked up. Please provide an emergency contact person that will be available during school hours of 8am-5pm to deal with any emergencies or is otherwise needed to pick up your child(ren) from Creature Klub if we are not able to reach you.

First Name

Phone

Last Name

Relationship to Child(ren)

Alternative Person(s) for Picking Up Child(ren)

If you have an alternative person you would like to authorize to pick up your child(ren), please list them below.

Alternative Person 1 First Name

Last Name

Phone

Relationship to Child(ren)

Alternative Person 2 First Name

Phone

Last Name

Relationship to Child(ren)

Rules, Release and Indemnity Agreement

1. Daily Park Excursions

In order to maintain a healthy and active experience, children enrolled in the 2022/23 Creature Klub Academic School Year Program will be brought in groups to either City View Park (800m approximately 10 min walk) or John Budd Cleary Park (900m approximately 11 min walk), weather permitting, under strict supervision from a minimum of two program facilitators. Children must exit the facility using the staircase in an orderly and quiet fashion holding the handrails at all times. Children will walk on sidewalks holding hands in an orderly fashion with a partner selected by the program facilitators. Children will not be allowed to run on the sidewalks that lead to the parks. Children must stay in the designated playground area visible to the program facilitators at all times. Children must use the structures at the park only as intended for use. If there is any breach by any child to the above rules, or there is any horseplay, silliness, or dangerous behavior, the child will receive a warning and will have to sit out the rest of that outing. You will be notified and will be asked to reinforce the rules described above to your child. If the child continues the same behavior on their next scheduled day then you will be notified to pick up your child immediately and the child will be removed from the program.

2. Health and Safety Protocol

You agree that you will not bring your child to camp if he/she is experiencing symptoms of Covid-19 or other related communicable diseases.

3. Medical Emergencies

If your child is injured in a way that requires immediate professional medical attention, you will be contacted immediately so that together we can make the necessary decisions and take the necessary steps to best remedy the situation. If we are not able to reach you, however, you must grant us permission here to transport your child to a local doctor or hospital for medical treatment if necessary.

4. Indemnity

The risks associated with an academic school program for children, however minimal, can never be completely mitigated. As a consequence, you freely accept and fully assume all risks and acknowledge the possibility of, and agree to be solely responsible for personal injury, death, disability, property damage or loss resulting from the risks except where such arises as a result of the negligence or willful misconduct of Creature Klub. You certify that your child(ren) have no pre-existing health or medical condition which could be triggered or exacerbated by participation in the activities or which could be expected to impact your child(ren)'s safety or the safety of others.

I agree to the terms & conditions of the Rules, Release and Indemnity Agreement

Parent/Guardian Full Name

Today's Date

On your child(ren)'s first day of school you will be presented with a physical copy of this agreement which you will have to sign off on below in person before your child(ren) will be admitted to the academic school program.

Please select a school schedule for your child/ children:

Full Time (5 days a week)

Part - Time (3 days a week - Mondays/ Wednesdays/ Fridays)

Part - Time (2 days a week - Tuesdays and Thursdays)

Thanks! We look forward to seeing you at the

2022/23 Academic School Year!