Emergency Contacts & Authorized Pickups

Please notify your TAC Site whenever an emergency contact/authorized pick up person will pick-up your child.

• You are authorizing the people listed above to pick-up your child from TAC.
• TAC requires all authorized people including parents/guardians to show a government issued photo ID at the time of pick-up.
• Identification questions listed on Page 1 will be used to confirm identity when calling in additional pick-up authorizations.
• In the case of an emergency when the TAC’s staff cannot reach you, we will call the persons designated above

Pickup Questions

Court Ordered Denied Pick-Up

The following individuals are prohibited from picking up my child(ren) and/or having contact with my child(ren) by court order. TAC must have a copy of the court order on file in order to deny pick-up.

Child Information

Billing

Health / Allergy Information

TAC Policies and Regulations

Please read all following sections and sign where required.

In consideration of the services to be provided by The Adventure Club, Inc., and for other good and valuable consideration, the undersigned, for myself and for my minor child, and any and all family members, heirs, representatives, executors, administrators, and assigns of myself or of my minor child, hereby accepts full responsibility and assumes all risk, for my minor child’s use of any and all apparatuses, appliances, facilities, privileges or services, of any nature, which is/are owned, operated or provided by The Adventure Club, Inc. While engaging in any contact, game, function, exercise, competition or any other activity operating, organized, arranged, or sponsored by The Adventure Club, Inc. either on or off their premises, my minor child shall do so at his or her own risk.

I hereby release and hold forever harmless The Adventure Club, Inc., its owners, employees, representatives, and agents (collectively, “the releases”), and each of them, from any and all losses, claims, injuries, damages, or liability of any kind, sustained or incurred by us resulting therefrom, whether caused by the negligence of the releases or otherwise. I specifically agree to indemnify and hold harmless The Adventure Club, Inc., its owners, employees, representatives, and agents as to any loss, cost, claim, injury, damage or liability, sustained or incurred by using the facilities, equipment, or services, of The Adventure Club, Inc., which is caused by an act or omission, whether negligent or otherwise, of an employee, representative, or agent of The Adventure Club, Inc.

I understand/acknowledge that it is my responsibility to ensure that my minor child participates only in those activities for which he/she has the required physical conditioning. My signature below indicates that I have carefully read and freely signed this waiver, and constitutes my full acceptance of this waiver.

I understand that in an effort to prevent any potential conflict of interest, childcare outside TAC hours by TAC staff members is discouraged. However, should I hire TAC staff, it must be outside the TAC premises and with the understanding that such arrangements and payments for services are solely between me and the member. TAC does not sanction the arrangements, and I agree to hold TAC harmless from any such arrangement. If a center staff member chooses to baby-sit for an enrolled child, the Site staff member and I must request and sign a Liability Release Form to be kept in the child’s file.

Thank you for enrolling your child at The Adventure Club. It is our mission to provide a before and after school program that is an Enriching, Inspiring, Educating and Exciting place for your child to learn and grow while meeting the childcare needs of our parents, the school and communities we serve.

Thank you for the opportunity to be a part of your child’s life.

I have received, read, and agree to abide by the Parent Handbook.

Special Permissions

Please read all following sections and sign where required.

I give permission for my child to leave the Site for outdoor fitness and educational purposes, with the understanding that my child will be accompanied by TAC staff and under supervision at all times.

I give permission for TAC to include my child in supervised playground and water activities. My child has my permission to use all the play equipment and take part in all TAC activities.

I hereby grant permission for my child to participate in and be transported by commercial transportation companies while under staff supervision at all times for field trips and other TAC sponsored activities. I understand that children not attending TAC fieldtrips
will remain on-site with TAC staff.

I understand that TAC is not responsible for any injuries that may result from the sun. I give permission for my child to apply/wear SPF 30 sunscreen that I supply.