child care programs family handbook - seattle,...

CHILD CARE PROGRAMS FAMILY HANDBOOK

Everyone is welcome. Financial assistance is available. The YMCA of Greater Seattle strengthens communities in King and south Snohomish counties through youth development, healthy living and social responsibility.

TABLE OF CONTENTS

Welcome 3 Homework Program 11

Locations & Contact Information 4 Sick Child Procedures 11

Partnering With You 5 Medication Management 12

YMCA Core Values 5 Medical Emergencies 13

Philosophy & Purpose 6 Special Needs 13

Nondiscrimination Statement 6 Behavior Management 14

Daily Sign-In/Out Procedures 6 Child Safety 14

Snack, Meal Plans & Lunch 7 Emergency Procedures 15

Peanut and Nut Allergies 7 Disaster Plan 15

What Not To Bring 7 Insurance 15

Staff Ratios & Training 8 Code of Conduct 16

Transportation & Trips 8 No Tolerance Policy 16

Lost and Found 8 Statement for Prevention of Abuse 17

Custody Issues 8 Inclement Weather 18

Tuition 9 Holiday & Site Closures 18

Payment, Credit, & Refund Policy 10 Pet Policy 18

Financial Assistance 10 Pesticide Policy 19

Subsidized Assistance 11 Late Pick-Up Policy 19

Typical Daily Schedule 11 Volunteers 19

Birthdays 19

Grievances and Appeals 20

Confidentiality 20

WELCOME

Dear YMCA Child Care Family,

Thanks for enrolling your child in our YMCA Child Care program for the 2015-2016 school year! We are pleased to offer a

wide variety of exciting and enriching programs for you and your family. YMCA Child Care programs are tons of fun and also

instructive for life. Our staff provide activities that have a positive life-long impact on your child through:

• Developing self-confidence and independence

• Communicating core values of caring, honesty, respect, and responsibility

• Creating lasting friendships and lifelong memories

• Encouraging learning and exploration in a supportive environment

• Infusing fun and good health into activities each day

Positive relationships among kids, staff, and parents are critical for each child's healthy development and social growth. A

small ratio of children to staff enables Y leaders to engage in activities and conversations with each child every day. In our

quality programs, staff are upbeat and interact with children using warmth, patience, understanding, and fairness. In addition

they:

• Are responsive to children’s feelings, needs, cultures, abilities, and languages

• Encourage leadership skills by letting them offer ideas to expand or enrich an activity and suggest and initiate

activities

• Allow children - as a key part of learning - to make and learn from their own mistakes

We also make sure that there are positive relationships among staff. We know the children look to Y staff as role models,

watching and learning as they cooperate, communicate and solve problems with each other. We are excited about your

interest in joining us for the 2015-2016 school year as a part of our Child Care programs. If we can answer any questions for

you, please do not hesitate to call your local YMCA. We look forward to having you as part of our Y family!

Sincerely,

Courtney K Whitaker

Child Care Executive

YMCA of Greater Seattle

LOCATION, CONTACT INFORMATION, AND HOURS OF OPERATION West Seattle & Fauntleroy YMCA-Serving Central, South and West Seattle

Site Name

Site Address Contact &

Phone Number Hours of Operation

Type of Care & Ages Served

(Preschool, School-Age, Before and After Care)

Arbor Heights Elementary

Boren School 5950 Delridge Wy SW Seattle, WA 98106

Program Supervisor: (206) 930-2591

Before School Care: 7:00 am – 9:00 am

After School Care: 3:00 pm – 6:00 pm

School Age Care Ages: 5 years – 12 years

Bailey Gatzert Elementary

1301 E Yesler Way Seattle, WA 98136





Concord International School

723 S Concord St Seattle, WA 98108





Fairmount Park Elementary

3800 SW Findlay St, Seattle, WA 98126





STEM K-5 at Boren 5950 Delridge Wy SW Seattle, WA 98106





Thurgood Marshall Elementary

2401 S Irving St Seattle, WA 98144





West Seattle Elementary

6760 34th Ave SW Seattle, WA 98126





PARTNERING WITH YOU

A great program requires a partnership between staff and parents. As a partner in your child’s success in our program, you

have free access at all times to all areas of the classroom used by your child. We invite you to become familiar with the staff

and encourage you to visit and to participate in the program as often as possible.

Parent/Staff Communication

At the Y we strive to provide you with timely and relevant information on our programs, engaging you as a partner in your

child’s success. This includes bi-annual satisfaction surveys, monthly newsletters, daily informal communication, and program

learning objectives. To best support you and your family at our Y, please feel free to provide suggestions for improvement

regarding these communication tools

YMCA CORE VALUES

The YMCA of Greater Seattle is committed to a value-based character development curriculum. Teaching of the following core

values is incorporated into all youth activities:

Honesty: Fairness of conduct and adherence to facts - including sincerity, truthfulness, honor, tact, forgiveness,

moderation, orderliness.

Respect: Special regard for others - including assertiveness, consideration, courtesy, gentleness, unity, tolerance,

humility.

Responsibility: Moral, legal, and mental accountability - including courage, determination, helpfulness, justice, reliability,

loyalty, self-discipline, obedience, cleanliness.

Caring: Interest and concern - including compassion, friendliness, generosity, kindness, love, mercy.

Values Reports

Through our values based programs, we expect all of our participants to uphold the YMCA values of respect, responsibility, caring, and honesty. Values Reports are used to recognize the positive demonstration of Y values or to assist with the framework for improving behavior. These Reports are great tools to use at home, in school, or wherever your child might be. When behavior improvements (including dishonesty, disrespect to other children or staff, failing to carry out responsibilities, etc.) are needed, families will receive a written “Needs Attention Values Report”. This report will be sent home and a copy will be placed in your child’s records. If a child receives one to three (dependent upon the offense) of these Reports, the Program Supervisor, child, and parent(s) will have a formal conference to determine a plan of action.

We are aware that children sometimes copy the behaviors of other children. Therefore, in order for a child to understand the

seriousness of their actions, any child engaging in behavior that is inappropriate at the YMCA, will receive disciplinary action.

This No Tolerance Policy along with the Values Reports will enable us to better communicate with our families.

Any problems your child may be having at home may affect his/her behavior in the Y program. Please keep the Program Supervisor informed so that we can be sensitive to your child's needs. Any information of a confidential nature will be shared only with those who need to know.

PHILOSOPHY AND PURPOSE

YMCA OF GREATER SEATTLE MISSION

We’re for youth development, healthy living and social responsibility.

YMCA child care programs will stimulate a child's physical, social, intellectual, and emotional development. We use small group

experiences that are developmentally appropriate.

In YMCA child care programs your child will:

• Develop physically, emotionally, and socially through a variety of safe, developmentally appropriate and challenging

experiences

• Support school learning objectives and partner in academic achievement

• Expand awareness and appreciation for the natural world

• Learn and display the four core values of the YMCA: Honesty, Respect, Responsibility and Caring

• Increase appreciation for their own family, friends and surrounding community

NONDISCRIMINATION STATEMENT

All people are welcome at the YMCA regardless of race, sex, national origin, religion, sexual orientation or abilities. Children

and parents who have limited English language ability can be assisted with the translation of written information or with an

interpreter. Contact the Program Supervisor to make necessary arrangements. In our efforts to promote an awareness and

understanding of the world around us, lessons about customs and celebrations of other cultures are a part of our curriculum.

YMCA child care will reflect and respect the diversity in our community. Religious education is not part of our program.

The YMCA of Greater Seattle is committed to providing developmentally and culturally appropriate programming that respect,

reflect, and support children and families; cultivate an understanding among children and staff and incorporate an anti-bias

approach to curriculum.

DAILY SIGN-IN/OUT PROCEDURES

• A sign in/out area will be available when you arrive at the site.

• You must sign your full name and time of drop off on the attendance roster when dropping and picking your child up.

• Your child will only be released to the parent/guardian or other authorized adult listed on the Youth Program

Registration Form.

• Identification may be checked daily. While we know it can be inconvenient to show your ID every day, we appreciate

your support of our staff in helping to keep your children safe.

• For the safety of your child, we will not release your child to anyone who appears to be under the influence of drugs

and/or alcohol, but will assist in making other arrangements for transportation home.

• If your child has not arrived by start of the day, we will assume he/she will not be attending and will begin our day

without him/her.

• Pick up your child on time each day. If an emergency arises and you are unable to reach the site before closing, call

the staff to inform them of your progress.

SNACK, MEAL PLANS & LUNCH

Children attending Y care will be offered a light morning and afternoon snack daily. These snacks are not sufficient to replace

breakfast or lunch. If you would like to provide alternate food for your child during snack time (eg. food from home, extra food

from their packed lunch) for dietary, health or other reasons please ask for a YMCA Parent Meal Plan Agreement (WAC 170-

297-7525-Parent or Guardian Provided Food).

During early release and non-schools days parents NEED to provide a lunch for their child. Lunches provided by parents

should strive to meet the USDA guidelines and contain a dairy product, a protein food, and two or more servings of fruit or

vegetables. Please do not send candy, gum or soda with your child to camp. It is not possible for us to provide refrigeration or

a microwave for lunches, so please do not send foods that may spoil such as mayonnaise or require reheating.

PEANUT AND NUT ALLERGIES

To help the YMCA create a safe environment for children with life-threatening nut allergies, you may be asked to refrain from

sending your child with food containing peanut butter or other nuts and/or other foods manufactured in a plant that

processes nuts. If you have any questions please speak with the Program Supervisor.

WHAT NOT TO BRING

We ask that you keep these things at home:

• I-pods

• Cell phones

• Money, gum and candy

• Trading cards

• Weapons of any kind (toys included)

• Drugs, Alcohol & Tobacco Products

• Any electronics

• Any valuables, including personal sports equipment

Many of these items can be lost, broken or stolen while at the site. If these items accidentally show up with your child, the

teacher will hold them for your child and return them at the end of the day.

STAFF RATIOS AND TRAINING

Ages 5-12

A staff to child ratio of 1:12 is normally maintained.

Staff-child ratios are adjusted to assure adequate supervision for the age group, ability, and physical condition of all the

children.

All of our staff have had previous experience working with children. Staff have attended, and continue to attend, regularly

scheduled training events on behavior management, communication skills, and creative activities to do with kids. Staff

maintain current certification in CPR, First Aid, Child Abuse Prevention, and other certification required by the licensor. In

addition, staff and volunteers are thoroughly screened prior to employment and evaluated on a regular basis to ensure

continually high performance.

To make sure your child remains safe outside of the YMCA's supervision and to protect our staff members and volunteers, we

request that you do not ask a YMCA employee or volunteer to baby-sit, host sleepovers, or spend one-on-one time with your

child outside of YMCA programs.

TRANSPORTATION AND TRIPS

Any fees incurred on a field trip will be paid by the YMCA and are included in the monthly fee. Additionally, upon signing the

Youth Program Registration form, you have already given permission for the YMCA to transport your child in the following

vehicles: YMCA vans, YMCA buses and public transportation. Drivers of all YMCA vehicles are thoroughly screened and

authorized by the YMCA, based on experience and good driving records. Each driver must also have a Washington State

driver's license, be currently certified in First Aid & CPR, and participate in an approved YMCA driver training program. Our

vehicles are regularly maintained and undergo daily inspections before being driven.

LOST AND FOUND

Please label all clothing and items brought to the Y Program with your child’s first initial and last name. A lost and found

center will be located in the classroom. At the end of each month, unclaimed items will be held at the branch for one month

and then donated to Goodwill.

CUSTODY ISSUES

We realize that custody decisions and parenting plans are very important to both parents. However, we are not a party to any

custody orders and not in a position to enforce parenting plans. If both parents are listed on the Youth Programs Registration

Form (or if one parent is listed on the form but that parent has confirmed the identity of the other parent) both parents may

pick up regardless of the custody agreement. Any disagreements must be addressed by the parents away from the site. Please

make sure you have established clear expectations between the parties. We do honor Restraining orders, Anti-Harassment

orders, or other court orders created for the protection of the child. Please provide a copy to the Program Supervisor.

TUITION

Our tuition is based on the number of school days from the first day of school to the last and broken up into10 even monthly payments. (See information below on missed days) Tuition for our child care program pays for all direct operation costs, staff, snacks, meals, and materials of which must be available for your child whether or not he/she attends. Therefore, days missed cannot be deducted from your fee. If you need to make changes or withdraw your child from our program, you will need to give written notification 30 days prior to the change. All children who participate in YMCA child care programs must pay a $50 non-refundable, non-transferable Registration Fee. A Rate Schedule is below:

Type of Care YMCA Facility Member Rate

*YMCA Program Member Rate

School Age Rates

AM Only (Includes Before School Care)

$295 $345

PM Only (Includes After School Care & Early

Release Days) $350 $410

PM Plus (Includes After School Care, Non-Student

Days & Breaks) $400 $460

AM & PM (Includes Before & After School Care, Early

Release Days, Non-Student Days & Breaks)

$505 $570

Additional Rates

Rate for children enrolled in AM Only or PM Only for Full Day of care

(per child/per day) $50 $60

PAYMENT, CREDIT, AND REFUND POLICY

Program Payments

Tuition payments must be received at the YMCA no later than the 1st of each month of care. If payments are not received by

the due date, your session will be cancelled and deposit will be forfeited. A $30 fee will be assessed for any returned/declined

payment transactions. For your convenience, a Payment Schedule is located below.

PAYMENT SCHEDULE

For withdrawal or cancellations, we request written notice 30 days prior to the start of each month. Failure to do so will make

the subsequent draft non-refundable. Deposits are non-refundable but can be transferred and applied to other YMCA

programs. We will follow the schedule below related to refunds & credits.

CREDIT & REFUND POLICY

FINANCIAL ASSISTANCE

Financial assistance and flexible payment plans are available through the YMCA for every program we offer. Please call your

local branch for an application. These funds are made possible through our annual Partners With Youth Campaign and the

United Way.

MONTH OF CARE: PAYMENT DUE DATE:

September September 1st

October October 1st

November November 1st

December December 1st

January January 1st

February February 1st

March March 1st

April April 1st

May May 1st

June June 1st

Notice Given Refund Credit Deposit

Thirty days with written notice 100% 100% 100% (Credit only)

Two weeks with written notice 0% 50% 0%

SUBSIDIZED ASSISTANCE

If your child receives subsidized care, a copy of your award letter must be on file prior to your child beginning care. Please call

your caseworker to arrange child care in sufficient time prior to your child’s start.

TYPICAL DAILY SCHEDULE

School Age – Morning Program

7:00am until Start of School: Child and staff initiated

• Activities, Snack, Group Time, and Prepare for Day.

School Age – Afternoon Program

End of School until 4:00: Children arrive and snack is provided

4:00pm-6:00pm: Afternoon Enrichment

Activities include the following core components:

• Service Learning, Literacy, Activities, Physical Wellness, Values & Social Skills Development, Literature, Art, and

Homework.

HOMEWORK PROGRAM

We know that a structured homework program supports the building of developmental assets in children. It specifically boosts

a commitment to learning, teaches positive values, and bolsters positive identity. The Y has developed a structured Homework

Program that has three major areas of focus:

• Assist children with their homework in a safe, quiet, and supervised environment.

• Assist children in the development of commitment to learning through engaging in homework daily.

• Partner with parents/guardians and teachers to promote the core value of responsibility and the development of good

study skills.

SICK CHILD PROCEDURES

The YMCA cannot accept children for child care when they are ill. Staff will observe each child upon daily arrival. If your child is experiencing any of the symptoms listed below, we will ask that other arrangements be made for his/her care.

• Vomiting on 2 or more occasions within the past 24 hours • Too tired or sick to participate in daily activities • Fever of 101°F or higher • Draining Rashes • Eye Discharge or Pink Eye • Diarrhea • Lice or Nits*

*If your child had lice or nits, he/she must be free of lice and nits to be able to return to the classroom.

If your child develops these symptoms after drop-off, parents will be contacted and asked to come pick-up their child. We will separate your child from other children until you can pick them up. Ill staff members will also be sent home. We will report communicable diseases to the local health department. We will also notify other parents so that they can take appropriate action to protect their children.

MEDICATION MANAGEMENT

If it is necessary for your child to take medications while he/she is in our care, please give the medication directly to a staff member when you sign-in your child. Written parental consent is required for us to administer any medication and you will be asked to complete a form when you hand over the medication. Medications are stored in a locked box out of the reach of children. We maintain a record of administration in the locked box on a medication log. The Program Supervisor or designee will be responsible for administering the medication per a doctor’s instructions. All prescription medication must be in its original container and properly labeled with your child's full name, date prescription was filled/or medication's expiration date, and legible instructions for administration, such as manufacturer's instructions or prescription label. The following non-prescription medications require written parental consent and can be given only at the dosage, duration, and method of administration specified on the manufacturer’s label for the age and/or weight of your child:

• Antihistamines • Non aspirin fever reducers/pain relievers • Decongestants or non-narcotic cough suppressants • Anti-itching ointments or lotions, intended specifically to relieve itching or dry skin • Sunscreen • Diaper ointment • Medicated lip balm • Mouthwash

A physician’s written authorization is required for any non-prescription medication that is: • Not included in the above list • To be taken differently than indicated on the manufacturer’s label • Lacks labeled instructions

We cannot give aspirin except with a written authorization from a physician. Any unused medication will be returned to you or properly disposed of.

MEDICAL EMERGENCIES

The Youth Program Registration Form includes a medical release, giving us permission to seek medical attention for your child

in case of an emergency. Please update this form as necessary with any changes in home, work or medical phone numbers.

In the case of life threatening emergencies, a member of our staff will immediately call 911, administer First Aid and CPR, and

notify you as quickly as possible. If you cannot be reached, your designated emergency contact will be notified. If

transportation to the hospital is needed, a staff member will accompany your child on the ambulance and will stay with

him/her until you arrive.

For minor emergencies and injuries, all of our staff are trained in First Aid and CPR, and we will administer as needed. A staff

member will then contact you to come and care for your child if additional care is needed.

For minor injuries that do not require us to notify you immediately, a verbal or written report will be given to you that day

when you pick up your child, explaining what happened and how the situation was treated. Accident reports are completed for

our records and are recorded in our medical log.

We are required to notify the Department of Social & Health Services by phone and in writing of any serious injuries that

require medical treatment, illness that requires hospitalization, occurrences of food poisoning, or communicable diseases.

The hospitals used for emergencies are:

Swedish Hospital Harborview Medical Center Seattle Children’s Hospital

747 Broadway 325 9th Ave 4800 Sand Point Way NE

Seattle, WA 98122 Seattle, WA 98104 Seattle, WA 98105

(206) 386-6000 (206) 731-3000 (206) 987-2000

SPECIAL NEEDS

YMCA staff members are encouraging, patient, and helpful in paving a pathway for children with mild to moderate disabilities

to succeed at YMCA Programs. We are not equipped nor staffed to work with children who need significant assistance with

personal care, constant one-on-one support, or have great difficulty in managing their behavior in a group setting.

If your child has a significant health issue or a special need, please contact the Program Supervisor to discuss appropriate

accommodations.

BEHAVIOR MANAGEMENT

The YMCA strives to meet the needs of all children by setting guidelines and boundaries appropriate to each stage of

development. If problems arise, we will use the following sequential procedures:

1. The child will be encouraged to use his/her words to try to solve the situation peacefully.

2. The child will be redirected to a new activity.

3. The child will be removed from the situation until he/she is able to rejoin the group.

4. Parents are alerted and encouraged to share ideas.

5. Parent & Staff conference will be held with recommendation for an immediate behavior contract or short-term

suspension from care.

6. Complete removal of the child from program.

As a partner in your child’s success, we encourage you to share information with us that may affect your child's behavior. We

are committed to working with you in the best interest of your child and the rest of the children in our care. We do not use or

endorse any form of corporal punishment by anyone (including parents). We do not condone biting, jerking, shaking, spanking,

slapping, hitting, kicking or any other means of inflicting physical pain.

Because there are such a wide variety of behaviors that children display, the YMCA reserves the right to make the decision to

suspend or expel a child based on the physical or emotional safety of the child, other children in the program, and the staff.

In such a situation, parents may be called to come pick-up their child immediately or the child may be separated from the

group for the remainder of the day.

CHILD SAFETY

As a partner in your child’s success, the YMCA of Greater Seattle is committed to providing a safe environment for all participants

and staff. We work hard to create an environment that is both physically and emotionally safe for children. If at any time you are

concerned about the physical or emotional health of your child, please do not hesitate to speak to a staff member or call the

Program Supervisor.

Personal Safety Talks

As part of our program, staff engages in discussions designed to increase children’s understanding of touching and personal space

limits. YMCA staff will model the use of correct words for body parts and functions and respond to conversations and questions in

age appropriate ways.

Child Abuse Reporting

YMCA staff are required to report immediately to Child Protective Services (CPS Intake), licensor or police any instance when

there is reason to suspect the occurrence of physical, sexual, or emotional abuse, child neglect or exploitation. We may NOT

notify parents if this occurs except upon the recommendation of Child Protective Services or the Police.

Supervision of Children During Transitions

YMCA staff are required to do face and/or name checks when transitions occur. Examples of transitions are moving from the

classroom to the playground and back, changing activities, use of transportation, etc. Staff utilize many different techniques

for supervising children during transitions, including the buddy system, roster checks, and additional staff to help with

transitions.

EMERGENCY PROCEDURES

All sites practice monthly fire drills and have a posted evacuation plan. The YMCA has written emergency policies for a variety

of issues. A copy may be obtained from your Branch or by contacting the Program Director.

DISASTER PLAN

Branch: West Seattle & Fauntleroy YMCA

Child Care Sites: Arbor Heights Elementary School (temporarily at Boren School), STEM K-5 at Boren, Bailey Gatzert

Elementary, Concord International School, Fairmount Park Elementary, Thurgood Marshall Elementary, and West Seattle

Elementary School

Each branch is required by law to develop and implement a disaster plan designed for response to fire, natural disasters, and

other emergencies. The plan must address what you are going to do if there is a disaster and parents/guardians are not able

to get to their children for two or three days (WAC 170-295-5030).

Q. How will you/the branch account for all children and staff during and after the emergency?

A. Roll call; staff assigned to groups; specific meeting places; children and staff files move with children.

Q. How will you/your branch evacuate the premises?

A. Evacuation routes posted at each site, based on the school or site disaster plan.

Q. At what location will you/your branch meet after evacuation?

A. See site-specific plan posted at each site on the Family Board.

Q. How will you/your branch contact parents/guardians or how will parents/guardians be able to contact your child care

center?

A. Site cell phone; most staff have cell phones; through emergency workers. Files with emergency contact phone numbers

remain with the children. Each child has been asked to supply an out-of-state contact so that someone can be

notified when in-state numbers are inaccessible.

Q. What kind of transportation method will you/your branch use, if necessary?

A. YMCA vans; parents; emergency worker vehicles. Private staff vehicles may be used only as a last option.

Q. Where can I obtain current licensing information?

A. Licensing information is available on site for your review. You will also find a copy of the most recent child care

checklist for licensing renewal, monitoring checklist, and facility licensing compliance agreement with any deficiencies

noted. Please contact your Site Supervisor for more information.

INSURANCE

It is the responsibility of every individual, parent, or legal guardian to provide their own accident and health coverage while

participating in all YMCA activities. The YMCA of Greater Seattle does not provide any accident or health coverage for its

participants.

CODE OF CONDUCT

The YMCA is committed to providing a positive atmosphere that is safe and inclusive to all in our community. Therefore, the

YMCA of Greater Seattle has adopted a code of conduct to govern the actions and behavior of all people while in our facilities

and while participating in YMCA programs.

Individuals are expected to:

• Uphold the YMCA core values of respect, responsibility, honesty, & caring

• Provide an atmosphere free of derogatory or unwelcome comments, conduct or actions of a sexual nature, or actions

based on an individual’s sex, race, ethnicity, age, religion, abilities, sexual orientation, or any other legally protected

statutes

• Be respectful and cooperative with YMCA staff and others

The following will NOT be tolerated at YMCA facilities and in YMCA programs:

• Abusive, harassing, and/or obscene language or gestures

• Threats of harm, physical aggression, or violent acts

• Weapons of any kind

• Smoking

• Damaging or defacing YMCA property

• Possession, sale, use, or being under the influence of alcohol or illegal drugs

• Offensive and unlawful conduct

Individuals who experience or observe inappropriate conduct are encouraged to promptly report their concern to YMCA staff.

Every effort will be made to ensure that reports are investigated and resolved promptly and effectively.

NO TOLERANCE POLICY

We ask for your support in maintaining a fun, safe place where children can achieve their potential. Please talk with your

children about the importance of not exhibiting the behaviors described below. Ideally, we want to work with families to

prevent these behaviors from occurring.

No Tolerance Policy

The following will NOT be tolerated in our Programs:

• Abusive, harassing and/or obscene language or gestures • Threats of harm, physical aggression, violent acts, or bullying • Weapons of any kind • Damaging or defacing YMCA property • Offensive conduct • Purposely leaving the area of supervision without permission • Improper exposure

Failure to follow this code of conduct will result in disciplinary action, which may include a one to three day suspension. A

parent conference will be scheduled to develop a behavior contract in order for your child to remain in the Program. It may

become necessary for the benefit of the child, as well as for the safety of the other children, to remove a child from our

Program.

STATEMENT FOR PREVENTION OF ABUSE A principal endeavor of the YMCA is to provide a healthy atmosphere for the growth and development of youth and children.

Thus, the mistreatment or neglect of youth or children and the resulting severe effects are of primary concern to the YMCA.

Child abuse is mistreatment or neglect of a child by parents or others resulting in injury or harm. Abuse can lead to severe

emotional, physical, and behavioral problems. Because of its concern for the welfare of children and youth, the YMCA has

developed policies, standards, guidelines, and training to aid in the detection and prevention of child abuse. In addition, all

employees are screened and background checks are conducted upon hiring or rehiring. Additionally, employees who have

contact with children and youth receive training in recognizing, reporting, and preventing child abuse, which includes training

in recognizing signs that a child is being groomed for abuse. Some of the guidelines employees are expected to follow are:

• Avoid being alone with a single child where you cannot be observed by other staff or adults.

• Not relating to children who participate in YMCA programs outside of approved YMCA activities. For example, baby-

sitting, weekend trips, foster care, etc. are not permitted. An exception must be approved in advance by the Director

of Risk Management and the Branch Executive or SVP/COO.

• Giving personal gifts to program participants or their parents is not allowed.

• Program rules and boundaries must be followed, including appropriate touch guidelines.

• Children or youth should not be singled out for favored attention.

• Dating a program participant under age 18 is not allowed. Some YMCA programs may have additional restrictions.

• Children may not be disciplined by use of physical punishment or by failing to provide the necessities of care.

• Verbally, physically, sexually, or emotionally abusing or punishing children or youth is not allowed.

• Children may be informed in a manner that is age appropriate to the group of their right to set their own “touching”

limits for personal safety.

• Children should only be released to authorized persons in programs with controlled pick-up procedures.

• Any information regarding abuse or potential abuse should be documented in writing.

• At the first reasonable cause to believe that any child abuse exists, it should be reported to the supervisor or branch

executive so that proper reporting can be initiated.

• At the first reasonable cause to believe that an employee or volunteer abused a child or youth, even if it was not

during working hours, his or her conduct should be reported to the program director and the branch executive or

another designated branch representative. Additionally, it is the YMCA’s protocol to make a report to the appropriate

authorities. Appropriate actions will be taken regarding the employee or volunteer, including suspension or

termination from YMCA employment or volunteer status.

Confidentiality of information related to child abuse is crucial and should be limited to the immediate supervisor and/or branch

executive and designated members of the Association office.

INCLEMENT WEATHER

When school operations are closed due to inclement weather, we will be closed. If schools are running late two hours, we will

also be running two hours late; when safe and possible, the staff will try to open the site. Please make sure that an authorized

staff member is available to supervise the site before leaving your child. Transportation to school will be provided only if it

can be accomplished safely in a YMCA vehicle or district school buses during inclement weather.

HOLIDAY & SITE CLOSURES

YMCA Child Care programs are closed on the following days:

• Labor Day

• Veterans Day (Staff Training Day)

• Thanksgiving Day

• The day after Thanksgiving

• Christmas Day*

• New Years Day*

• Martin Luther King Jr Day

• President’s Day (Staff Training Day)

• Memorial Day

• Independence Day*

*If the holiday falls on a Saturday, there will be no care on the preceding Friday. If the holiday falls on a Sunday, there will be

no care the following Monday.

In addition, there may be closures at the end of the school year and prior to the beginning of the school year for center clean

up/set up and staff training and development. Contact your Program Supervisor for specific closure dates.

PET POLICY

Our classrooms may have a pet. This gives children responsibility for feeding and caring for animals. A designated staff in each classroom will be responsible for the pet’s environment and supervision of the learning opportunities.

Reptiles and amphibians will be in a self-contained area except during educational activities. Children five years of age or less will not physically handle reptiles and amphibians. List of possible pets: rabbits, hamsters, guinea pigs, fish, or insects. Accommodating arrangements can be made if your child has allergies to any of these pets.

PESTICIDE POLICY

You will be notified at least 48 hours in advance of the application of any pesticides, as we receive notification from the

school district or city. This notification will include the product name of the pesticide being used, intended date and time of

application, location where the pesticide will be applied, the pest to be controlled and the name and number of a contact

person at the site. Signs and/or markers will be posted following the application of the pesticide. These will state, “This

landscape has recently been sprayed or treated with pesticides.” They will also state who has treated the landscape and who

to call for more information.

LATE PICK-UP POLICY

Children must be picked up by the time the site closes. If an emergency arises and you are unable to reach the site by close, please

phone us to assure both the staff and your child that you are on the way. State law requires us to notify CPS when children are left

in a program without notification from families and when no contacts can be reached to pick up the child.

Each site follows these guidelines in response to a late pick-up:

1. Staff notifies the family to ensure that someone is on the way to pick up the child. If the family is not reachable, staff

notifies emergency contacts.

2. If the family and emergency contacts cannot be reached, staff notifies the police.

3. If your child is picked up late on three occasions, your child’s participation in the program may be terminated.

VOLUNTEERS

At the YMCA we welcome parents or guardians to help throughout the day in your child’s programs. We also offer many other

volunteer opportunities such as helping with field trips, administrative work, classroom decorations, youth sports, and involvement

in our Annual Campaign. Please speak with staff at your program for more information.

BIRTHDAYS

Birthdays are a special time for children and we are happy to help you celebrate them. You are welcome to send a special treat (no

homemade items please) on your child’s birthday. Please check with the Program Supervisor to make arrangements and learn about

special food allergies. We ask that party invitations not be passed out at the site, to avoid any hurt feelings unless all children are

invited.

GRIEVANCES AND APPEALS

Our grievance process is designed to address your concerns, complaints and problems. Any individual grievance that a family may have regarding the care of their child or with the policies or practices of the YMCA, should be first addressed with the Program Supervisor, within 5 calendar days of the incident referred to in the grievance. If the problem is not satisfactorily resolved the family may request a meeting with the Senior Program Director within 10 days of the original incident. If the problem is still not satisfactorily resolved, the family may request a meeting with the YMCA Branch Executive Director within 15 days of the original incident. If no resolution is attained at this level, the family may submit the grievance in writing within 30 days of the original incident to the Personnel Committee of the YMCA Board of Directors, with a copy to the Branch Executive Director stating the nature of the grievance and the desired resolution. Within 10 days after the receipt of the grievance, the Personnel Committee shall establish a date and time for a hearing, which the family may attend. The Branch Executive shall implement the decision of the Personnel Committee.

CONFIDENTIALITY

The YMCA considers personal information to be confidential and has policies and procedures in place to protect it against unlawful use and disclosure. By “personal information,” we mean information that relates to your child and family. Personal information does not include publicly available information or information that is available or reported in a summarized or aggregate fashion but does not identify you. All children and family personal information remain confidential and the YMCA is not sharing any of that information with anyone without parent/guardian permission. Any information of a confidential nature will be shared only with those who need to know.

We look forward to having you as part of our Y family this school year!

West Seattle Family YMCA

4515 36th Ave SW

Seattle, WA 98126

206-935-6000

westseattleymca.org

Fauntleroy YMCA

9140 California Ave SW

Seattle, WA 98136

206-937-1000

westseattleymca.org

YMCA OF GREATER SEATTLE Child Care Registration Form

CHILD’S INFORMATION Legal First Name

MI Legal Last Name

School Attending in the Fall

Grade in Fall

MONTHLY CARE OPTIONS FACILITY MEMBER RATE PROGRAM MEMBER RATE

□ Before School Care Cost includes Before School Care Does not include cost of Early Release days, Non-Student

Days and Breaks

$295/month $345/month

□ After School Care Cost includes After School Care and Early Release days Does not include cost of Non-Student Days and Breaks


□ After School Care Plus Cost includes After School Care, Early Release days, Non-

Student Days and Breaks


□ Before and After School Care Cost includes Before and After school care, Early Release

days, Non-Student Days and Breaks


□ Non-Student Days, or School Breaks This option is for those already enrolled in Before

School or After School Care

$50/day for Non-Student Days and Breaks

$60/day for Non-Student Days and Breaks

SITE SELECTION

Please select site and transportation if applicable: NOTE: All transportation is provided via Seattle Public School District bussing. Please contact SPS transportation department at (206) 252-0900 to determine if bussing will be available from your child’s school to the Y program site.

□ Arbor Heights Elementary (at Boren) Transportation to/from ___________________________

□ Bailey Gatzert Elementary Transportation to/from ___________________________

□ Concord International School Transportation to/from ___________________________

□ Fairmount Park Elementary Transportation to/from _________________________

□ STEM K-5 at Boren Transportation to/from _________________________

□ Thurgood Marshall Elementary Transportation to/from _________________________

□ TOPS K-8 Transportation to/from _________________________

□ West Seattle Elementary Transportation to/from _________________________

REGISTRATION Start Date: __________________________________ (minimum of 2 business days are needed to process a registration, prior to care) A $50 registration fee per child is required at the time of registration.

$_______________________

YMCA OF GREATER SEATTLE Youth Program Registration Form

YOUTH INFORMATION

Legal First Name M Legal Last Name Preferred Name Date of Birth Gender Ethnicity

Home Address Apt City State Zip Code

SPECIFIC MEDICAL, BEHAVIORAL OR DEVELOPMENTAL NEEDS

Date of Last Physical Date of Last Dental Exam Date of Last Tetanus

/ / / / / /

Depending upon your child’s need, additional paperwork and a meeting with a YMCA Director may be required prior to your child’s start to ensure your child can best be accommodated. Failure to share information that identifies your child’s special care, accommodations or supervision needs may jeopardize the placement of or continued participation by your child in the program. Write “none” if none.

Dietary Modifications/Allergy Chronic/Recurring Illness

Current Medications (medication authorization may be required) Operations/Serious Injury

Physical Disability Behavioral Disorder

Developmental Delays

List any activities from which your child should be exempted for health reasons:

EMERGENCY & INSURANCE INFORMATION

Child’s Physician Address Phone Number

Child’s Dentist Address Phone Number

Local Emergency Contact (other than parents or doctor) & Phone Number Out of Emergency Contact & Phone Number

It is the responsibility of every individual, their parent or legal guardian, to provide for their own accident and health coverage while participating in all YMCA activities. The YMCA of Greater Seattle does not provide any accident or health coverage for its participants.

Medical Insurance Company Policy Number

PARENT OR GUARDIAN


Home Address (if different than child) Apt City State Zip

Phone Number Cell Phone Work Phone Does Child Live With You?

Primary Email

Employer Name

PARENT OR GUARDIAN


Home Address (if different than child) Apt City State Zip

Phone Number Cell Phone Work Phone Does Child Live With You?

Primary Email

Employer Name

PICK UP AUTHORIZATIONS

Legal First Name M Legal Last Name Phone Number

Address Apt City St Zip







YMCA POLICIES

Everyone is Welcome: The YMCA is a membership organization open to all people.

Financial Assistance: If you cannot afford the full cost of a program or membership, please ask for a confidential scholarship application. Financial assistance, to the extent possible, is available to those in need.

Personal Safety Discussions: Our staff will engage children in discussions to help them understand how they can set their own personal safety and touching limits. These discussions will emphasize respect, set the ground rules for appropriate behavior, and encourage children to tell if someone touches them in a way that makes them feel uncomfortable. The YMCA of Greater Seattle respects the diversity and rights of the individuals it serves.

AUTHORIZATIONS

Participation I give permission for my child to participate in all activities, including field trips, climbing wall, overnights, and swimming and to be transported as authorized by the YMCA. I give permission for the YMCA to use any pictures of my child for future promotional purposes.

Medical Treatment I hereby give permission for my child to be given cardiopulmonary resuscitation (CPR) and first aid treatment by a qualified staff member of the YMCA. In the event I cannot be contacted, I also give permission for my child to be transported by ambulance or aid car to an emergency center for treatment. I further consent to the disclosure of health information and to the medical, surgical and hospital care treatment and procedures (including, but not limited to, administration of necessary anesthetics, tests, x-ray examinations, transfusions, injections, drugs) to be performed for my child by a licensed physician or hospital selected by the YMCA director when deemed immediately necessary or advisable by the physician to safeguard my child’s health.

Release from Liability Recognizing that the YMCA will do its best to ensure a safe experience, I understand that accidents may occur both from my child’s participation in program activities and from transportation to and from the program. I agree to assume these risks. By signing below, I release the YMCA of Greater Seattle, its employees, volunteers, independent contractors, directors and agents from all liability based on any damage, loss or injury whether it is the result of ordinary negligence or otherwise, caused to my child or to me from participation in YMCA programs.

Photo Release: The applicant hereby gives permission for the YMCA (local, national and international) to use, without limitation or obligation, photographs or other media that may include the members’ image or voice to promote or interpret YMCA programs.

I have read and understand the above and have completed this form to the best of my ability.

Signature of parent or legal guardian: Date:

Certificate of Immunization Status (CIS) DOH 348-013 January 2015

Please print. See back for instructions on how to fill out this form or get it printed from the Immunization Information System. Child’s Last Name: First Name: Middle Initial: Birthdate (mm/dd/yyyy): Sex:

I give permission to my child’s school to share immunization information with the Immunization Information System to help the school maintain my child’s school record.

Parent/Guardian Signature Required Date

Symbols below: Required for School and Child Care/Preschool Required for Child Care/Preschool Only

■ Recommended, but not required

I certify that the information provided on this form is correct and verifiable. Parent/Guardian Signature Required Date

Vaccine Dose Date

Month Day Year Hepatitis B (Hep B) 1 2 3 or Hep B - 2 dose alternate schedule for teens 1 2

■ Rotavirus (RV1, RV5) 1 2 3 Diphtheria, Tetanus, Pertussis (DTaP, DTP, DT) 1 2 3 4 5 Tetanus, Diphtheria, Pertussis (Tdap) 1

■ Tetanus, Diphtheria (Td) 1 2 Haemophilus influenzae type b (Hib) 1 2 3 4

■ Influenza (flu, most recent)

Vaccine Dose Date

Month Day Year Pneumococcal (PCV, PPSV) 1 2 3 4 5

Polio (IPV, OPV) 1 2 3 4

Measles, Mumps, Rubella (MMR) 1 2

Varicella (chickenpox) 1 2

■ Hepatitis A (Hep A) 1 2

■ Human Papillomavirus (HPV) – does not print from the IIS; write dates in by hand 1

2

3

■ Meningococcal (MCV, MPSV) 1 2

If the child named on this CIS had chickenpox disease (and not the vaccine), disease history must be verified. Mark option 1, 2, OR 3 below (see # 5 on back) 1) Chickenpox disease verified by printout from the Immunization Information System (IIS) Must be marked by printout (not by hand) to be valid. 2) Chickenpox disease verified by healthcare provider (HCP) If you choose this box, mark 2A OR 2B below.

2A) Signed note from HCP attached OR 2B) HCP sign here and print name below:

Licensed healthcare provider signature Date (MD, DO, ND, PA, ARNP) Printed Name: 3) Chickenpox disease verified by school staff from the Immunization Information System

If the child can show immunity by blood test (titer) and hasn’t had the vaccine, ask your HCP

to fill in this box. Documentation of Disease Immunity

I certify that the child named on this CIS has laboratory evidence of immunity (titer) to the diseases marked. Signed lab report(s) MUST also be attached.

Diphtheria Hepatitis A Hepatitis B Hib Measles

Mumps Polio Rubella Tetanus Varicella

Other: _______________

_______________

Licensed healthcare provider signature Date (MD, DO, ND, PA, ARNP) Printed Name:

Office Use Only: Reviewed by: Date:

Signed Cert. of Exemption on file? Yes No

EXAMPLE

Instructions for completing the Certificate of Immunization Status (CIS): printing it from the Immunization Information System (IIS) or filling it in by hand.

#1 To print with information filled in: First, ask if your healthcare provider’s office puts vaccination history into the WA Immunization Information System (Washington’s statewide database). If they do, ask them to print the CIS from the IIS and your child’s information will fill in automatically. Be sure to review all the information, sign and date the CIS, and return it to school or child care. If your provider’s office does not use the IIS, ask for a copy of your child’s vaccine record so you can fill it in by hand using steps #2-7 (below):

#2 To fill in by hand: Print your child’s name, birthdate, sex, and your own name in the top box. #3 Write each vaccine your child received under the correct disease. Write the vaccine type under the

“Vaccine” column and the date each dose was received in the “Month,” “Day,” and “Year” columns (as mm/dd/yyyy). For example, if DTaP was received Jan 12, March 20, June 1, ’11, fill in as shown here

#4 If your child receives a combination vaccine (one shot that protects against several diseases), use the Reference Guide below to record each vaccine correctly. For example, record Pediarix under Diphtheria, Tetanus, Pertussis as DTaP, Hepatitis B as Hep B, and Polio as IPV.

#5 If your child had chickenpox (varicella) disease and not the vaccine, use only one of these three options to record this on the CIS: 1) If your child’s CIS is printed directly from the IIS (by your healthcare provider or school), and disease verification is found, box 1 is automatically

marked. To be valid, this box must be marked by the IIS printout (not by hand). 2) If your healthcare provider can verify that your child had chickenpox, mark box 2. Then mark either 2A to attach a signed note from your provider, or

2B if your provider signs and dates in the space provided. Be sure your provider’s full name is also printed. 3) If school staff access the IIS and see verification that your child had chickenpox, they will mark box 3.

#6 Documentation of Disease Immunity: If your child can show immunity by blood test (titer) and has not had the vaccine, have your healthcare provider fill in this box. Ask your provider to mark the disease(s), sign, date, print his or her name in the space provided, and attach signed lab reports.

#7 Be sure to sign and date the CIS, and return to the school or child care.

Vaccine Trade Names in alphabetical order (For updated lists, visit https://fortress.wa.gov/doh/cpir/iweb/homepage/completelistofvaccinenames.pdf)

Trade Name Vaccine Trade

Name Vaccine Trade Name Vaccine Trade Name Vaccine Trade Name Vaccine

ActHIB Hib FluLaval Flu Ipol IPV PedvaxHIB Hib Twinrix (Twnrx) Hep A + Hep B

Adacel Tdap FluMist Flu Infanrix DTaP Pentacel (Pntcl) DTaP + Hib + IPV Vaqta Hep A

Afluria Flu Fluvirin Flu Kinrix (Knrx) DTaP + IPV Pneumovax PPSV or PPV23 Varivax Varicella

Boostrix Tdap Fluzone Flu Menactra MCV or MCV4 Prevnar PCV or PCV7 or PCV13

Cervarix HPV2 Gardasil HPV4 MenHibrix (Mnhbrx)

Meningococcal C/Y- HIB-PRP

ProQuad (PrQd) MMR + Varicella

Daptacel DTaP Havrix Hep A Menomune MPSV or MPSV4 Recombivax HB Hep B

Engerix-B Hep B Hiberix Hib Menveo Meningococcal Rotarix Rotavirus (RV1)

Fluarix Flu HibTITER Hib Pediarix (Pdrx) DTaP + Hep B + IPV RotaTeq Rotavirus (RV5)

Vaccine Abbreviations in alphabetical order (For updated lists, visit https://fortress.wa.gov/doh/cpir/iweb/homepage/completelistofvaccinenames.pdf) Abbreviations Full Vaccine Name Abbreviations Full Vaccine Name Abbreviations Full Vaccine Name Abbreviations Full Vaccine Name

DT Diphtheria, Tetanus Hep A (HAV) Hep B (HBV)

Hepatitis A Hepatitis B

MPSV or MPSV4 Meningococcal Polysaccharide Vaccine

Rota (RV1 or RV5)

Rotavirus

DTaP Diphtheria, Tetanus,

acellular Pertussis Hib

Haemophilus influenzae

type b MMR / MMRV

Measles, Mumps, Rubella /

with Varicella Td Tetanus, Diphtheria

DTP Diphtheria, Tetanus, Pertussis

HPV Human Papillomavirus OPV Oral Poliovirus Vccine Tdap Tetanus, Diphtheria, acellular Pertussis

Flu

(IIV or LAIV) Influenza IPV

Inactivated Poliovirus

Vaccine

PCV or PCV7 or

PCV13

Pneumococcal Conjugate

Vaccine TIG Tetanus immune globulin

HBIG Hepatitis B Immune Globulin

MCV or MCV4 Meningococcal Conjugate Vaccine

PPSV or PPV23 Pneumococcal Polysaccharide Vaccine

VAR or VZV Varicella

If you have a disability and need this document in another format, please call 1-800-525-0127 (TDD/TTY call 711). DOH 348-013 January 2015

Vaccine Dose Date Month Day Year

Diphtheria, Tetanus, Pertussis (DTaP, DTP, DT) DTaP 1 01 12 2011 DTaP 2 03 20 2011 DTaP 3 06 01 2011

PARENT/GUARDIAN STATEMENT OF UNDERSTANDING The following information is important for the safety and protection of your child. Please read the information and sign this form. I understand that the adult who signs the child up for the program is responsible for payments to the YMCA. I understand all financial, attendance, enrollment and other business documents will be provided only to the adult who signs the child up for the program and is responsible for payment. I understand that YMCA staff are not allowed to baby-sit or transport children outside of the YMCA program. I understand children should not receive gifts (video games, jewelry, movie tickets…) that are not part of the YMCA program from YMCA staff or volunteers, and I should report this to a supervisor if they do. I understand that I have free access, at all times, to areas of the program used by my child. I also understand that I will have opportunities to participate in program activities, and that this participation may require me to go through a screening process. I also understand that if my participation obstructs the program in any way, this privilege will be revoked. I understand that I am not to leave my child at the YMCA or program site unless a YMCA staff is there to receive and supervise my child. I understand that my child will not be allowed to leave the program with an unauthorized person. 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. I understand that YMCA staff will engage children in discussions to help them understand how they can set their own personal safety and touching limits. I understand that I will be provided information about my child’s progress and/or any issues related to his/her care, however, both parents/guardians may receive this information upon request. I understand that staff in licensed child care programs, family and mental health services and specific staff in other programs are mandated by state law to report any suspected cases of child abuse or neglect to the appropriate authorities for investigation. I also understand that employees in all YMCA programs follow the same reporting protocol. Furthermore, our staff are protected from liability for good faith reporting. I understand that the Health Care Plan is posted and available for my review. I have read and understand the statements above and I have received a copy of:

_______________ Family Handbook (Containing all policies, procedures, philosophy, Medical Procedures, Disaster Preparedness Plan, Pesticide Policy, and Statement for Prevention of Abuse)

________________ Protect Your Child From Abuse When Your Child Is Not With You brochure is available from your YMCA branch and on ykids.org.

____________________________________________________________________ Child’s Full Name _________________________________________________ __________________ Parent/Guardian Signature Date

COPY OF STATEMENT WILL BE FILED WITH CHILD’S RECORDS. 3/31/2015 1

YMCA OF GREATER SEATTLE - Policies for Child Care Program

I have read and understand the Payment, Credit and Refund Policy, page 10 of the Child Care Programs Handbook, outlined below. • Payment must be received no later than 1st day of the month of care. If payments are not received by

the due date, your child care may be cancelled and deposit will be forfeited.

• Cancellations or transfers require written notice 30 days prior to the effective date of the change.

• Registration fees are non-refundable and non-transferrable.

• A Payment Schedule is located in your Child Care Programs Handbook.

• A fee of $30 will be assessed for any returned/declined payment transactions.

• Refund and credit policy will use guidelines below:

Notice Given Prior To: Refund Credit Thirty days with written notice 100% 100% Two weeks with written notice 0% 50%

I have read and understand the No Tolerance Policy, page 16 of the Child Care Programs Handbook.

I have read and understand the Snack, Meals Plans & Lunch, page 7 of the Child Care Programs Handbook, outlined below.

I understand that if I would like to provide alternate food for your child during snack time (eg. food from home, extra food from their packed lunch) for dietary, health or other reasons please ask for a YMCA Parent Meal Plan Agreement (WAC 170-297-7525-Parent or Guardian Provided Food).

I have read and understand the Peanut and Nut Policy, page 7 of the Child Care Programs Handbook, outlined below.

To help the YMCA create a safe environment for children with life-threatening nut allergies, you may be asked to refrain from sending your child with food containing peanut butter or other nuts and/or other foods manufactured in a plant that processes nuts.

I have read and understand the Holiday & Site Closures as listed on page 18 of the Child Care Programs Handbook and agree to the following statement:

I have read and understand the days outlined for holiday or training closures.

Agreement I have read and initialed the above information and I fully understand all policies of the YMCA’s Child Care Programs. Child’s Full Name: ____________________________________________________________________________________________________________ Parent/Guardian Signature: _______________________________________________________ Date: _______________________________

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