Nativity Child and Family Center

Family HandbookTable of Contents

WELCOME LETTER 5ABOUT THE CENTER 5Mission Statement 6Program Philosophy and Beliefs 6

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Incorporation 6Licensing 6Board of Directors 6Administrative Team 6Faculty 7Days and Hours of Operation 7Center Closings 7ENROLLMENT 7Eligibility 7Registration 8Late Payment Fee 9Late Pick-Up Fee 9NSF Checks or Transactions 9Multiple Child Discount 9Children Enrolled Part-Time 9Change in Enrollment or Withdrawal 9Childcare Leave 10Illness, Holiday, or Vacation 10Method of Payment 10PROGRAMMING 10Ages Served 10Daily Schedule 11Curriculum 11Assessment 12Parent Teacher Conferences 13Transitioning to a New Age Group 13Early Childhood Screening 14Family Ministry 14FOOD 14General Information 14Food from Home 14

POLICIES AND PROCEDURES 15Center Emergency Closings 15Confidentiality 15Arrival and Departure 15Unauthorized Pick-Up 15

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Grievance Procedure 15Babysitting 16Minnesota Clean Air Act 16Prohibited Substances 16Drug and Alcohol Use 16Firearms 16Photos 16Rest Time 16Dress and Belongings 17Supervision 17Animals 17School-Age Bus Stop 17School-Age Release Days 17School-Age Summer Program 17Guidance and Socialization 18Weather 19Transportation 19Field Trips 20Grievance Procedures 20Data Privacy 20Research 21Mandated Reporting Policy 21FAMILIES IN THE PROGRAM 22Parent Volunteers 22Parent Involvement and Communication 23HEALTH AND SAFETY 23Special Diets, Medical, or Developmental Needs 23Medications 23Exclusion of Ill Child 24Health Consultation Services 25Emergency Care Procedures 25Diapering and Toileting 25Hand Washing 26Sanitation and Hygiene 26Insect Repellant 26Sunscreen 26Emergency Evacuations 26

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AGREEMENT 27Family Handbook Agreement 27Enrollment Agreement 28

Welcome to Nativity Child and Family Center!

We are pleased that you have chosen Nativity Child and Family Center, “NCFC”, to be an active part of your child’s early learning experience. Our professional team of early childhood educators works to build trusting relationships with your child and your family. We believe in creating a safe, loving, and inclusive environment, where everyone feels a sense of community. Developing partnerships with families is key to

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our success in offering high quality care for children. Please let us know if we can ever assist you in locating community resources, or information on topics in early childhood. We are excited to be able to offer your child a safe, caring and loving environment. We look forward to getting to know all members of your family!

Nativity Child and Family Center’s policies are written under the guidance of the Minnesota Department of Human Services, National Association for the Education of Young Children, Child Care and Adult Food Program, and Hennepin County Environmental Health.

If you have questions concerning any of the policies in our handbook, please ask for clarification. Your suggestions and insights are always welcome.

Sincerely,

Sue Marusic Jen EvensonExecutive Director Assistant Directordirector@nativitychurch.org jen@nativitychurch.org

3312 Silver Lake Road NESt. Anthony MN 55418612-781-1537 phone

612-781-2768 faxwww.nativitychildcare.org

ABOUT THE CENTER

MISSION STATEMENTNativity Child and Family Center is committed to sharing God’s love, hope, joy, and peace with children and their families by providing quality care, education, and family support.

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PROGRAM PHILOSOPHY AND BELEIFSNativity Child and Family Center is an early childhood ministry with children, parents and families in the community. We are a ministry to the "whole child," encouraging growth and development physically, emotionally, intellectually, spiritually, and socially.

The staff of Nativity Child and Family Center is committed to the continuing development of a creative curriculum and does not permit discrimination because of race, color, sex, creed, religion, age, disability, national or ethnic origin.

Our goal is to provide support for the child’s family as well as to provide a nurturing and loving environment of planned experiences which encourage a child to explore and examine the world around her/him through individual and group activities. In our caring and accepting atmosphere, children develop a sense of trust and security and can explore new materials, as well as their own feelings in accepting and socially appropriate ways. We recognize children develop at their own pace and we will, at all times, strive to assess children where they are and help them to grow and learn to reach their full potential.

INCORPORATIONNativity Child and Family Center is a nonprofit 501(c)3 corporation governed by a volunteer Board of Directors. Bylaws, Governance, and the Annual Report are available upon request.

LICENSINGNativity Child and Family Center is licensed by the Minnesota Department of Human Services, Division of Licensing. The Division of Licensing can be reached by calling 651-431-6500. Families may review the Center Program Plan at any time. Faculty and children’s files may be reviewed by the licensor at any time. Nativity Child and Family Center is licensed for 149 children, including school-age children (not to exceed 74 preschoolers and 15 toddlers). The Center enrolls children between the ages of 16 months through 12 years.

BOARD OF DIRECTORSThe Board is committed to providing high quality early childhood education with a Christian emphasis. The Board is ultimately responsible for defining the organization’s missions and setting the organization’s strategic direction. The Board provides direct oversight and direction for the Executive Director.

ADMINISTRATIVE TEAMThe administrative team consists of the Executive Director and Assistant Director. The team is responsible for the development and implementation of goals and objectives for the program and staff, ensuring all aspects of Nativity Child and Family Center meet necessary licensing requirements.

FACULTYOur faculty members come from a variety of backgrounds and experiences which meet or exceed the requirements of the Department of Human Services for the positions they hold. All staff members have received training in Abusive Head Trauma prior to working with children. In addition, all Teachers and Assistant Teachers have both Pediatric CPR and First Aid certification. All staff members are required to participate in continuing professional training equal to at least 1% to 2% of their annual classroom time. All staff have completed and passed a background study by the state of Minnesota. Teachers work in

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partnership with parents to determine the best way to meet the needs of each child while providing a warm, nurturing environment for all of the children in their group. Teachers develop and implement an experiential emergent curriculum. Classroom Assistant Teachers and Aides provide nurturing care under the direction of Teachers. They assist with classroom activities and management. The Center also employs a cook who prepares our meals onsite for the children.

DAYS AND HOURS OF OPERATIONNativity Child and Family Center program operates Monday through Friday from the hours of 7:00 a.m. to 6:00 p.m.

Morning half-day preschool hours are from 9:00 a.m. to 11:30 a.m. during the school year only.

Before and after school-age care hours are from 7:00 a.m. to 8:45 a.m. and 2:45 p.m. to 6:00 p.m.

CENTER CLOSINGSThe Center will be closed on designated holidays and for two teacher workshop days. You may get a current calendar of closure days in the office.

ENROLLMENT

ELIGIBILITYNativity Child and Family Center celebrates individuality of all persons regardless of age, gender, ethnicity, ability, sexual orientation or religion. In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.). should contact the Agency (state or local) where they applied for benefits. Individuals who are deaf, hard or hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.To file a complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at http://ascr.gov/complaint_filinf_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint for, call (800) 632-9992. Submit your completed form or letter to USDA by:

(1) Mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 140 Independence Avenue, SW, Washington D.C., 20250-9410

(2) Fax (202)690-7442(3) Email: program.intake@usda.gov

This institution is an equal opportunity provider.

REGISTRATIONParent(s) must visit the program before making an application for enrollment. Visiting the program allows both parent and child to become comfortable with our environment, staff, and schedule. During this visit, the parent will receive a Family Handbook, have a personal interview with the Director, and receive a packet of registration forms which must be completed before the child begins the program. A

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registration fee of $45 (maximum of $60 per family), along with one week of tuition is payable when a child is enrolled. This fee is non-refundable. Upon enrollment, your family will have an intake meeting with your child’s teacher. At this time the teacher will discuss with you the specific needs and interests of your child, and you will get an orientation to your child’s classroom.

Classes are filled on a first-come/first-served basis according to the date of enrollment with the Director. If classes are filled when a parent calls, the child’s name will be placed on a waiting list to fill as vacancies occur.

Children with special needs will be enrolled if, after consultation with parents and professionals in the specified area(s) of need, it is determined that our program can meet the need(s) of the child. Outside consultants and referrals are utilized within our programs when indicated and when it will enhance the experience of an enrolled child and improve upon the ability of our staff to provide a successful experience.

The Center requires the following forms to be complete at time of enrollment:- Enrollment Form- Permission for Emergency Medical Care- Financial Agreement Form- Immunization Record (documentation of current immunizations according to MN Statutes; a signed notarized statement of parental objection to the immunization; or a medical exemption). Immunization records must be updated whenever your child receives additional immunizations.- Health Care Summary (For children already admitted to the Center, NCFC must obtain an updated report of physical examination signed by the child’s health care provider at least annually for all children under 24 months of age, and whenever a child 24 months or older advances to an older age category.- Photo Permission- Directory Permission

These forms must be provided before the first day the child attends. Parents are responsible for keeping the center staff informed of changes on these forms, such as work phone numbers, email addresses, special needs, allergies, health history, immunization updates, etc.

Registration Fee$45.00 non-refundable ($60.00 maximum per family)

Toddler Program3 Full Days per week $210/week 5 Full Days per week $285/week

Preschool 3 Full Days per week $195/week 5 Full Days per week $255/week

Preschool Half Day Mornings (9:15-12:30 am, Tuesday-Thursday) 3 Mornings per week $225 / month

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Lunch Bunch $40/month

School-Age Child Care ProgramBefore School Component (7:00-8:45 am) $11.00/dayAfter School Component (3:30-6:00 pm) $11/dayRelease Days and Summer $41/day

Nativity Child and Family Center is a nonprofit organization which operates solely from the tuition fees that are paid for each child. Therefore, it is essential that your fees be paid promptly and regularly.

LATE PAYMENT FEETuition is due on the first day of care for that week (first day of the month for Morning Preschool). A late charge of $5.00 per day will be added to each payment that is received after the due date. After two consecutive late payments, you will be required to enroll in our automatic withdrawal program where funds will be directly withdrawn from your bank account and credited to your tuition account. Failure to make payment may result in a forfeit of your space.

LATE PICK-UP FEEA late fee of $10 plus $1.00 per minute per child will be charged for parents picking up their child after 6:00 pm, or after 11:30 am for morning preschool. The late pick-up fee will be added to your statement.

NSF CHECKS OR TRANSACTIONSThe center will charge a $20.00 handling fee for the processing of any check or ACH returned due to insufficient funds. Upon receipt of the second NSF check or returned ACH, all future tuition payments must be paid by cashier's check or money order.

MULTIPLE CHILD DISCOUNTFor families who have more than one child enrolled for five days per week, the discount is 10% of the total tuition fee of the oldest child only. Discount applies to school-age children during the summer only.

CHILDREN ENROLLED PART-TIMEA part-time (less than 5 days) enrolled child’s day of attendance may not be switched. If a parent wishes to add an additional day, they must pay for the days committed, plus the additional day they have requested and must be approved by the office ahead of time.

CHANGE IN ENROLLMENT OR WITHDRAWALBoth parties must be given two weeks written notice for termination or change in schedule, or one month written notice if enrolled in the morning preschool program. The goal of Nativity Child and Family Center is to foster and provide for each child's well-being. However, it may be necessary to ask parents to find alternative care for your child(ren) if it is determined that the center is not able to meet the needs of your child. Nativity Child and Family Center seeks to provide a program designed to support children’s growth and to learn as individuals with unique ways of responding to the world. It is on rare occasion that a child’s behavior may warrant the need to find a more suitable setting for care. Examples include:

A child appears to be a danger to him/herself, other children attending the Center, Center employees or anyone else at the Center:

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Medical, psychological or social service personnel determine that the continued care at the Center could be harmful to or not in the best interest of the child.

Any other situation in which the child’s success and participation place an undue burden on Center resources and finances and removal is in the best interest of the child or the Center.

At any time that a child’s behavior becomes a concern to a teacher or administrator; written documentation and family/teacher communication will begin as the first steps to understanding the problem. CHILDCARE LEAVEA $45.00 deposit is required to reserve an enrolled child’s placement at the Center for parents wishing to keep the enrolled child home during a childcare leave related to the birth of another child. The deposit will be credited to tuition upon return. In addition, parents on said childcare leave will not be charged for the first two weeks of that leave.

ILLNESS, HOLIDAY OR VACATIONAll fees must be paid for the days your child is registered to attend. If your child is absent, the fees are still due in full. We cannot refund or credit tuition.

METHOD OF PAYMENTTuition is due on the first day of care for that week (first day of the month for Morning Preschool) . The Center’s preferred method of payment is automatic withdrawal which can be drafted from either your bank or a credit card. You may also pay online at www.tuitionexpress.com, or by check.

PROGRAMMING

AGES SERVEDNativity Child and Family Center offers the following programs. Each classroom is assigned a teaching team who has primary responsibility for working with that group of children:

1. Toddler Care Program: This program serves children from 16 to 33 months. The teacher to child ratio is 1:7, with a maximum capacity of 16. Care is offered on a full-time and part-time basis (minimum of three days.

2. Preschool Child Care Program: This program serves children from age 33 months until the start of kindergarten. The teacher to child ratio for preschool is 1:10 with a maximum group size of 20. Care is offered on a full-time and part-time basis (minimum of three days).

3. School-Age Child Care Program: This program is designed for extended care of school-age children before and after school and full days when school is not in session, including a full day summer program. The ratio for school-age children is 1:15 with a maximum group size of 75. Care is offered on a full-time and part-time basis (minimum of three days in the summer).4. Family Ministry: Our goal is to support and nurture families. Nativity Lutheran Church’s

Family Ministry Team offers many opportunities for families to come together, learn, and havefun.

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5. Creative Arts Classes: Music enrichment classes are available for an additional fee. Enrollment forms and information regarding Creative Arts Classes are available in the Center’s office.

DAILY SCHEDULEToddler and Preschool: We strive to provide the best possible Christian environment for the growth and development of children. Experiences will include large and small group activities, child choice, rest time, snacks, indoor and outdoor large muscle time, creative play, art and music, social and dramatic play, literature and pre-math activities.

Theme-based curriculum is carried out though learning centers to emphasize and facilitate learning. All activities add, in some way, to the spiritual life of the children. Lessons are designed to help the children understand God’s love for all people as well as helping children to see themselves as God’s children. They learn to respond to God’s love by caring for others.

Before and After-School Components: The staff prepare the environment and provide suggestions for possible activities from which the children can choose. Choices include: Outdoor play, drama, music, arts and crafts, science, food experiences, and team sports. The schedule allows for great flexibility in activities and experiences. School-age children are allowed to select their own activities, fostering initiative and effective decision making.

CURRICULLUM

Nativity Child and Family Center implements The Creative Curriculum. At NCFC we recognize that children are capable learners and have many ways to express their understanding of the world around them. The curriculum is dependent on strong relationships and respect between the teachers, parents and children. The curriculum is reflective of the children, their families, cultures, home languages, and our community.

On-going assessments of each child’s ability, developmental stages, and learning styles are factored into curriculum planning, learning journeys, interest areas, and classroom environment. Individualized learning and small group activities are implemented with the emergent framework to ensure the curriculum is aligned with the assessment of child progress.

The curriculum is derived from families’, children’s and/or teachers’ interest. Teachers observe children at play to determine evolving interests. An interest is then shared with the children. During large or small group meetings the children are given an opportunity to share what they know about the topic, or believe to be true, and what questions they may have. Teachers of younger age children are observant and base assumption on children’s actions.

Based on this information, teachers make appropriate preparations and develop activities and projects to enhance learning. The teacher helps sustain the children in their exploration and extend the interest into classroom learning centers, introduce project work, and bring in related items, books and materials into the classroom. The curriculum emerges in the process of each activity and/or project and is adjusted accordingly through this continuous dialogue among teachers and children. Teachers become co-learners and researchers along with the children.

Nativity Child and Family Center has developed tools to assist teachers in their preparations. The quality of the curriculum is determined by teachers’ intentionality in planning. Teachers should provide a variety of ways for the children to share what they are learning through use of art mediums, drama,

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storytelling, music and movement. Teachers continually assess children’s progress, curriculum goals, and the children’s interest level. The journey may be altered or change paths in the process. Teachers actively engage parents to assist in enhancing and personalizing the curriculum and the classroom environment.

We believe in documentation as a way to make learning journeys visible to parents, children, co-workers, and our community. Good documentation shows that children learn through exploration and play. Documentation is a key component of our curriculum and philosophy and is reflective of the children in the classroom. Documentation can take many forms including hypothesis; explanation of activities or learning components; pictures; documentation boards; displaying children’s work or products; webbing; recording dialogue; displaying quotes; creating graphs, books and videos. Documentation is

revisited with the children to deepen their understanding of the topic and to celebrate the learning journey.

Teachers are allocated weekly programming time out of the classroom to research and plan the curriculum. Center management reviews the curriculum weekly.

ASSESSMENT

All children must receive a developmental screening within three months of enrollment by their health care provider including screening of the children’s health status and their sensory, language, cognitive, gross motor, fine motor, and social-emotional development.

Nativity Child and Family Center uses the Teaching Strategies GOLD Assessment System. We assess children using authentic measures including observation, work sampling, and parental anecdotes. Our program goals include on-going assessments as an integral part of our program, necessary to ensure the best outcomes for each child, and essential in directing our curriculum. By using on-going authentic measures in a setting familiar to the child, we are able to ensure that assessments are meaningful and accurate.

The purpose of assessments includes describing the developmental progress and learning of children; identifying children’s’ interest and needs; improving curriculum by ensuring it is relevant; adapting teaching practices; making changes to the environment; and planning program improvement. Assessments obtain information on all areas of development and learning, including cognitive skills; language; social-emotional development; approaches to learning; and health and physical development, including self-help skills.

Teachers have programming time weekly to interpret and use assessment results to align curriculum and teaching practices to the interest and needs of the children.

Parental input is an important part of our assessment process and we encourage parents to share milestones, new skills, goals and concerns with their child’s teacher. Teachers should work to achieve consensus with families about assessment methods that will best meet their child’s needs. Assessment methods must be sensitive to and informed by family culture, experiences, children’s abilities and disabilities, and home language. Assessments will be discussed at biannual parent/teacher conferences. Teachers’ communication with families about their child’s assessments must be sensitive to families’

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values, culture, identity, and home language. Assessments are confidential and will be maintained in the center office in a locked cabinet. Our licensing authority and accreditation representative may ask for access to these files for the purpose of completing reviews of the center’s standards and practices.

Assessment information is shared during bi-annual conferences, daily notes, individual portfolios, documentation, daily conversations and email. In addition to bi-annual conferences, parents and/or teachers may request a conference at any time. When teachers have concerns regarding a child’s development, they should discuss the concern with the Director. The concern will be communicated to families in a sensitive, supportive, and confidential manner. The teacher will provide documentation and explanation for the concern. The teachers and/or administrative team will offer suggested next steps, and information about resources for assessment.

When indicated, the administrative team will help arrange for developmental screening and referral for diagnostic assessment. Program staff will encourage and support families to make the primary decisions about services that their child needs and will encourage families to advocate for needed services.

For more information on Teaching Strategies GOLD, visit www.teachingstrategies/GOLD.

PARENT TEACHER CONFERENCES

You are a crucial partner in your child’s development. Conferences with parents are encouraged at any time during the year, but are scheduled for all children in the fall and spring. At this time, we encourage discussion regarding your child’s intellectual, physical, social, emotional, and spiritual development, as well as setting goals for your child for the upcoming months. You will receive a copy of this information and a copy will be placed in your child’s confidential file.

TRANSITIONING TO A NEW AGE GROUPWhen a child is ready to transition to a new group, the parent will receive a Transition Packet. At this time we will also ask you to update your child’s information, including a new Health Care Summary and Immunization Report. The child will visit their new classroom over a week period, increasing the length of the visit as the child adjusts and becomes more comfortable. Parents will have the opportunity to drop-off and pick-up in the new classroom prior to the formal move up date. We always look forward to discussing your child's transition with you and welcome any questions you may have. Children transition to new rooms throughout the year; we make these transitions when children are developmentally ready and as space allows.

EARLY CHILDHOOD SCREENINGScreening is an early look at a child’s development. The screening can be completed at least one year prior to a child entering Kindergarten, ideally near a child’s third birthday. The screening is required by the state of Minnesota for kindergarten entry into public school. This service is offered at no cost.

ContactsFor families living in St. Anthony/New Brighton School Districts: 612-706-1166

For families living in the Mounds View School District: 651-621-7420

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For families living in Minneapolis School Districts: 612-668-3715

FAMILY MINISTRYThese programs are provided by Nativity Lutheran Church in cooperation with Nativity Child and Family Center.

Parent Resources: Together with Nativity Child and Family Center staff, the Nativity Family Ministry Team will serve as a resource for parent’s concerns about any area of their child’s development.

For more information about these opportunities, call Tori at 612-781-2766 (ext. 1013).

Worship Services: If you do not have a church home and would like to attend worship, services at Nativity Lutheran Church are held on Saturdays at 5:30 pm and Sundays at 8:00 am, 9:00 am, and 10:30 am. For more information about Nativity you are welcome to call (612)781-2766 or go to www.nativitychurch.org.

Sunday School: Faith Formation classes are held at 5:30 pm on Saturday nights and 9:00 and 10:30 am on Sunday mornings. You are welcome to visit. For more information, call (612) 781-2766.

FOODGENERAL INFORMATIONWe participate in the USDA Food Program (CACFP) and all menus are approved by the program for nutritional values. Menus are posted on our website and are also available by hard copy. The Center provides breakfast, lunch and an afternoon snack. Teachers and children sit together at the table and eat family style. We have a full-time cook on staff who attends regular food program meetings and stays up-to-date on program requirements. We have safe food handling procedures posted in the kitchen and staff are trained annually on following these procedures. The kitchen is licensed by the Minnesota Department of Health. Food program forms are required for all children at the Center annually. The USDA National Director can be reached at (202) 720-5964. Safe drinking water is always available to children.

FOOD FROM HOMEIt is the parent/guardian’s responsibility to alert the Center of food allergies and/or special dietary needs. A list of children with food allergies and special dietary needs is kept in the kitchen and the classroom. A special diet statement signed by a Minnesota licensed physician will be required before a child with a disability who is requesting a special dietary accommodation will be served. We are a peanut and tree nut aware Center, but we do not guarantee that all of our foods are peanut or tree nut free. Food brought from home to share with other children (i.e., for special occasions), must be commercially prepared and packaged, and may not contain peanuts or tree nuts. Please check label carefully before purchasing.

POLICIES AND PROCEDURES

CENTER EMERGENCY CLOSINGS Inclement Weather: NCFC will be closed any time the St. Anthony ISD 282 is closed due to weather. If the St. Anthony ISD 282 is delayed or has an early release due to weather, Nativity Child and Family

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Center will maintain its regular operating hours. All closings will be announced on WCCO or KARE 11 and will also be listed on the school closing web-site of each station.Utility Failure: In the event of a power failure, the Center Director will contact the utility company to obtain information. In most cases, the Center would remain open. If it is determined that the failure is cause for closure, parents will be notified to pick up their children and the Center will close.

Other Emergency: In the event of another emergency (natural disaster or emergency evacuation ordered by police), Nativity Child and Family Center will evacuate to the St. Anthony Community Center, or to a site designated by the police department. Parents will be notified and given evacuation information.

CONFIDENTIALITYYour child’s records are considered confidential and will only be shared with our licensor, state agent or accrediting body. Your child’s records can be shared with other outside resources with written request from a parent or guardian.

ARRIVAL AND DEPARTURENativity Child and Family Center's responsibility begins once your child has been signed in by the adult responsible for care. Parents are required to sign their child in and out on a daily basis utilizing the Sign In/Out Computer and their Personal Identification Number (PIN). Under no circumstances should your child find her/his own way into the Center or sign themselves in. Please advise the teachers in writing if someone new is picking up your child. Children will be released only to the person(s) listed on the enrollment form unless the center is notified otherwise. A picture ID is required for any person picking up a child. We cannot authorize pick up to anyone that is not listed on the emergency card and will call authorities if an unauthorized person does attempt to pick up your child. If you are planning to drop off or pick up your child at a time other than the usual arrival or departure time, please call the Center. When picking up your child, please sign your child out and be sure the teacher knows you are leaving.

UNAUTHORIZED PICK-UPIf there is a parent or other person who cannot legally pick up your child, you must provide a copy of the legal document (Custody Decree or Order of Protection).

GRIEVANCE PROCEDUREPlease contact the Director or Assistant Director if you have any issues or concerns. The administration will first listen to the parents/guardians, and then follow up with program staff. The administration will try to arrange a meeting with all parties to resolve issues. In some cases, the administration may contact licensing, or other outside resources for help in resolving the matter. For concerns regarding administration, or for matters that cannot be resolved with administration, please contact Dan Doerrer at 612-781-2766. We strive to offer high quality services to both children and families at the Center, and we appreciate all feedback from families.

BABYSITIINGNCFC staff may “babysit” for NCFC families as long as both parties understand that Nativity Child and Family Center bears no legal or professional responsibility for independent arrangements. Babysitting must not interfere with the employee’s job responsibilities at Nativity Child and Family Center and babysitting arrangements may not be made during an employee’s work hours.

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MINNESOTA CLEAN AIR ACTNativity Child and Family Center is a smoke free environment. This includes vapor cigarettes. Smoking is permitted off the premises only.

PROHIBITED SUBSTANCESThe Center bans the use of prohibited substances on any part of its grounds.

DRUG AND ALCOHOL USEThe Center prohibits employees and volunteers with child contact from abusing prescription medication, being under the influence of a controlled substance or alcohol or in any other manner that impairs or could impair the person’s ability to provide care or services. If the Center has reasonable cause to suspect that any person picking up a child is under the influence, or is physically or emotionally impaired in any way and may endanger your child, we will offer to call a cab, other parent, or authorized person to come for the child. If the intoxicated adult is uncooperative and is driving a vehicle, we will alert the police. We will request that another emergency contact be notified to pick up the child.

FIREARMSNativity Child and Family Center prohibits the use, possession, and storage of weapons on its premises. This rule applies to all employees, enrollees and visitors. Weapons include firearms, ammunition, knives, or similar dangerous items, even if lawful. These prohibitions apply even to those who are qualified to carry handguns under Minnesota law.PHOTOSPictures of children will not be used without parents’ written permission. A permission form is included in the enrollment packet. Children’s names will not accompany pictures. REST TIMEChild care regulations state that children in a child care program need rest and quiet as part of their daily routine. Rest time allows each child some time alone. Toddler and Preschool children will be provided with a cot. Each child should bring a blanket (a small pillow is optional). Items should be clearly marked with the child’s name. Blankets and pillow cases should be taken home weekly to be laundered. Sleeping arrangements will be made so no child is deprived of needed sleep. All children who are still asleep at the end of rest time will be awakened. Cots will be arranged so there is easy access to each child and accessibility of exits is maintained.

Preschool children who no longer nap will be provided with a half hour quiet rest period. The remainder of time will include individual quiet activities such as reading, puzzles, etc.

On release days and during the summer the children in grades 1 - 6 will be provided with a quiet activity/reading time after lunch.DRESS AND BELONGINGSBe sure your child is dressed appropriately for the day. The children play hard and need durable clothes. Your child should come to the Center with appropriate outside clothing (coat, boots, mittens, etc.), as we will be spending time outside each day, weather permitting. Children's clothing and personal belongings should be marked clearly to lessen the chance that the items will be lost. Each child will need to have at least one spare set of clothes (shirt, pants, underwear, socks, etc.). Each child will have an assigned cubicle for their personal belongings.

SUPERVISION

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Staff are responsible for the protection of the health and safety of every person who enters the Center’s premises. Nativity Child and Family Center takes very seriously the safety and well-being of children, families, staff and visitors to the Center. All children are required to be under supervision of a qualified staff at all times while in care at the Center.

ANIMALSParents will be informed of pets in the Center at the time of admission. Center staff will care for pets following proper sanitation procedures. All pets will be licensed and vaccinated following local health department requirements. During in house or offsite fieldtrips, guest educations may occasionally have animals for the children to see or touch. Also, children may encounter animals while on walks in the community. Safety precautions will be taken to make sure the children are not harmed.

SCHOOL-AGE BUS STOPSchool-age children who attend the before school component will board the school bus at the Center entrance in the west parking lot. A staff member will be at the bus stop to help the children on and off the bus. If your child is scheduled to attend the after school program and does not get off of the bus, a staff member will contact you to verify that your child is accounted for.

SCHOOL-AGE RELEASE DAYSParents of school-agers will receive a release day form to complete for any care needed when elementary school is recessed. A copy of the form will be returned to the parents for reference.

On days the elementary schools are recessed, the staff will plan a full day of activities. The children play a central role in determining the activities and experiences offered and in which they participate. These days may lend themselves to field trips. The trips are diverse in nature, and are one way of helping the children become involved in and aware of the community at large. There is an extra fee for field trips.

SCHOOL-AGE SUMMER PROGRAMNativity Child and Family Center offers a full summer program for school-age children. Parents will receive a preliminary care form in February to indicate needs for the summer. Some of the special activities offered during the summer are:

Community Service Projects Library Trips Open swim at the St. Anthony High School Pool Baseball, croquet, soccer, kickball, basketball, etc. Bowling Special crafts and cooking projects Picnic lunches One Field Trip each week

GUIDANCE AND SOCIALIZATIONGoals Consistently emphasize basic respect for each child and maintain a safe environment for both

children and staff.

Assist children to be self-regulating with themselves and others

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Assist children in developing self-control and coping strategies

Help children balance their needs and wants with those of others

Help children learn new problem solving skills, including conflict resolutions

Assist children in learning to use equipment, materials and other resources in caring and

appropriate ways.

Methods of Guidance Strive to build individual relationships with each child; make individualized adaptations in teaching

strategies, learning environments, and curricula; and consult with the family so that each child

benefits from the program.

Plan for appropriate behavior through the environment by arranging furniture and other materials

to encourage active learning and independence;

Plan daily scheduling that prevents boredom, waiting, hurriedness, with time to relax and enjoy

activities;

A daily routine with ample opportunity for children to select activities and move between them at

their own pace and one that gives children ample notice of transitions ahead of time;

Provide children with expectations that are clear, age-appropriate and applied in a consistent way.

Allow children to participate in the establishment of rules, policies and procedures where

appropriate and feasible;

Reinforce positive behavior by recognizing children’s positive actions;

Adults model appropriate behavior by being consistent with what the program’s expectations for

children;

Redirect children toward positive activities by interrupting a child’s negative behavior and steering

the child toward an acceptable substitute activity;

Teach children new skills and encourage them to discuss and resolve their conflicts on their own or

with the adult’s assistance when necessary rather than imposing an adult’s solution on them.

Encourage children to express their feelings in words and to resolve problems peacefully;

Ignore simple inappropriate negative behavior that is unpleasant;

Behavior Problems and Family Concerns

Employ a team approach including the child’s family, teachers, director and health care

provider;

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Work in close partnership with parents to address children’s difficulties at home and at the

program. Develop shared understanding to encourage consistency between home and child care;

Observe and document children’s behavior and the staff response to the behavior;

Meet with parents to develop a plan to address the behavior documented, keep them informed of

their children’s behaviors and document parent discussions;

Assess specialized support services if a child’s behavior continues to be harmful to themselves or

others. With written parental permission, we will refer the family for mental health counseling or

other specialized services that can help address the child’s behavior problems. If after such efforts have been exhausted, the current placement does not meet a child’s needs, or the child is seriously jeopardizing the ability of other children to benefit from the program, we shall collaborate with the child’s family and appropriate specialists to determine the additional services needed and/or the placement option(s) most likely to ensure the child’s success.

Prohibited Actions

The following actions are prohibited by or at the direction of a staff person; rough handling, shoving, hair pulling, ear pulling, shaking, slapping, kicking, biting, pinching, hitting or spanking. Subjection of a child by a staff person including, but not limited to; name calling, ostracism, shaming, making derogatory remarks about a child or the child’s family, or using language that threatens, humiliates, or frightens a child is also strictly prohibited. Punishment for lapses in toileting, withholding of food, light, warmth, clothing or medical care, or use of mechanical restraints, such as tying are prohibited.

WEATHERWe will not go outdoors if the wind chill is at 0 or below or the heat index is 100 or above.

TRANSPORTATIONThere is no transportation provided for regular attendance for children while enrolled in our program other than to Wilshire Park and St. Charles for those enrolled in our school-age program. Nativity Child and Family Center Staff cannot transport children to or from the Center. If your child were to miss bus transportation, you would be contacted to drive your child to school.

When planned activities at our program (i.e., field trips) require transportation, the methods used will be in accordance with the Department of Human Services regulations and Minnesota law. The Center utilizes a school bus, contracted with a bus company, for all field trip transportation needs. FIELD TRIPSParents will be informed of a field trip prior to the event. State law requires that parents sign a permission slip before each field trip is taken. Transportation arrangements will be made and indicated on the field trip information sheet (i.e. bus, walk, van). There will be an extra fee charged for the field trips. Parents are welcome to accompany their children on any field trip. Parents who do not desire their

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child to participate in a field trip will need to find alternate care for their child. A CPR and First Aid trained staff person will be on all field trips. Children are accounted for after each transition on and off of the bus. Central Park and Water Tower Park are considered secondary play areas and may be used daily without specific notification.

GRIEVANCE PROCEDURESIf you have a grievance, action should be initiated immediately, as we want to resolve the problem as quickly as possible. We have a procedure to handle grievances and you are encouraged to use it:

If your Grievance is related to teacher-child interactions:1. Within five (5) working days of the grievance, discuss the grievance with your child’s teacher.

2. If you are not satisfied after talking with your child’s teacher, within five (5) working days discuss the concern with the Director. The Director will respond within 10 working days.

3. If the grievance is not resolved within the time prescribed, you may submit your grievance to the Center’s Board of Directors. The Board will review your grievance and determine whether a meeting is necessary. Such meeting will normally take place within seven (7) working days after receipt of the grievance. Within 15 working days of meeting or receipt, the Board will issue a written response.

If your grievance is related to Center policies:1. Discuss the grievance with the Director.

2. If the issue is not resolved within 10 working days, you may submit your grievance to the Board of Directors. The Board will review your grievance and determine whether a meeting is necessary. Such a meeting will normally take place within seven working days after receipt of the grievance. Within 15 working days of meeting or receipt the Board will issue a written response.

DATA PRIVACYThe information requested on our Admission form is useful and important for us to be able to serve your child. Certain information, such as emergency and health information, is required by the Minnesota Department of Human Services for licensed programs to have on file in order to serve a child. Other requested information is desirable for our program to best serve your child but may not be legally required. If you fail to provide required emergency and/or health information we will not be able to serve your child. You may refuse to provide other information not required by law and the Director will make a determination if your omission of information will prevent us from serving your child.

Your personal will be kept in confidence in a locked cabinet in the office and made available only to staff who work with your child and staff who are involved in billing. In addition, if your services are subsidized, fully or in part, we are required to allow the funding source access to your records if requested. Also, access to our records may be requested by the Minnesota Department of Human Services or Accrediting Body to assure our compliance with licensing requirements.RESEARCHBefore any research, experimental procedures, and/or public relations activity, parents will be notified of the procedure and written parental permission will be required.

MANDATED REPORTING POLICY

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FOR PROGRAMS PROVIDING SERVICES TO CHILDREN

Who Should Report Child Abuse and Neglect Any person may voluntarily report abuse or neglect. If you work with children in a licensed facility, you are legally required or mandated to report

and cannot shift the responsibility of reporting to your supervisor or to anyone else at your licensed facility.

If you know or have reason to believe a child is being or has been neglected or physically or sexually abused within the preceding three years, you must immediately (within 24 hours) make a report to an outside agency.

Where to Report If you know or suspect that a child is in immediate danger, call 9-1-1. All reports concerning suspected abuse or neglect of children occurring in a licensed facility

should be made to the Department of Human Services, Licensing Division’s Maltreatment Intake line at (651) 297-4123.

Reports concerning suspected abuse or neglect of children occurring within a family or in community should be made to Hennepin County Child Protection at (612) 348-3552 or local law enforcement at (612) 789-5015.

If your report does not involve possible abuse or neglect, but does involve possible violations of Minnesota Statutes or Rules that govern childcare facilities, you should call the Department of Human Services, Licensing Division at (651) 296-3971.

What to Report Definitions of maltreatment are contained in the Reporting of Maltreatment of Minors Act

(Minnesota Statutes, section 626.556). A report to any of the above agencies should contain enough information to identify the child

involved, any persons responsible for the abuse or neglect (if known), and the nature and extent of the maltreatment and/or possible licensing violations. For reports concerning suspected abuse or neglect occurring within a licensed facility, the report should include any actions taken by the facility in response to the incident.

An oral report of suspected abuse or neglect made to one of the above agencies by a mandated reporter must be followed by a written report to the same agency within 72 hours, exclusive of weekends and holidays.

Retaliation ProhibitedAn employer of any mandated reporter shall not retaliate against the mandated reporter for reports made in good faith or against a child with respect to whom the report is made. The Reporting of Maltreatment of Minors Act contains specific provisions regarding civil actions that can be initiated by mandated reporters who believe that retaliation has occurred.

Failure to ReportA mandated reporter who knows or has reason to believe a child is or has been neglected or physically or sexually abused, and fails to report, is guilty of a misdemeanor. In addition, a mandated reporter who fails to report maltreatment that is found to be serious or recurring maltreatment may be disqualified from employment in positions involving direct contact with

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persons receiving services from programs licensed by the Department of Human Services and by the Minnesota Department of Health, and unlicensed Personal Care Provider Organizations.

Internal ReviewWhen the facility has reason to know that an internal or external report of alleged or suspected maltreatment has been made, the facility must complete an internal review and take corrective action, if necessary, to protect the health and safety of children in care. The internal review must include an evaluation of whether:

1) Related policies and procedures were followed;2) The policies and procedures were adequate;3) There is a need for additional staff training;4) The reported event is similar to past events with the children or the services involved; and5) There is a need for corrective action by the license holder to protect the health and safety of

children in care.

Primary and Secondary Person or Position to Ensure Internal Reviews are CompletedThe internal review will be completed by the Executive Director. If this individual is involved in the alleged or suspected maltreatment, the Assistant Director will be responsible for completing the internal review.

Documentation of the Internal ReviewThe facility must document completion of the internal review and provide documentation of the review to the commissioner upon the commissioner’s request.

Corrective Action PlanBased on the results of the internal review, the license holder must develop, document, and implement a corrective action plan designed to correct current lapses and prevent future lapses in performance by individuals or the license holder, if any.

Staff TrainingThe license holder must provide training to all staff related to the mandated reporting responsibilities as specified in the Reporting of Maltreatment of Minors Act (Minnesota Statures, section 626.556). The license holder must document the provision of this training in individual personnel records, monitor implementation by staff, and ensure that the policy is readily accessible to staff, as specified under Minnesota Statutes, section 245A.04, subdivision 14.

FAMILIES IN THE PROGRAM

PARENT VOLUNTEERSWe welcome and encourage parent (or legal guardian) volunteers in our classrooms. Please watch for posted volunteer opportunities or talk to your child’s teacher about sharing a special interest or skill, a special family tradition, vacation, or activity. Grandparents are also welcome.PARENT INVOLOVEMENT AND COMMUNICATIONThe most effective learning situation for young children involves cooperation and involvement of home and school. We value each family’s values and beliefs, and will do our best to support your child and family. We are eager to support, encourage and assist families with their parenting challenges.

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Likewise, we hope parents will be eager to support, encourage and assist teachers with their teaching challenges. Parents are welcome to visit any time the program is in operation. Parents are also invited to attend a variety of programs, assist on field trips, or serve as a classroom volunteer and/or resource person.

Parents will be informed of the Center's plan through posted weekly lesson plans, monthly newsletters, and posted information on the parent bulletin board. Each child is provided a mailbox. Please check this mailbox regularly. Parents may review the Center's Child Care Program Plan by requesting a copy of the plan from the Director. Your involvement and satisfaction are vital pieces to the partnership between your family and the Center. Translator services will be provided upon request.

HEALTH AND SAFETY

SPECIAL DIETS/MEDICAL/DEVELOPMENTAL CONCERNSParents have a responsibility to inform the Center when their child has any special medical condition, needs, or allergies so that we can provide for appropriate care and support. We are a nut-aware Center, and make every effort to prevent peanuts and tree nuts from entering the center. When a child has a known medical or development concern or other condition that might require special care in an emergency (i.e. allergy, chronic condition, asthma, seizures, etc.) an Individual Child Care Plan will be written and followed.

Dietary modifications because of special dietary needs shall be made under the direction of the child’s trained health care provider. Written permission from the child’s parent or legal guardian and the child’s health care provider is required before the Center can make any dietary modifications.

MEDICATIONSAll prescription medication must be in its original container, with a legible label from the pharmacy indicating the child’s name, date, name of medication, dosage, instructions for use, doctor’s/nurse practitioners’ name, pharmacy name and telephone number. Medications will be stored in a container that is inaccessible to the children. Medications are to be given only to the child indicated on the label. A separate authorization is required for each medication and each episode of illness. Please give as many doses as possible at home. Parent must sign a Prescription Medication Authorization/Administration Form available in your child’s classroom or in the office. All non-prescription medication must be in its original container, labeled with the child’s first and last name. Medications are to be given only to the child indicated on the container. Exact directions will be followed in accordance to the manufacturer’s instructions on the container unless accompanied by a physician’s/nurse practitioner’s authorization is required. A separate authorization is requested for each medication and each episode. Parent must sign a Non-Prescription Medication Authorization/Administration Form available in your child’s classroom or in the office. Medication will be given as needed by a teacher, and documented on the appropriate medication administration form.EXCLUSION OF ILL CHILDThe Department of Human Services requires that we exclude a child with an illness or condition that the Commissioner of Health determines to be contagious and a physician determines has not had sufficient treatment to reduce the health risk to others.

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We will follow the exclusion guidelines listed below which are taken from INFECTIOUS DISEASES IN CHILD CARE SETTINGS: INFORMATION FOR DIRECTORS, CARE GIVERS, AND PARENTS OR GUARDIANS, prepared by Hennepin County Community Health Department, Epidemiology Program. We must exclude a child with any of the following conditions:

Chicken pox Until all the blisters have dried into scabs; usually about 6 days after rash onset.

Conjunctivitis (Pinkeye) Bacterial (with pus): Until 24 hours after treatment begins. (pink or red conjunctiva with white or yellow discharge that causes matting of the eyelids; pain or redness of eyelids).

Diarrhea (Infectious) Until diarrhea has stopped. For some infections, the person must also be treated with antibiotics before returning to child care.

Diarrhea (Uncontrolled) Until uncontrolled diarrhea stops, or until a medical exam indicates that it is not a communicable disease. (Uncontrolled diarrhea is an increased number of stools, compared with a person's normal pattern, along with watery stools, and/or decreased stool form that cannot be contained by the diaper or use of the toilet).

Fever Until a medical exam indicates the child may return. Axillary armpit temperature: 100o F. or higher, before fever-reducing medication is given, when accompanied by behavior changes or other signs or symptoms of illness.

Impetigo Until child has been treated with antibiotics for at least 24 hours.

Lice (head) Until no nits are found.

Rash With or Without Fever or Behavior Change

Until a medical exam indicates these symptoms are not that of a communicable disease (i.e., chickenpox, fifth disease, measles, roseola, rubella, shingles, strep throat).

Respiratory Infections (Viral)

Until child is without fever for 24 hours and is well enough to participate in normal activities. No exclusion for other mild respiratory infections without fever as long as child can participate comfortably.

Ringworm (skin & scalp) Until 24 hours after treatment has been started.

Scabies Until 24 hours after treatment has been started.

Signs/Symptoms of Possible Severe Illness

Until a medical exam indicates the child may return (Unusually tired, uncontrolled coughing, irritability, persistent crying, difficult breathing, wheezing).

Streptococcal Sore Throat

Until 24 hours after treatment begins and child is without fever for 24 hours.

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Vomiting Until vomiting stops (vomiting is defined as two or more episodes in the previous 24 hours).

We must exclude a child with any of the following conditions: A child Who is not able to participate in child care program activities with reasonable comfort, including outdoor play, Who requires more care than staff can provide without compromising the health and safety of other children in care, When a child in our care has been medically diagnosed with a communicable disease. We will notify the appropriate

health authorities and follow their recommendations to provide information to parents of all exposed children. The child care program will notify the parents of exposed children on the same day or within 24 hours by a written notice that will be posted at the Center.

Parents are required by State law and our Center policies to inform the Center within 24 hours, exclusive of weekends/ holidays, if their child is diagnosed with a communicable disease. The center will post any communicable disease that is reported, so that parents are aware of it.

HEALTH CONSULTATION SERVICESOur program receives health consultation services from Barb Stoll, R.N., Health Consultants for Child Care. The phone number is 952- 472-3915. Health Consultants for Child Care reviews Center practices and child health records quarterly.

EMERGENCY CARE PROCEDURESAll staff are required to have First, Aid, CPR, and Shaken Abusive Head Trauma training. In the event of any injury or illness, appropriate first aid will be administered by trained staff and an Accident Report will be completed. If staff decides this is an emergency situation, 911 will be contacted to provide emergency first aid. If necessary, the emergency medical service will transport your child to a medical facility as designated by emergency services. A representative from Nativity Child and Family Center will travel with your child to the designated source of emergency care, or nearest hospital. A parent or alternate listed on the Emergency Card will be contacted as soon as possible. An attempt to contact your child's health care provider may also be made.

DIAPERING AND TOILETINGFamilies will supply diapers, diaper wipes and diaper cream if needed for their child. Disposable diapers are recommended by our Public Health Nurse, however, we can accommodate cloth diapers by following guidelines set forth by our nurse. We follow the Diapering Procedure that has been written by our Public Health Nurse. The procedures are posted in all diaper changing areas. Toilet training guidelines are available upon request. We follow an individualized method following the signs of the child’s readiness. Communication between families and teachers are encouraged to enable the child to be successful and build self-esteem throughout the process.

HANDWASHINGThe Center follows hand washing guidelines set forth by the Public Health Nurse and our accrediting body. Please have your child wash their hands with soap and water upon arrival to the classroom. Hand washing is done throughout the day including, but not limited to, before and after meals, after diaper changes, after handling animals and after coming in from outside.

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SANITATION AND HYGIENEThe Center has a contracted cleaning company that cleans the facility on a daily basis. Staff follow sanitation guidelines for cleaning of equipment set forth by the Public Health Nurse and Accrediting Body Tables and diapering areas are sanitized using a bleach method before and after each use. Major cleaning projects are done on a set schedule set forth by the Center. Hand washing is our number one method of germ fighting, and is done throughout the day by both adults and children.INSECT REPELLANTInsect repellant must be provided by the child’s parents and will be applied only with the permission of the child’s parent. Insect repellant will not be used on children under two months of age. Staff will apply repellant no more than once a day. Only repellants containing DEET may be used. Alternatives to DEET are acceptable when written approval is provided by the individual child’s health care provider. Insect repellants may not be an aerosol.

SUNSCREENWe must have a parent’s written permission to apply sunscreen. Teachers will apply sunscreen prior to children going out in the sun. Sunscreen with an SPF of 30 will be provided for your child at the Center.

EMERGENCY EVACUATIONSWe conduct routine fire drills and tornado drills at the Center. This can cause some anxiety for young children, so teachers talk to the children frequently about these drills. These drills are required by licensing, and we do our best to make them as smooth as possible. Fire emergency plans are posted in all rooms.

AGREEMENT

FAMILY HANDBOOK AGREEMENTI have received a copy of Nativity Child and Family Center’s Family Handbook. I understand and agree that it is my responsibility to read and become familiar with the Policies and Procedures as stated in the

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Center’s Family Handbook. I understand that it is my responsibility to go directly to the Director or Assistant Director with any questions I may have regarding the Policies and Procedures and information contained in this handbook. Information in this handbook may be subject to change.

____________________________________ _______________Signature Date

ENROLLMENT AGREEMENTNativity Child and Family Center’s hours of operation are 7:00 a.m. to 6:00 p.m., Monday through Friday. The center is closed 12 days per calendar year, the center will set these days on an annual basis and supply parents with a copy of the calendar. No credit shall be given on days the center is officially closed.

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A non-refundable registration fee of $45.00 shall be paid upon enrollment. A tuition fee of $___________ is due in advance each week on the first day of attendance with a late fee of $5.00 per day. I hereby agree to notify the center two weeks in advance of withdrawal, should such an event occur, or pay the difference.Nativity Child and Family Center shall provide services for:

___________________________________ __________________Name of Child Birthdate___________________________________ __________________Name of Child Birthdate___________________________________ __________________Name of Child Birthdate

Child’s Hours of Attendance Mon______Tues______Wed______Thurs______Fri______

My signature below indicates that I have read the terms of this agreement.

___________________________ _______________________Parent of Guardian Date

___________________________ ________________________Parent or Guardian Date

___________________________ _______________________Executive Director

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