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Key Kids Account Update/Registration
Please complete the following information to update your account and to REGISTER your child for 2019 Summer Key Kids or 2019-2020 Ater-School Key Kids IF YOU ARE A CURRENT OR RETURNING KEY KIDS FAMILY. If you are a NEW FAMILY, please complete the New Family Registration on the website by clicking on the New Family tab or register at MyProcare.com You will receive an email confirmation once your registration is processed.
Parent/Guardian Name *
Your answer
I have updated my account information at MyProcare.com *
Parent(s) Email Address: *
Your answer
Parent Account Information *
Required
Child's Last Name *
Your answer
Child's First Name; MI *
Your answer
Child's Date of Birth *
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Child's Gender *
Child's School *
Child's Grade in 2019-2020 School Year *
Child lives with: *
Does your child have any allergies? *
Does your child take any medications? *
Does your child have any special needs? *
Does your child have an Individual Education Plan (IEP) *
Complete this question to request special billing arrangements, e.g. split bills, Child Care Assistance, third party billing, etc. Please explain under "other"
I HAVE CHANGES TO MY EMERGENCY CONTACTS AND AUTHORIZED PICK UP PERSONS *
Contact 1: Updated Emergency Contact Information Name
Your answer
Contact 1:Updated Emergency Contact Information Phone
Your answer
Contact 1: Updated Emergency Contact Information Relationship to child
Your answer
Contact 2: Updated Emergency Contact Information Name
Your answer
Contact 2: Updated Emergency Contact Information Phone
Your answer
Contact 2: Updated Emergency Contact Information Relationship to child
Your answer
Key Kids Start Date *
MM
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DD
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YYYY
Key Kids Site *
What days is your child attending care *
Required
Please list any other information that would be helpful to our Key Kids staff.
Your answer
Consent to Enrollment
Emergency/Medical Consent
Billing Information *
Required
Billing Statement Preference *
Fees - I understand that the following fees will be billed to my account as they are incurred for services provided. Note: please review and check all of the appropriate boxes
I have read, understand, and agree to the above contract. *
Required
BEHAVIOR GUIDANCE PLAN & DISMISSAL POLICY (Please review with your child) It is the goal of Key Kids School Age Child Care Program to provide a safe, kind, nurturing, and enriching environment for all children. We will problem solve with each parent and child to address any behavior concerns and develop a common plan to solve each concern. In order to provide quality care, it is important that both parent and child are aware of our behavior guidance plan and dismissal policy. Please refer to the Key Kids Policy Handbook on the website. BEHAVIOR GUIDANCE PLAN: 1st Incident Report – Parents, staff, and child will discuss the behavior at pick up time to resolve the situation. 2nd Incident Report – Parent will be contacted for a meeting with staff and child; a plan will be formed and implemented. A written warning will be given regarding consequences of a third incident. 3rd Incident Report – Parent will be notified that child will need to take a one day leave of absence from the program on the next scheduled day. Written notice will be given for consequences of a fourth incident. 4th Incident Report – Parent will be notified that child will be suspended from care for three days effective immediately. 5th Incident report – Parent will be notified that alternate care will be needed immediately. Child will not be able to return to program. Charges will end with the last date of service. DISMISSAL POLICY For serious behavior concerns, staff may at any time begin the process of completing Behavior Incident Reports. Behavior such as a violent outburst, willfully hurting other children, throwing objects without regard to safety, profane language, leaving room/building/group without notifying staff, verbal or physical abuse toward staff or others, or inappropriate sexual behavior will be considered serious behavior concerns. See parent handbook for details. We understand that our program might not meet every child’s needs. We will do our best to meet everyone’s needs and assure each child is happy, healthy and given quality care *
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