The Opportunity Center @ The Arc of McLennan County Enrollment Agreement
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Date forms completed.

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Participant's Full Name

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What name does participant prefer to be called?    
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Paricipant date of birth *
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Participant sex *
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Prefered Pronouns *
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What days during the week will participant attend?
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Required

First date of attendance?

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How will participant be transported to and from program?

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Approximate arrival time? (Program starts at 10am)
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Does the participant have a phone number? What is it? *
Parent(s)/ Guardian(s)/ Custodian(s) Identification
#1: Name + Relationship to participant *
#1: Address including city, state, zip
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#1: Phone number *
#1: Employer
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#1: Employer Phone
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#1: Employer address including city, state, zip. *
#1 Work hours *
#1 Resides with above?  *
Required
If no, please explain arrangement  *
#2 Name + Relationship to participant *
#2 Address including city, state, zip
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#2 Phone number *
#2 Employer
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#2 Employer phone
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#2 Employer address including city, state, zip *
#2 Work hours *
#2 Resides with above?  *
Required
If no, please explain arrangement  *
Person to be contacted first? *
Required
If someone other than parent/guardian/caregiver #1 or #2 will be picking up, please list information including name and phone number.
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Emergency Contacts
*These should be local persons who may be notified in case of emergency or illness when the parents or other caregivers are not available. *
Emergency contact #1 
Name, Relationship, Address, Phone  
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Emergency contact #2 
Name, Relationship, Address, Phone   
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Emergency contact #3 
Name, Relationship, Address, Phone   
Release
May the participant leave The Program with the persons listed above? 
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Information
If there are any eating problems or food allergies, please list them.
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What types of foods are appropriate for snack?
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What are some of the participants favorite things? *
  How does the participant get along with others?  
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  What forms of discipline are appropriate?   
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  What makes the participant upset?  
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How do you suggest we calm the participant down?  
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Does the participant tire easily?
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If the participant can be aggressive, please explain:  
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If the participant is sensitive to any stimulus we should know about, please explain.
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Please give any further information that you believe will be helpful to staff in understanding and caring for the participant.
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List any sibling(s) + date(s) of birth *
Medical Information
Diagnoses:
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Allergies not already mentioned (food, medication, bees, etc)
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  Chronic or recurrent illnesses or disorders:  
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If medications are taken for illnesses listed above, please state the name of the medication and the dosage.
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If the medication needs to be given during program hours list time and directions for administering.
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List any other medications that The Arc staff may administer to the participant during program hours.

(i.e., Tylenol, Aspirin, etc.)

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What should we (you) do if there is a problem related to participant's medical condition during program hours?   
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What are the signs of problems that may occur?
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Doctor's name + phone 
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Hospital preference *
  Insurance Company  
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  Policy Holder’s I.D.  
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Policy Holder's Date of Birth

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My child may NOT leave with the following people:

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I give consent for my child to be transported and supervised by The Program's employees (please check all that apply): *
Required
I give consent for my child to participate in field trips. *
Required
I give consent for my child to participate in the following water activities (check all that apply): *
Required

Please give any further information that you believe will be helpful to staff in understanding and caring for the participant.

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Medical Consent:

In the event that my child may require medical and/or surgical care while I am out of the city or unable to be reached, I hereby give my consent to medical and/or surgical treatment to above named hospital and physician or his/her designee to provide this care.

I agree to pay all the costs and fees contingent on any emergency medical care and/or treatment for my child as secured or authorized under this consent.

(Name entered below recognized as consent.)

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I agree to adhere to the Policies and Procedures of The Opportunity Center @ The Arc as stated here and give the above participant permission to participate fully in ths program.

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Required

I understand that I am enrolling my child/myself in Opportunity Center @ The Arc being held at 4901 Lakewood Dr., Waco, Texas 76710. Hours of operation are 10:00 a.m. to 3:00 p.m., Monday through Friday, excluding holidays. 

I understand that there is a $25.00 non-refundable registration fee. Arc membership dues are $20.00 per year and must be current or paid with enrollment forms for attendance.

I understand that I am responsible for payment of $25.00 per day or weekly fees in the amount of $125.00. These weekly fees are due the Friday prior to attendance.   

I understand that in the event of any absences during Center hours, I will be responsible for fees for time reserved (no per diem for care), not actual time spent at The Center.

I further understand that I am responsible for notifying The Arc ahead of time when my child WILL NOT be attending The Cetner by calling (254)756-7491. Voicemail is available to leave a message.

I will update personal information as changes occur.

The Center staff will assume full responsibility, as deemed reasonable, for my child/me from the time he/she/I arrive(s) at The Center until my child leaves The Center.

If a medical emergency arises, The Center staff will first attempt to contact parent/guardian as listed on enrollment form. If the emergency is such that immediate hospital attention is necessary, an ambulance or emergency vehicle may transport to the hospital.

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Required

PHYSICAL ASSESSMENT

TO BE COMPLETED BY PHYSICIAN OR HIS/HER DESIGNEE (form must be forwarded to your child's physician for completion)

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Captionless Image
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RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT

This is a release. Read it carefully before signing. By signing this release, you are giving up your and the participant's rights to sue The Arc of McLennan County, a Texas nonprofit corporation, its agents, officers, volunteers, employees and any parties that operate, administer, co-organize or provide transportation to or from the activities described below (collectively, the “Released Parties”) or expect the Released Parties to be legally responsible or pay for any damages or medical expenses if your child is injured or killed, becomes ill or the participant's belongings are damaged as a result of participation in the activities described below.

Voluntary Participation. I acknowledge that the participant, and I have voluntarily chosen to...

(a) participate in THE ARC OF MCLENNAN COUNTY Opportunity Center, a day program administered by the Released Parties, which may include numerous activities, including, but not limited to, sports, hikes, arts and crafts, science experiments, cooking projects, and possibly, field trips to various locations by private car and bus including bowling alleys, sporting events, movies and fairs, any activities incidental thereto and 

(b) be present at or use, as applicable, facilities, other locations, equipment and/or transportation provided by the Released Parties or others in connection with my participation in such activities. (The activities in clauses (a) and (b) are referred to collectively as the “Activity”).

Acknowledgement and Acceptance of Risks. The participant and I understand that certain risks are inherent in the Activity, and that these risks cannot be eliminated, altered or controlled. The participant and I understand that the risks that contribute to the unique character of the Activity can also be the cause of the participant's injury, illness or death or damage to my the participant's belongings. The participant and I voluntarily elect, with knowledge of the risks involved, for the participant to participate in the Activity. The participant and I acknowledge and willingly assume all risks and hazards in the Activity and in the use of the Released Parties’ facilities and/or equipment.

Release. I am the parent or legal guardian of the participant. In consideration for the participant being permitted to participate in the Activity, the participant and I voluntarily agree and promise not to make a claim against, sue or attach the property of the Released Parties, and the participant and I release, waive, discharge and hold harmless the Released Parties for all demands, actions or claims of liability arising out of their negligence, fault, recklessness or any other act or omission that causes the participant illness, injury, death and/or damage to me or the participant property as a result of the participant participation in the Activity and in the use of the Released Parties’ facilities and/or equipment.

Knowing and Voluntary Execution. I have read this document in its entirety. I understand that by signing this document, the participants and I are assuming all the risks of the Activity. I understand that this is a release of any and all claims. I understand that this is the entire agreement between us and the Released Parties and that it cannot be modified or changed in any way by oral statements by any Released Parties or by us. I voluntarily sign my name as evidence of the acceptance by me and the participant of all the provisions in this document and our agreement to be bound by them.

Media Release. I give permission for The Arc of McLennan County to have the participant appear in any media coverage and use for publicity and fundraising purposes photographs of the participant.

(Name entered below recognized as acknowledgement and consent.)

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VIDEO CAMERA POLICY

To ensure the safety and security of our clients, staff and facility, The Arc of McLennan County has been equipped with video cameras in all classrooms and parking lots. To ensure compliance with The Arc policy, cameras will be monitored by the Executive Director, Program Director and Office Manager.

PROCEDURE:

1. Video cameras will not be used in areas of The Arc where clients and staff have a “reasonable expectation of privacy”, i.e. private offices and restrooms.

2. Notice of video cameras will be posted at The Arc facility.

3. The cameras will be constantly on and recording 24/7.

4. In the case of a reported incident, video will be reviewed to better determine the nature of the specific incident.

ACKNOWLEDGEMENT:

I acknowledge The Arc’s video camera policy and am aware that The Arc’s Lakewood facility has video cameras in operation in all classrooms.

(Name entered below recognized as acknowledgement.)

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The Arc of McLennan County

POLICIES AND PROCEDURES

ENROLLMENT IN THE OPPORTUNITY CENTER @ THE ARC CONSTITUTES AN UNDERSTANDING THAT YOU WILL ABIDE BY THE POLICIES LISTED AS FOLLOWS:

SECTION I. PARENT'S EXPECTATIONS OF THE PROGRAM

PARENT/GUARDIAN MAY EXPECT THAT:

1.  The participant is cared for in a safe, supportive environment.

2. They may visit with the Program Director(s) about concerns related to the participant or The Program.

3. They will be told about any misbehavior on the participant's part and to visit with the Program Director and Coordinator to improve the situation.

4. They will be regularly informed by the Program Director about Program activities.

SECTION II. PROGRAM'S EXPECTATIONS OF THE PARENTS/GUARDIANS

THE PROGRAM EXPECTS THAT PARENTS/GUARDIANS WILL:

1. Pay fees on time as explained in the Payment Policy.

2. Keep the participant's records up to date, such as Enrollment Forms and Release Forms.

3. Have participants at The Arc from 10:00 a.m. to 3:00 p.m. for program hours. If the participant is absent, the parent/guardian is responsible to notify by calling 254-756-7491 or 254-224-6956. Voicemail is available.

4. Seven days' written notice is required before withdrawal from the program, and all payments and fees must be current. 

5. Contact the Program Director at 254-756-7491 if the participant will not attend on a scheduled day.

6. Pay attention to any communications from the Program Director regarding the participant's behavior and cooperate to improve the situation.

SECTION III. PARTICIPANT'S EXPECTATIONS OF THE PROGRAM

PARTICIPANT MAY EXPECT:

1. To have a safe, supportive, and consistent environment.

2. To use all The Program equipment, materials, and facilities equally.

3. To receive respectful treatment.

4. To have discipline that is fair and non-punitive.

5. To receive nurturing care from staff members who are actively involved with them.

6. The Program staff is to assume responsibility, as deemed reasonable for the participant from the time they arrive until the time they leave The Program. 

7. If a medical emergency arises, Program staff will first attempt to contact the parent/guardian. If they cannot be reached, the doctor on record will be contacted. If the emergency is such that immediate hospital attention is necessary, and an ambulance or emergency vehicle may be used for transportation to the hospital.

SECTION IV. PROGRAM'S EXPECTATIONS OF THE PARTICIPANT

THE PROGRAM EXPECTS THAT THE PARTICIPANT WILL:

1. Be responsible for their actions.

2. Respect Program rules that guide them while at The Opportunity Center.

3. Remain with the group and staff at all times.

4. Take care of materials and equipment properly and return them to their place when done or before taking out new ones.

SECTION V. FEES AND PAYMENT POLICY

1. $125.00 per week plus a one-time, non-refundable enrollment fee of $25 and a $20 annual membership fee.

2. Tuition payments are due the Friday prior to attendance. Payments can be made for more than one week at a time, i.e., every two weeks, monthly.

3. This Program will be year-round (except for The Arc holidays). LIST HOLIDAYS

SECTION VI. TAX STATEMENTS

The Program does not provide an itemized statement for tax purposes. Please keep a record of your monthly checks as an accurate account of your childcare expenses.

SECTION VII. REGISTRATION AND ENROLLMENT

The Program encourages participants of all backgrounds to attend. The Program does not discriminate based on sex, race, color, creed, national origin, or ethnic background. The purpose of this enrollment policy is to outline the procedure and criteria for admission and enrollment into The Opportunity Center @ The Arc of McLennan County, an adult program to support adults with intellectual and developmental disabilities. 

Eligibility Criteria:

Age: The Opportunity Center accepts individuals with intellectual and developmental disabilities, who have graduated from high school, whether that is 18, 21, or 22 years old, and older.

Intellectual and Developmental Disabilities: Individuals with intellectual and developmental disabilities, including but not limited to autism spectrum disorders, Down syndrome, cerebral palsy, and other cognitive impairments, are eligible for enrollment.

Residency: Enrollment is open to individuals residing within McLennan County or neighboring areas, subject to available services and resources.

Physical Criteria: Participants must be able to manage the restroom independently. 

 Application Process

Initial Inquiry: Prospective applicants or their legal guardians must contact The Arc of McLennan County to express their interest in enrollment.

Application Form: The organization will provide an application form that must be completed with accurate and up-to-date information, along with the  $25.00 non-refundable registration/enrollment fee.

Supporting Documentation: Applicants may be required to submit additional documents, such as medical records, assessments, or Individualized Education Programs (IEPs).

Review Process: The Arc of McLennan County will review each application and supporting documentation to determine eligibility and the availability of suitable services.

Waiting List: If the demand for enrollment exceeds the organization's capacity, a waiting list may be established. Applicants will be informed of their status on the waiting list and will be updated periodically regarding their position.

 Admission Decision

Admission Committee: The Arc of McLennan County will evaluate each application based on the eligibility criteria, available resources, and the organization's mission to provide appropriate support and services.

Notification: Applicants will be notified in writing of the admission decision within a reasonable timeframe.

 Enrollment Procedures

Enrollment Acceptance: Once an applicant is accepted, the applicant or their legal guardian will be required to complete additional enrollment forms, including consent forms, medical information forms, emergency contact information, and any other relevant documentation.

Orientation: New enrollees and their families will be provided an orientation to familiarize them with the organization's programs, services, policies, and procedures.

Personalized Support Plan: The Arc of McLennan County will collaborate with the individual and their family to develop a personalized support plan, which outlines the goals, objectives, and services to be provided.

Annual Review: The personalized support plan will be reviewed annually to assess progress, update goals, and make any necessary adjustments.

 Confidentiality and Privacy

The Arc of McLennan County is committed to maintaining the confidentiality and privacy of all personal information obtained during the enrollment process. All information will be handled in accordance with applicable privacy laws and regulations.

 Amendments to the Policy

This enrollment policy may be subject to periodic review and updates as deemed necessary by The Arc of McLennan County. Any amendments will be communicated to all stakeholders and implemented accordingly.

SECTION VIII. HOURS OF OPERATION

10:00 a.m.- 3:00 p.m. - Monday thru Friday, all year, except for The Arc holidays. 

SECTION IX. DISTRIBUTION OF MEDICATIONS

Whenever a participant is given a prescription or over-the-counter medication, the parent/guardian must provide a completed, signed medication authorization form to The Program Director. Medication must be provided in the original or duplicate container or a container accompanied by the doctor's directions. If medication is to be kept at The Program for treatment of a chronic condition, no more than a one-month supply should remain at The Program at any time.

SECTION X. HEALTH AND SAFETY POLICY

If the participant has a known medical condition (asthma, diabetes, seizure disorder, etc.), please be sure the director knows what to do if a problem should occur during Program hours. Please ensure that any medication is available and the appropriate forms for its use have been completed. There is no licensed nurse on-site or any licensed health care professional on call. If the participant has any one of the following conditions, the parent/guardian will be notified to pick up the participant immediately: Contagious Disease, Fever over 100 degrees Fahrenheit, Vomiting or Diarrhea, Accident Requiring Medical Attention.

A list of communicable diseases is posted at the site and will be reported as appropriate and as mandated by state guidelines.

In case of an accident or illness, the participant's parent/guardian/caregiver will be called immediately.

If someone appears on the premises with a firearm, the emergency number (911) should be called, and the participant should be taken out of danger and given aid.

Caregivers are to make every effort to keep participants from getting into a car with a parent/guardian under the influence of drugs or alcohol. Police will be contacted to give the participant and parent/guardian a ride home. Caregivers should not under any circumstances give transportation to a parent who appears to be impaired by drugs or alcohol because The Program insurance does not cover this type of transportation.

The Program is required to report suspected cases of abuse. This includes the reporting of parents/guardians who appear to be impaired by drugs or alcohol. The Program may have pets as classroom mascots and/or as visitors. All required safety standards will be met per childcare guidelines. The Arc does not require employees (i.e., caregivers) to present proof of vaccines, including TB, as McLennan County does not require it.

SECTION XI. INSURANCE

The Program carries minimal liability insurance but has no financial resources of its own. Families are encouraged to provide their own insurance coverage. Many families are covered by the parent/guardian's policy at work and/or their own private policies.

SECTION XII. PERSONAL PROPERTY

Participant's personal property (coats, clothing, school bags, etc. 0must be labeled and also must be cleared from the Opportunity Center each afternoon of The Program. Although The Program attempts to help participants stay organized, The Program cannot be responsible for lost personal property.

SECTION XIII. VISITORS AND OBSERVATIONS

Parents/guardians or community members who the Program Director screens are welcome to observe The Program. We are always looking for ways to improve our program and welcome your suggestions.

There are also therapy and services provided by other agencies that are welcome to come see participants in The Program that they also serve. However, such agency representatives must provide some form of identification and verification of proof of services, or content from parent/guardian/caregiver of services from other agencies.  

SECTION XIV. DISCIPLINE AND DISCHARGE

Participants are entitled to a pleasant and harmonious environment at The Program. The Arc's Opportunity Center Program cannot serve participants who display chronically disruptive behavior. Chronically disruptive behavior is defined as verbal or physical activity that may include, but is not limited to, such behavior that: requires constant attention from the staff, inflicts physical or emotional harm on other children, abuses the staff, ignores or disobeys the rules which guide behavior during the school day and Program time. If a participant cannot adjust to The Program setting and behave appropriately, then the participant may be discharged.

Reasonable efforts will be made to assist participants to adjust to The Program setting. Disruptive behavior will be dealt with in the following manner:

1. The misbehaving participant will be given a five-minute time-out in order for them to cool off and think about their actions.

2. If a second, 10-minute time-out is given to the child in a single day, The Program representative will write an incident report. This report will be given to the parent or guardian to read and sign. The report will be returned to the caregiver, remaining with the participant enrollment information.

3. If a participant receives three written behavior-related incident reports, the participant will be suspended effective at the end of the day of the third report. During the first week of the suspension, the parents/guardians, caregivers, and Program Coordinator will meet in a conference setting to determine the reinstatement conditions. Parents will be responsible for tuition payment during the period of suspension or until the participant is withdrawn from The Program or discharged.

4. If the child is reinstated in The Program and receives a fourth behavior-related incident report, the Program Director may suspend the participant immediately, notifying the parent/guardian to come and get the participant. Parents/guardians will continue to be responsible for tuition payment during the period of suspension or until the participant is withdrawn from The Program.

5. If the severity of a problem is great enough that it could endanger the safety of the participant or other participants in The Program, discharge will be effective immediately after the director consults with The Program Coordinator and The Arc Executive Director.

6. A participant may be discharged for non-payment of fees.

SECTION XV. PROCEDURES FOR QUESTIONS AND CONCERNS

If you have a question or concern that cannot be addressed by The Programs representative, please contact the director to arrange a meeting or call The Arc office at (254)756-7491 to discuss your concern(s).

SECTION XVI. PROCEDURES FOR REVIEWING STANDARDS AND REPORTS

A copy of the minimum standards is available for review in The Arc office. Our most recent Licensing inspection report is always posted on the bulletin board in the entryway. You may also review the standards and our compliance history at

www.txchildcaresearch.org.

SECTION XVII. PROCEDURES FOR CONTACTING CHILD CARE LICENSING

We are regulated by the Department of Family and Protective Services. You can find out more about the regulation of childcare facilities by visiting their website at ww.txchildcaresearch.org.

You may contact the local Licensing office by calling (254) 526-9011. You may report the suspected abuse or neglect of children by calling the child abuse hotline at 1-800-252-5400.

EMERGENCY EVACUATION PLAN

In the event of a fire, the participant will be safely evacuated to the parking lot across the street at Friends for Life, 5000 Lakewood Drive. In the event of a tornado threat, the children will be moved to an inner room with block walls.

PARENTAL/GUARDIAN STATEMENT

I have discussed and been given the Policies and Procedures of The Opportunity Center @ The Arc of McLennan County. (Name entered below recognized as consent.)

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