2018-2019 - PAWS School Year Program - Online Registration Form
PAWS Families,
Welcome to Paynesville Area Community Education PAWS Childcare Program. We are so very excited to have you as a part of our program.

Please see below for our PAWS Online Registration Forms. This is the online alternative to the written packet that was emailed out to all participants.

Make sure you read the entire PAWS School Year Registration Packet which is available at www.PaynesvilleCE.com prior to continuing to the Online Registration Form Below.

Please fill out one online registration form per child.

Email address *
Child's First, Middle & Last Name *
Your answer
Child's Home Address (including City, State, Zip) *
Your answer
Primary Household Information
Primary Household Parent/Guardians
Mother's First & Last Name *
Your answer
Mother's Phone Number *
Your answer
Mother's Email Address *
Your answer
Father's First & Last Name
Your answer
Father's Phone Number
Your answer
Father's Email Address
Your answer
I am authorizing payment for my 2018-2019 School Year PAWS Registration Fee: $20 each child/$40 per household max (One time charge) *
PAWS Weekly Contract Fee - Check box for the fee you are authorizing payment for in this contract. *
Required
Credit/Debit Card Information - 16 Digit Number *
Your answer
Expiration Date - Month/Year *
Your answer
3 Digit Security Number on the back of the card *
Your answer
Name as it appears on the credit card *
Your answer
Is the billing address for the credit card the same as the home address listed above? If no please list address below.
Your answer
PAWS School Year 2018-2019 Contract
PAWS Release & Agreement to Terms
Please read carefully the following program guidelines:

Contract Guidelines
 I have received a copy of the PAWS Family Handbook (Please Download) and understand the fees, payment policies, behavior expectations, procedures, and policies described therein
 I understand that I may not start with PAWS until I have received confirmation from Paynesville Area Community Education.
 I agree to pay the following fees:
• Registration fee (non-refundable)
• Tuition payments: Payments will be accepted weekly for the upcoming week of service.
• PAWS closes promptly at 6:00 p.m. When picking up my child, I will to come into the site, acknowledge to the PAWS staff that I am taking my child, and sign my child out using the check-out system. For the safety
of my child.
• I understand that late fees ($1/minute) begin at 6:01 p.m.
• I understand I will be charged a late payment fee of $10 if my account becomes 5 days past due and that PAWS services will be suspended, until payment is made in full, if my account becomes more than 30 days past due.
• I understand that if my bill is more than three months outstanding, the bill will be sent to a Board-approved collection agency.
• I understand that if my check is returned to the District for reasons of “Not Sufficient Funds” or “Account Closed,” I will be charged an additional $30/check.
Site Policies and Procedures
 For safety, I understand that I must provide PAWS staff with the most current/accurate contact information at all times.
 At drop off and pickup, I will acknowledge to PAWS staff that I have brought him/her in, and sign my child in/out using the check in system. For the safety of my child
 If my child regularly attends PAWS, but is going to be absent, I will inform the PAWS staff, by phone/email. Likewise, if my child attends infrequently, I will inform my PAWS staff, by phone or email,that my child will be attending.
Serious Accident/Illness
 I give permission to PAWS to take whatever emergency measures are judged necessary for the care and protection of my child while under the supervision of PAWS staff. In case of a medical/life-threatening emergency, I understand that my child may be transported, at my expense, to the hospital by local emergency personnel as they deem necessary. It is understood that in some medical situations, the staff will need to contact the local emergency personnel before the parent and/or other adult acting on the parent’s behalf.
Sick child
 I will not send my child to PAWS if he/she has vomited or had a fever greater than 100 degrees in the last 24 hours or would not be allowed to come to school based on their symptoms. Likewise, if they develop symptoms of the same as above, the parent will be contacted to pick up their child immediately.
Medication
 Medication will be administered under limited circumstances, when prescribed or authorized by a physician. All medications must be given to the PAWS site leader, in the original prescription bottle and be accompanied by a completed Medical Administration form.
Movies
I give permission for my child(ren) to watch age appropriate G and PG rated movies. (If permission is not granted I understand I will need to pick up my child on days PAWS will be attending movies off site, or provide a quiet activity for my child(ren) to do during movies at the PAWS site.)

Fieldtrip & Transportation
 I give permission to PAWS Staff to take my child on supervised walking trips within 12 blocks of the site and/or bus trips.
No babysitting policy
 Staff members at PAWS are not permitted to babysit for families within our program.
Both parents’ right to pick up
 Under the laws of the State of Minnesota, both parents have the right to pick up their child unless a court document restricts that right. PAWS must have a copy of those documents to enforce the unauthorized pickup.

Termination of Care
Dismissal from the program could result from any of the following:
 The staff and/or parent determines that the program cannot meet the needs of the child.
 The child and/or parent refuses to follow the program procedures.
 Invoices/fees are not paid.
If your child attends the PAWS program after their termination date, the child will be sent to the school office immediately and they will contact you for pick up.

I agree to adhere to the above contract language and authorize weekly PAWS Payments to be made to the above credit/debit card. *
Required
Please type full name to act as your signature to the above agreement. *
Your answer
Publicity – Please check only if you want to Opt out of having your child’s picture being taken and used within the confines of our program.
Please help us get to know your child.
Please tell us about your child.
Your answer
Does your child have any activity restrictions? Please specify.
Your answer
Please list your child’s hobbies, interests and sports
Your answer
My child is most looking forward to doing this in the PAWS Program?
Your answer
What techniques are effective when your child is distressed?
Your answer
Is there anything that upsets your child?
Your answer
Are there any family circumstances that the PAWS Staff should be aware of to better care for your child? Please Explain:
Your answer
Special Needs? If yes, please describe below. (If your child(ren) requires special support during the school day, a participation plan should be discussed with the PAWS Program Coordinator at 320-243-7570 in order to provide the most appropriate level of care. PAWS is a program of Community Education; the District is not obligated to share information about your child’s needs with the PAWS Program so we ask that parents communicate all special needs.)
Your answer
Please give us any other information about your child that you think would be helpful to us.
Your answer
Authorized Pick-up List (Other then the Parent/Guardians listed above)
Contact 1 - Name & Phone Number
Your answer
Contact 1 - Relationship to Child
Your answer
Contact 2 - Name & Phone Number
Your answer
Contact 2 - Relationship to Child
Your answer
Contact 3 - Name & Phone Number
Your answer
Contact 3 - Relationship to Child
Your answer
Contact 4 - Name & Phone Number
Your answer
Contact 4 - Relationship to Child
Your answer
PAWS Rules
PAWS Rules
1. REMAIN WITH THE GROUP AND PROGRAM AT ALL TIMES.
2. RESPECT EACH OTHER, STAFF, SCHOOL PROPERTY, AND
EQUIPTMENT AT ALL TIMES. ARGUING WITH STAFF IS
UNACCEPTABLE.
3. HITTING, FIGHTING, AND/OR PHYSICALLY HARMING ANOTHER
PERSON IS ABSOLUTELY NOT TOLERATED!!!
4. USE APPROPRIATE LANGUAGE. SWEARING AND FOUL
LANGUAGE ARE UNACCEPTABLE.
5. WALK IN THE SCHOOL AT ALL TIMES. RUNNING IS ONLY
ALLOWED IN THE GYM OR OUTDOORS.
6. EQUIPMENT ROOM, TABLE ROOM, AND OTHER STAFF AREAS
ARE OFF LIMITS.
7. MUST HAVE PERMISSION TO LEAVE THE GROUP FOR BATHROOM USE.

Summer CAMP PAWS Pledge 2018 Program
This agreement is a pledge to keep PAWS a safe, fun and positive environment!

As PAWS member, I pledge to continue to…
Be respectful to all others by using kind words and good
manners. Obey PAWS rules and Supervisors.
Be respectful of school property.


As the parent/caring adult, I pledge to continue to…
Support the PAWS program in its efforts to maintain proper discipline.
Encourage my child and help when necessary.
Stay informed about what my child is involved in.
Respond to communications sent home.
Bring up concerns as they arise.

Consequences for Harmful or Inappropriate Behavior
Participation in PAWS is a privilege. A child must follow the rules of the program. Harmful or inappropriate behavior towards other students or PAWS staff is a reason for suspension or dismissal from the program.
Children are assisted in finding solutions to current situations, understanding consequences and developing self-control. If the child is having difficulty: PAWS uses a 3 strikes discipline policy.
1. When a child breaks a PAWS or School-wide rule after a warning has been given, they will be given strike one. This consists of a note home.
2. The second strike is also a note home and a phone conference.
3. After three strikes within 30 days, the child will be suspended from PAWS for two-five days. In this case, a note will be sent home, and a conference or phone call between the PAWS Coordinator and the child's parent will take place before the student can return to PAWS. Parents are responsible to pay during this time frame.
4. Any verbal threat using words such as kill, gun, and cut are automatic suspension for three days. Call the parent immediately. Parents have two hours to pick their child up.
My child and I agree to the above PAWS Rules & Pledge
Thank you for registering for our PAWS Childcare Program!
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