Medical Release (in the event that you the parent are not available) *

I, the parent or legal guardian of child(ren) listed here, hereby authorize and give permission to the physician or medical practitioner, selected by Mountainview Christian Reformed Church to hospitalize, secure proper treatment including but not limited to the prescription of medications, diagnostic studies, and any other medical procedure for my child as deemed necessary by the physician under the circumstances. It is understood that this authorization is given in advance of any specific medical treatment being needed, and is given to provide authority to the physician to render that care which in exercise of his or her best judgment is advisable.

Agreed

Disagree - I will discuss this with the Children's Director

Medial Information - Details i.e, vision, hearing, seizures, diabetes, mobility, etc... *

Yes

No

Allergies / Asthma *

Yes

No

Developmental / Learning - i.e. ADD/ADHD/Autism, Downs, etc... *

Yes

No

CONTACT INFORMATION

Check here if there are NO changes to the address, phone #, email, or emgergency contact information.

NO CHANGES

Family Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Family Phone #

(###)

###

####

Release and Waiver of Liability * *

I/We, the parent(s) or Guardian of the above mentioned child, in consideration of my/our child being permitted to enter the Mountainview Christian Reformed Church (hereafter Mountainview CRC) property, and being permitted to participate in Mountainview CRC activities and events, AGREE TO WAIVE, RELEASE, DISCHARGE AND COVENANTS NOT TO SUE, its employees, officers, directors, servants and agents from all liability to the child, to myself, or any personal representative of either, assigns, heirs, and next of kin, for any and all claims for damages, for death, personal injury or property damage, suffered by me or my child while participating in any Mountainview CRC event or activity. I/WE UNDERSTAND THAT THIS RELEASE AND WAIVER OF LIABILITY applies to any claims occurring from injury to person or property, whether caused by negligence of Mountainview CRC or otherwise. I/We acknowledge that the intent of this RELEASE AND WAIVER OF LIABILITY is to prevent Mountainview CRC from being held liable for injuries to person or property, and that selecting YES constitutes my/our agreement and the agreement of the child listed above, not to hold Mountainview CRC responsible for any damages, losses, injuries to person or property, as a result of any negligence or other wrongful conduct on the part of Mountainview CRC or on the part of other third parties. I/We ALSO AGREES TO INDEMNIFY AND HOLD HARMLESS Mountainview CRC from any loss, liability, damage, or cost that Mountainview CRC may incur due to the presence of myself or said child, upon Mountainview CRC premises or in any way using any of Mountainview CRC facilities or attending any events of Mountainview CRC, whether caused by negligence of Mountainview CRC or otherwise. FURTHER, I/WE EXPRESSLY AGREE THAT THIS RELEASE AND WAIVER OF LIABILITY is intended to be as broad and inclusive as is permitted by the law in the Province of Ontario. If any portion is held to be invalid, it is agreed that the balance shall continue in full legal force and effect. I/We further agree that this Release and Waiver of Liability shall be valid for the program season or year. I/We have read and voluntarily agree, and further acknowledge that no oral representations, statements, or inducements apart from the written agreement have been made.

Yes, I agree

No, I do not agree

Check Out for older Children (Grades 1-5) *

It has been requested by some parents that they NOT BE required to pick up their older children in their classroom after the service. By checking yes, your child(ren) (only grades 3-4-5) will be allow to leave the class.

Yes - they can be released on their own

No - I will come to pick them up

N/A - I understand that my child(ren) (aged 0-5) are not permitted to be released on their own and will be picked up by a Parent/Guardian.

CODE OF CONDUCT for Participants of Kid’s Ministries @ Mountainview *

At Mountainview Kids, it is our hope to create a fun, safe, and respectful environment for all our children. Everyone deserves an awesome experience! It is for this reason our team always keeps a close watch on any unkind behaviours such as teasing or bullying which may affect another child’s experience. Children must: • Be able to take instruction and follow direction from our Children’s Director and Kids@Mountainview staff and volunteer team leaders. • Not behave in a manner that negatively affects another child’s experience. • Understand that they may not physically or verbally hurt others, and they will respect the feelings & safety of themselves and others. • Respect church property and/or another property. Parents/Guardians will be responsible to pay for any damages deliberately caused by their child by defacing or damaging property. Behaviour deemed inappropriate & unkind includes: a. Leaving the instructed boundaries unless accompanied by a Mountainview Church staff or volunteer team member. b. Threatening behaviour, bullying, offensive or insulting language, verbal or physical abuse to other children, volunteers, staff and guests. c. Borrowing of other’s possessions without their consent. d. To be in possession of a weapon or implement that Mountainview staff or volunteers deem dangerous or potentially dangerous. e. Any illegal activity. Should there be any concerns with behaviour, the Children’s Director will communicate immediately with the parent/caregiver. Though certain scenarios might require a unique behaviour plan, for most situations, if a child is unable to participate respectfully and engage with kindness, the child will no longer be able to participate in Kids@Mountainview. The parent/guardian of each child must indicate by checking the appropriate box on Kid’s Registration form that they have read and understood this Code of Conduct. Please take the time to familiarize yourself with our Safe Church Policy, it can be found at: https://www.mountainviewcrc.org/safe-church

We have read and understood this code of conduct as indicated by checking here