Enroll a child.

PLEASE NOTE:

CFC does not provide transportation.

Description I hereby grant to Center for Champions and those acting under its authority, to record on film, tape or otherwise my child's and my name, likeness, voice, performance, and actions. I acknowledge that my child's or my performance may be edited as desired by Center for Champions and may be used in perpetuity and authorize others to use, such recording as Center for Champions sees fit on television and radio broadcasts, audio-visual use, in any production, in any and all media now known or hereafter devised throughout the world, and to use, license, market, and distribute in any medium or forum said productions and any other productions in which said recording may be incorporated. I waive the right to inspect or approve any such use of my child's name or my name, likeness, voice or actions, and hereby also authorize Center for Champions and those acting under its authority (mentors, REFs) to use my child's name or my name, likeness, voice, actions, biography, and/or composition for purpose of promotion and publicity in connection with the program material. Further, I hereby waive and forego any compensation for my appearance in the production. I release Center for Champions from all claims and liabilities of any kind arising out of or in connection with the making or uses of such films, videos, photos, or recordings. The rights granted herein shall insure to the benefit of Center for Champions, its licensees, successor and assigns.
Description I hereby give permission to the medical personnel selected by Center for Champions to order x-rays, routine tests, or treatment; to release any records necessary for insurance purposes, and to provide or arrange necessary related transportation for my child. In the event I cannot be reached in an emergency, I hereby give permission to the attending physician to administer treatment, including hospitalization, for the person named above. This completed form may be photocopied for trips where participants are off site.
Description Center for Champions will not administer any medications during program hours. If your child needs to use an inhaler or any other necessary medication they will be responsible to self-administer those medications. Center for Champions will store the medication until it is needed, but no staff member will be able to administer the medication. All medications that are brought to Center for Champions must be brought in their original packaging with the prescription intact. IF YOUR CHILD NEEDS REGULAR MEDICATION DURING PROGRAM HOURS YOU WILL NEED TO CALL TO MAKE ARRANGEMENTS PRIOR TO THE FIRST DAY OF THE PROGRAM.
Description I give my child permission to participate in programs facilitated by Center for Champions during the times my son or daughter is in the care of Center for Champions. I understand that this permission covers the participation of my child with outside agencies visiting Center for Champions, as well as, their participation in field trips and off-site agency visits. I also understand that Center for Champions aims to provide safe, enriching and educationally sound activities and partnerships in order to facilitate student learning and growth. Any field trips or interagency collaboration would be in line with these goals.
Description Volunteers, mentors, and staff at Center for Champions are mandated reporters. Therefore, they are legally obligated to report suspected child abuse or neglect to the state of Pennsylvania. In some cases, Center for Champions will discuss the situation with the parent or caregiver prior to reporting but please understand that we are not obligated to do so. If and when a report is made, please understand that we do it with the child's best interest in mind.
Description Though rare, occasionally students get into a fight or get upset with a mentor or staff member. If/when a student is violent and others can potentially get hurt, CFC staff will "block" the student from others and may even need to hold them back. Though we never intend to hurt a student we also don't want others to get hurt by a student who has lost control. At times, students have left the building when upset. Again, CFC staff will do our best to keep a student inside but we cannot physically force them. Should a student leave the premises we will contact caregivers immediately and we may contact authorities as well if any one, including the studen, is at risk of harm. CFC staff will do our best to keep a student in sight when they leave the building but we cannot guarantee this as a student may run. Lastly, on rare occasion, an upset student has left a vehicle. In this case, CFC staff and/or volunteers are instructed to contact the authorities first and then contact caregivers as this student may be in immediate danger. Volunteers/staff are instructed to try to monitor the student if possible but this cannot be guaranteed. Do you understand and agree with this policy? If no, please contact CFC staff to ask questions.