Parent/Guardian Agreement & Release of Liability:
PLEASE READ THE FOLLOWING TO ENSURE A SUCCESSFUL CLUB EXPERIENCE.
I understand that being a member is a privilege and therefore can be revoked if necessary, at any time.
I, the parent/guardian of the minor child on this application, for ourselves, our heirs, executors and administrators, hereby release, waive, acquit and forever discharge Boys & Girls Club of Malvern & Hot Spring County and Boys & Girls Club of America, their representatives, successors, insurers, assigns or any other person or entity associated with any of the above organizations such as staff, directors or volunteers, from all liability, claims, demands, or causes of action for any and all loss, damage, injury or death and any claim of damages resulting from use of facilities owned or controlled by the above organizations, or participation in activities of the said organizations either at or away from the club or while traveling in bus, van or in a private vehicle.
Medical Treatment:
I give permission to Boys & Girls Club of Malvern & Hot Spring County to seek emergency medical treatment for my child if I cannot be reached. I will be responsible for any costs of medical attention and treatment. I understand that Boys & Girls Club of Malvern & Hot Spring County will not store or distribute any type of medication.
Mentoring & Surveys:
I, the parent/guardian give permission for my child listed on the application, to participate in the mentoring program(s) and member surveys affiliated with Boys & Girls Club of Malvern & Hot Spring County.
Free & Reduced Lunch:
I understand that if my child qualifies for free or reduced lunch, that I must complete the TANF forms provided at Boys & Girls Club of Malvern & Hot Spring County office by Wednesday, May 1, 2019. I also understand that I must provide verification of their free/reduced lunch status from their school, at the same time as registration. Please email required forms to malbgc@yahoo.com .
Miscellaneous:
I understand that I must come in to pick my child up and it is my child's responsibility to check out at the front desk. I also agree that it is my responsibility to have my child picked up no later than 5:00 pm. Failure to comply can result in fines and authorities being notified.
I understand that Boys & Girls Club of Malvern & Hot Spring County are not responsible for the time and manner in which my child may arrive to or leave the Club.
I understand that Boys & Girls Club of Malvern & Hot Spring County are not responsible for lost or stolen items. I agree to label any items my child may bring.
I understand that the Club is not, nor claims to be, a licensed day care center and is not structured as such.
I understand that Boys & Girls Club of Malvern & Hot Spring County will not tolerate any type of BULLYING, FIGHTING, STEALING, THE USE OF ALCOHOL, DRUGS, TOBACCO, FIREARMS or PROFANITY from parents, guests or members while on the Club premises or otherwise.
I am aware that Boys & Girls Club of Malvern & Hot Spring County uses e-mail services, website and social media as the primary informational tool. Please 'like' us on Boys & Girls Club of Malvern & Hot Spring County facebook page for updates and pictures.
I agree to explain the rules to my son/daughter. I understand that if my child does not follow the rules of the Club, I may be contacted to pick my child up and they may be suspended or lose their membership.
I understand that any fees I pay for; memberships, programs, snack accounts, or activities are NON-REFUNDABLE.
I have read and agree to the above statements and understand the rules of the Club and request that my son/daughter be admitted into membership. I also agree to express any concerns I may have with the Program Director or Executive Director ONLY. Again, I realize that being a member is a privilege and can be revoked at any time, if necessary, and I will do my part to help ensure a successful Club experience.
