I understand that my child will be transported by the FAC buses and/or vans. I grant the Fayetteville Athletic Club team permission to transport my child to/from their school.

I agree to the Fayetteville Athletic Club's Waiver release statement. I understand that I am releasing all claims for injury, I or my child may sustain through any of our programs. I agree to assume full risk and to waive, relinquish, and release all claims I and/or the participant may have against, indemnify, hold harmless and defend the Fayetteville Athletic Club. This release includes FAC officers, agents, servants, and employees from such claims resulting from injury, damages, or loss sustained while participating in the FAC program or event. I understand that I am responsible for all personal insurance and understand that I must cover any medical costs incurred for my family participating in this FAC program. I also understand that every precaution is taken to protect the safety of each participant.

I, (mother/father/guardian), do hereby give my consent to the Director of the Child Care facility, or his/her representative, for said child to receive medical or surgical aid as may be deemed necessary and expedient by a duly licensed or recognized physician or surgeon in case of emergency when parent/guardian can not be reached. Consent is also given for the Director or his/her duly appointed representative to transport said child for emergency medical treatment, if the parents cannot be reached. Please sign below.

The Registration fee and first week of After School fees must be paid to register your child(ren) for the FAC After School Program. The balance will be billed the Friday prior to each week of After School. This balance must be paid by a credit card or bank account on file with FAC. Payments must be received for your camper to attend After School. Non-payment by the required due dates will result in relinquishing the camper's space in the program. FAC Junior Membership are required for each child to receive the Member discount for our After School program. Changes or cancellation requests must be received a minimum of 2 weeks prior to the start of After School and must be made in writing to the Director. FAC member discounts will be voided and additional charges will occur if the FAC Junior membership is canceled at any time during the program duration. A $25 returned payment fee will be applied to any returned payments. Fayetteville Athletic Club accepts, Visa, Master Card, Discover, American Express, bank drafts and checks. I agree to abide by the Billing policy that has been presented.

This is a statement of verification that I have been informed that child care licensing/ child maltreatment investigators and/or law enforcement may possibly interview my child for the purpose of determining licensing compliance or for investigative purposes. This is accordance with Minimum Licensing Requirements: DCCEDE/ Child Care Licensing Unit: 200.201.4

This is to acknowledge that I have received and will comply with the rules as stated in the Kids Fun FACtory Parent Handbook.

I have been informed of the behavior guidance policy practiced listed in the Kids FACtory Parent Handbook.

I understand that I may ask for a conference with the caregiver(s) as needed.

The discipline policy of the Fayetteville Athletic Club, Kids Fit Fun FACtory will be that any time a child's behavior jeopardizes the safety of him/herself, others or is acting in a disruptive manner, the child will be removed from the class or program. The Kids FACtory uses "timeout" to encourage good behavior. A child who has been given a "timeout" will be taken out of the group/class participation and must sit alone quietly under staff supervision for 1 minute for each year of age. After the 2nd offense, another timeout will be given. Following a 3rd offense, the child will be sent home for the remainder of the day. The parents and child will need to schedule a conference with the Director to discuss the issue. Continuous or more serious behavior issues may result in suspension/ pending termination from the Kid's Fit Fun FACtory program. I understand and agree to comply with the Discipline Policy.