Out-of-School Care Application

A) My child may leave the premises of the Y-COP under the supervision of authorized personnel to attend field trips, community service & events.

B) My child may be included in all photos, videos or film likeness to be used for any legitimate purposes that promote the Y-COP program.

I agree to the enrollment of my child in the Y-COP (out of school day) program and have been advised of the policies regarding its fees.

I hereby give permission to the Y-COP staff to take whatever steps necessary to obtain medical care for my child. These steps may include, but are not limited to:

1. Administer basic first aid.


2. Attempt to contact a parent/guardian, emergency contact person and/or the child’s physician.


3. Attempt to contact a parent/guardian or the child’s physician, the Y-COP will do any or all of the following:
   
   
   
   
   • Call another physician
   
   
   • Call an ambulance or have the child taken to the nearest hospital
   
   


4. While participating in Y-COP activities, I understand that my child will be covered under my medical insurance.