Creston Kids Outside Society
P.O. Box 972, V0B1G0
250-428-8426 * www.crestonkidsoutside.com
crestonkidsoutside@gmail.com

Kootenay Nature School

Please arrange a phone call with one of our leaders before registering, so we can help ensure KNS will be a good fit for your family: 250-428-8426 or email crestonkidsoutside@gmail.com

Consider these indicators of readiness for our outdoor program: 

1) Child responds when name is called 2) Can alert adults when they need to use the bathroom 3) Can remember and follow basic safety rules 4) Generally tolerant to varying weather conditions 5) Gets along with other children 6) Not prone to running or hiding when upset 7) Able to communicate needs or issues to an adult (cold, discomfort, etc) 8) Willing to wear appropriate clothing for various weather conditions (e.g. raincoats, hats, gloves, boots)

I am registering for: *
Method of Payment: Please make cheques payable to the Creston Kids Outside Society, P.O Box 972, V0B1G0 ​Payment Schedule: ​*Please send your $30 registration fee within two weeks of filling out your application, to secure your child's spot. ​Fees are due by: *Fall Session: Sept 1, 2018 *Winter Session: Nov 23, 2018 *Spring Session: Mar 15, 2019 *

Participant Information

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Guardians

Phone Numbers (home/work/cell): *
Phone Numbers (home/work/cell): *

PERSONS AUTHORIZED TO CALL FOR THE CHILD AND CONTACT IN EMERGENCY: (children will not be permitted to leave with anyone not on this list unless arranged verbally or in writing)

Medical Information

Special instructions concerning Care, Medication, Diet, or Custody: *
 
Has the child(ren) had previous experience away from home? *

Emergency Medical Treatment Authorization

I give Creston Kids Outside employees permission to obtain emergency medical treatment for my child(ren): *
Parent/guardian signature: *
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Photograph Release Form

I grant Creston Kids Outside permission to use and publish in print or digitally, any photographs or videos taken during the sessions for promotional and educational Purposes. Any photographs appearing on social media (Creston Kids Outside Facebook and website, will not include children’s names and no one will be ‘tagged’). *
Parent/Guardian Signature: *
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Confidentiality and Client Files

It is the policy of Creston Kids Outside that any information or records held regarding your family and child will be kept confidential. The only release of information or records would be for a legal matter that is requested or required by law. It is also appreciated that any information you become aware of regarding other families at child care be kept confidential.



Parent/guardian signature: *
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Please use an electronic signature to acknowledge that you have read and understand our policies. A paper copy of a waiver provided by our insurance company will be given to you to sign on the first day of your child's program.

*I have read through the Parent Handbook and agree to abide by the policies/procedures outlined there. 

* I have read and understand the withdrawl/refund policy. 
 
*I understand that a family member is required to volunteer approx 1 hour per session to help with morning snack and field supervision. 
 
*I grant permission for the above named participant to participate in all planned activities during Kootenay Nature School.

*I understand that participation in activities can expose the named participant to risk and possible injuries. I understand that there is a qualified certified First Aider on site and grant permission for them to treat the above named participant in the event of an injury. 

*I recognize that Creston Kids Outside reserves the right to postpone or cancel programs/sessions due to unsafe weather conditions or other unforeseen circumstances. Where possible Creston Kids Outside will attempt to reschedule, but this may not always be possible. I will not hold Creston Kids Outside liable for loss of fees or programs. 

*All tools and materials will be provided by the Kootenay Nature School program. Participants are discouraged from bringing additional items to sessions as they may be lost or stolen. I will not hold Creston Kids Outside responsible for any lost or stolen items.

*I understand that it is my responsibility to ensure that the named participant is dressed properly for weather conditions as this is a program based outside in natural settings. I understand that the participant may not be admitted to a session if they are not clothed properly for the conditions.

*While participating in the Kootenay Nature School program, I understand that the named participant will be required to listen and follow the guidance of the Facilitators. This includes participation in outlined activities, expectations for age appropriate behaviour, and able to respect the health, safety for themselves and any member of the group. If for any reason the named participant is unable or unwilling to follow expectations, engage in acceptable behaviour, or acts in an unsafe manner towards themselves or others, they may be removed from the session or the entire program. I understand that Creston Kids Outside reserves the right to deny access to a participant who has been disruptive in the past or sent home because of behaviour issues.

*In the event that: the participant’s behaviour is felt to be unsafe or unmanageable; if an illness or injury should arise in which a doctor's diagnosis is required; unsafe weather conditions develop; other unsafe conditions develop that require participant’s removal from program I authorize Kootenay Nature School leaders to dismiss my child early, in which case I will assume responsibility for transporting my child from the program at a time specified.

*I acknowledge that I have read and fully understand this agreement, and accept the risks involved with the above named participant’s engagement in these activities at Creston Kids Outside.

Signature *
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