REGISTRATION
Child’s name (first/middle/last) :
Street Address
Primary contact person: Mother/Father/Guardian's name:
Home address:
Occupation:
Home, Cell, and Work Phone #: H: C: W:
e-mail address:
Other parent/guardian's name :
Home, Cell, and Work Phone #: H: C: W:
Hospital preference in an emergency:
Child's insurance name and Policy #:
Emergency Contact if parents cannot be reached
Childcare Plan (Underline choice): One (van- after school only)
Two (bus- after school only)
Three (van- before and after)
Full-day childcare (Underline choice) Option A: / Option B:
Quest Disciplinary Guidelines and Behavioral Expectations
Because Quest is seeking to promote and uphold certain ideals, it is important each family strives to support the same goal so that we are all working together as a team. When even one or two children regularly exhibit a bad attitude, it can impact the rest of the children and undermine the ability for the program to flourish. The guidelines and expectations for behavior, therefore, are as follows:
No destructive talk. This not only includes obvious cursing/foul language but also any tearing down of others with words like "idiot," "stupid," "fool," "butt," etc.... The old addage, "If you can't find something good to say about someone, don't say anything at all" applies. The goal is to speak in ways that edify and build one another up.
No disrespect or challenging attitudes -- especially toward authority, and along with this, no whining or fussing about chosen group activities. The goal is to exhibit respect and a spirit of cooperation.
No entitlement attitudes or selfishness exhibited. The goal is to learn how to compromise, take turns and share.
No physically harmful behavior such as poking, shoving, slapping, hitting, jerking, etc.
The bottomline goal is that all Quest Kids seek to practice the Golden Rule with one another.
What happens if / when :-) violations of these guidelines occur?
First offense: Sit down for 10 minutes in an assigned location apart from the rest of the group. Second offense: Sit down for 20 minutes (same as above). Third offense: If a problem occurs three times within the same day, the results are the child will be completely restricted the following day from participation in any Quest activities for the entire afternoon. (Parents will be notified about 2nd and 3rd offenses). If this problem occurs repeatedly without any changes or signs of progress, the child may at some point be denied attendance. With these guidelines in mind, the following signed statement of faith and statement of agreement with our childcare philosophy and policy is required of each family:
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We are fellow Believers and, therefore, welcome and support references to God, the Golden Rule, basic tenets of Scripture, etc. We would never find fault with this approach to childcare.
sign & date (parents): _________________________________________________________________
We have read and agree with the behavioral and disciplinary guidelines for Quest After School Program
sign & date (parents) __________________________________________________________________
sign (child) __________________________________________________________________________
sign (child) _________________________________________________________________________
sign (child) __________________________________________________________________________
sign (child) __________________________________________________________________________
We understand that Quest will do everything reasonably within its power to provide the safest environment possible for the children but in that understanding also know that even with the highest quality of care, accidents still will occasionally occur. Therefore, we hold that Quest is not in any way liable or financially responsible for any medical expenses incurred from a misfortune which occurs while in transit to, from, or at its location.
sign & date (parents): _______________________________________________________________
In the event of an accident or injury to our child/children and our being unable to be reached by phone, we grant permission to proceed with any necessary emergency medical intervention by trained and qualified personnel.
sign & date (parents): _______________________________________________________________


