kinder works dig /arts summer camp · 2016 mtg sc parent handbook 3/10/16 2 how the kinder works...

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Kinder Works Kinder Works DiG DiG ital ital /Arts /Arts SUMMER SUMMER CAMP CAMP For 3 to 12 year olds For 3 to 12 year olds Location: Kinder Works in Montgomeryville Route 309 & Richardson Road (2 lights north of ‘5 Points’ intersection in our beautiful air-conditioned building, playground & park!) More Info: 215-822-7510; kinderworks.net Click on “Summer Camps” and follow the links to see our Dig/Arts Camp video! Dates: June 20 – August 26, 2016; 10 weekly sessions; (You can buy by the week!) Schedules: 5, 3, or 2 Full or Half days Full day: 9 AM – 4 PM (Includes all extended hours: 7 AM – 6 PM) Half day: 9 AM – Noon or 1 PM – 4 PM; (Includes AM or PM extended hours: 7AM – 9 AM or 4 PM – 6 PM) Staffing: All staff are Certified Teachers! DVDS: Join us to create and produce 3 movies this summer! Campers collaborate to write the storyboard, make costumes, design scenery & sets, star in the show, assist with the production & finally take home a DVD of each movie! (More on the next pages!) ART STUDIO: Come experience the visual arts! Create your own masterpieces as we experience art through sculpting, printing, photography, painting, and so much more. We’ll learn new techniques, try numerous tools, & use various media, inspired by world-renown artists as well as our own imaginations! (More on the next pages!) GAME ROOM & Play, relax, & socialize! Enjoy our air-conditioned Game Room, fully equipped with computers, OUTSIDE SPORTS : Wii, & video games as well as the classic board & card games. Also experience outdoor sports activities, & cool water games on our playground & park next-door! other Camps : Please visit our DIG/ARTS SummeR Camp in Limerick & Camp Kinder Works in Doylestown. You can register for all of our camps with one $35 registration fee & enjoy summer fun at any of our 3 locations! 2016 D IG /ARTS Summer Camp Tuition Schedules FULL DAY PROGRAM: 9AM 4PM HALF DAY PROGRAM: 9AM – Noon or 1PM – 4PM INCLUDES ALL EXTENDED HOURS! 7 AM – 6PM INCLUDES AM or PM EXTENDED HOURS! 7AM – 9AM or 4PM – 6PM Monday through Friday $273/week Monday through Friday $187/week Monday/Wednesday/Friday $202/week Monday/Wednesday/Friday $128/week Tuesday/Thursday $147/week Tuesday/Thursday $92/week *We are closed on Monday, July 4 th , and tuition for M-F and M,W,F schedules will be prorated for this week. See more info on the next pages!

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K i n d e r W o r k sK i n d e r W o r k s D i GD i G i t a li t a l / A r t s/ A r t s

S U M M E R S U M M E R C A M PC A M P

For 3 to 12 year oldsFor 3 to 12 year olds

Location: Kinder Works in Montgomeryville

Route 309 & Richardson Road (2 lights north of ‘5 Points’ intersection in our beautiful

air-conditioned building, playground & park!)

More Info: 215-822-7510; kinderworks.net Click on “Summer Camps” and follow the links to see our Dig/Arts Camp video!

Dates: June 20 – August 26, 2016; 10 weekly sessions; (You can buy by the week!)

Schedules: 5, 3, or 2 Full or Half days Full day: 9 AM – 4 PM (Includes all extended hours: 7 AM – 6 PM) Half day: 9 AM – Noon or 1 PM – 4 PM; (Includes AM or PM extended hours: 7AM – 9 AM or 4 PM – 6 PM)

Staffing: All staff are Certified Teachers!

DVDS: Join us to create and produce 3 movies this summer! Campers collaborate to write the storyboard, make costumes, design scenery & sets, star in the show, assist with the production & finally take home a DVD of each movie! (More on the next pages!)

ART STUDIO: Come experience the visual arts! Create your own masterpieces as we experience art through sculpting, printing, photography, painting, and so much more. We’ll learn new techniques, try numerous tools, & use various media, inspired by world-renown artists as well as our own imaginations! (More on the next pages!)

GAME ROOM & Play, relax, & socialize! Enjoy our air-conditioned Game Room, fully equipped with computers, OUTSIDE SPORTS: Wii, & video games as well as the classic board & card games. Also experience outdoor sports

activities, & cool water games on our playground & park next-door!

other Camps : Please visit our DIG/ARTS SummeR Camp in Limerick & Camp Kinder Works in Doylestown. You can register for all of our camps with one $35 registration fee & enjoy summer fun at any of our 3 locations!

2016 DIG/ARTS Summer Camp Tuition Schedules

FULL DAY PROGRAM: 9AM – 4PM HALF DAY PROGRAM: 9AM – Noon or 1PM – 4PM INCLUDES ALL EXTENDED HOURS! 7 AM – 6PM INCLUDES AM or PM EXTENDED HOURS! 7AM – 9AM or 4PM – 6PM

Monday through Friday $273/week Monday through Friday $187/week

Monday/Wednesday/Friday $202/week Monday/Wednesday/Friday $128/week

Tuesday/Thursday $147/week Tuesday/Thursday $92/week

*We are closed on Monday, July 4th, and tuition for M-F and M,W,F schedules will be prorated for this week.

See more info on the next pages!

2016 MTG SC Parent Handbook 3/10/16

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HOW THE Kinder Works DIG/ARTS SUMMER CAMP WORKS

All Camp activities are led by caring, professional artists and teachers. Your camper can participate in all activity areas every morning and/or every afternoon. Morning

presentations and materials are different from those offered in the afternoons, so full-day campers can choose from a wide variety of projects and experiences.

Please note: We suggest registering for the 3 week clusters which focus on each DVD

production. Visual Arts themes change every week.

Our camp is designed for children 3 – 12 years old. Each child is placed in a group of children with a similar age range so that activities may be offered to meet their stage of development and interests.

Each group is under the care of an experienced, trained Camp Counselor (who is a PA Certified Teacher). The Counselor and campers enjoy the schedule of events together. This way each camper has the chance to enjoy friendships with the other children, and the Counselor gets to know his or her group well.

As the campers move from one activity to another, they interact with the Activity Specialists (who are PA Certified Teachers specializing in visual or dramatic arts or games/sports) as well as their own Counselor. So wherever the group goes, there are always at least two adults with them: the Counselor and the Specialist(s). Our 4 Activity Areas are: PERFORMING ARTS – Enter our Performing Arts area as a camper, but leave as a STAR! Here our campers collaborate to create the storyboards that become our DVD productions. They have great fun creating characters by using voice, body movements & facial expressions, trying on costumes & using props as they experiment with improvisations & scripts. In 3 weeks, they are ready to film a movie!

SETS & STAGING – Every production requires a whole lot of action “BEHIND THE SCENES”… and every camper plays a part in designing, arranging, and creating the scenery, costumes, and props utilized in each of our productions! In this area we work together to make many sets, each used for the scene shots of our story board, all ready for 'filming day' with our professional videographer.

***Please note: Our DVD productions are a collaborative art form; they come from the hearts and minds of the children involved, coached by caring professionals. As such, there are no bad ideas and there are no mistakes (only “bloopers!”). DVD’s will be ready for pick-up in approximately two weeks following production taping. Your DVD is free. If you wish to buy an additional copy for $20, please sign up the week of the production on the sheet posted at the Director’s desk.

ART STUDIO - Our art experiences and projects are individualized, guided and supported by professional instructors. We celebrate and value each child’s visual art as the product of his or her own ideation and expression. You will find works of art on display as we transform the Atrium into an Art Gallery, and they are yours to take home and cherish.

GAME ROOM & OUTSIDE SPORTS - Our Game Room provides a cool and relaxed environment where campers can play, unwind, and socialize. Outside we have our own well-equipped playground for fresh air fun, and for our older campers, we have a shady park with a playground and picnic area right next door!

2016 MTG SC Parent Handbook 3/10/16

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Our Movie Themes:

* Weeks 1–3: “ZOO-PHORIA” June 20 – July 8 *

Our first DVD: Inspired by Disney’s personification of animals in Zootopia (and countless other movies over the years! Jungle Book, Lion King, and 101 Dalmatians to name a few...), our campers will find themselves in a place where animals rule! We might meet a slow-moving sloth, encounter an elephant named “Smalls,” or a dog who just wants to be friends with everyone -- even the CAT! When a new and unfamiliar furry face comes along with big plans to “civilize” the town, the creatures realize they must set aside their differences and come together to save their home. Confronted by the clash of conflicting personalities (like the upcoming Secret Life of Pets), they’ll overcome stereotypes and discover unlikely friendships, and they might even find that not ALL change is bad.... some changes can be quite nice!

* Weeks 4–6: “GALAXY GAMES” July 11 – July 29 *

“Uuuuuuuuur ahhhrrrr aaaaarhg!” Let us translate: Chewbacca wants us to include him in our 2nd DVD this summer! Our campers will join up with Chewy and friends, such as Finn, Rey, and BB-8 (all from Star Wars, the Force Awakens), who find themselves down on their luck (much like Charlie Brown from The Peanuts Movie, or Alexander in Alexander and the Terrible, Horrible, No Good, Very Bad Day), and realize that they must join forces to save their planet? Their ship? Their treasure? Even in a galaxy far, far away, our characters will face obstacles that can be hurdled through the strength of their character. Bravery, compassion, and selflessness win, even as things don’t go according to plan.... * Weeks 7-9: “FINDING DOROTHY” August 1 – August 19 *

For our 3rd and final DVD of the summer, our adventures will take us under the sea! Our mission is to find what – or maybe even who – is lost... (like in the long-awaited Pixar sequel, Finding Dory and in The Wizard of Oz)... And the journey that enfolds will be exciting, silly, even a little scary at times... (We’ll search with an adventurous spirit like Indiana Jones, Pirates of the Caribbean, or even the kids in Goonies!) What if we find ourselves like “fish out of water” in a quaint seaside town (remember when The Little Mermaid wanted to walk on land?)... We’ll find ourselves searching for what we’ve lost... and discover so much more than we’d bargained for... We’ll learn to appreciate both family and friends in this epic ocean adventure!

*Week 10: TALENT SHOW & CAST/BACKSTAGE CREW PARTY! Aug 22-26* Our final week of summer camp will be a celebration of all our talents & accomplishments, complete with live performances, bloopers, screenings, and ice cream sundaes!

2016 MTG SC Parent Handbook 3/10/16

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Our Art Studio Themes:

OurArtStudioincludes:mixedmediatechniques/texture,sculpture(includingclay),printing,photography,collage,studyingelementsofart,paintingwith&withoutabrush(acrylics),pastels,

architecture,PopArt,watercolortechniques,fiberart,installations,&inspirationfromtheMasters...Eachweek,wewillhaveathemeaswellasofferingmanyvisualartworkoptions!

WEEK1:TheScienceofArt June20th–June24thRollupyoursleeves&preparetoinvestigatethe“ScienceofArt!”Getreadytoexplorecolormixing&colortheory,experimentwithpapermaking(likeMelissaJayCraig,moderndayartist),anddiscoverhowsaltreactstowatercolor&oilresist!

WEEK2:SpotlightArtist:WayneThiebaud June27th–July1stLet’stalkaboutfood!WayneTheibaud’syummypiecesofartfocusonourfavoritetreats(suchaspies,pastries,icecream,evengumballs!)&hisrealisticstyleofpaintingwillinspireustocreateourowncolorfulrenditions.

WEEK3:CulturalCreativity:NativeAmericanArt July4th–July8thThisweekwill be filedwith native patterns & design.Wewill focus on totem poles, tee pees, dream catchers &weavings,whilealsostudyingtheartoftheNavajo!

WEEK4:MathMeetsArt July11th–July15thHowdoesMathmeetArt?Wewilldiscuss theworksof “Dot-DotSeurat”&PennsylvaniabornSculptorAlexanderCalder.Wewill examine shapes&lines to createbiggerpictures– likemandalas& tessellations – focusingon theamazing,sometimesimpossible,worksofM.C.Escher.

WEEK5:SpotlightArtists:ClaudeMonetandCézanne July18th–July22ndWhilefocusingonMonetwewillexplorehisuniquebrushstrokes&famousworksofart,&discusshiswell-knownpaintingsofflowers,seascapes,&landscapes.We’llalsodabbleintheartofCézanneasweexplorestilllifepainting,texturedlandscapes,&wemightsurpriseourselveswithanotheruniquestyleofpainting...

WEEK6:CulturalCreativity:CelticArt July25th–July29thWhile visiting the countryside of Ireland, wewill design ornate castles & create rolling hill landscapes like IrishPainter Paul Henry. And who can forget the shamrock, which might inspire an exploration of symmetry, linedrawings,oreventhemanyshadesofthecolorgreen?

WEEK7:IspeaktheLanguageofArt August1st–August5thDuringthisweek,wewillexploreArtasitisexpressedinbooks.Wewilldiscoverthecolorfulartintheever-popularbooksofEricCarle(TheVeryHungryCaterpillar,TheGrouchyLadyBug,&manymore!)aswellasauthor/illustratorPeter H. Reynolds (The Dot& Ish, to name a few).Language plays a big role in Art in the form of illustration, &LanguagecanevenbecomeArtthroughcalligraphy&script,evenmonograms...

WEEK8:SpotlightArtists:MatisseandChihuly August8th–August12thWhenwethinkofHenriMatisse&DaleChihuly,wethinkoffree-flowingshapes&forms.Thisweekwe’llexploreArtinboth2D&3D.WhenfocusingonMatisse,wewillcreatelayers&useboldcolorstocreate2Dartworks.WhenweswitchtoChihuly,wecancreatevibrant,abstractsculptures,inspiredbyhisincredibleblownglassmasterpieces.

WEEK9:CulturalCreativity:ArtofSouthAmerica August15th–August19thWithbrightlycoloredyarnsandfabricswecancreatetraditionalMolas,&tryourhandsattheChileanstitchingartcalledArpilleras.We’lltakealookattheartisticstylingsofRaúlRecioandFridaKahlo,aswellastheancientSouthAmericanArtoftheAztec&Mayanpeople.WEEK10:CelebrationofSummer... August22nd–August26thCelebrate another summer gone by! It’s time for one final “hurrah” as we reflect on our summer of fun withautograph pages & scratch-art souvenirs to remember our fun & friendships. Let’s celebrate our unboundedcreativity! Specially designed picture frameswill be the perfect keepsakes to hold our specialmemories; beadedbracelets&sand-artmakegreatgiftsthatsay,“Seeyounextsummer!”

2016 MTG SC Parent Handbook 3/10/16

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IN SUMMARY: Dig/Arts * are all about self-image

* provide lessons in teamwork * contribute to a sense of belonging

* lead to higher test scores in core subjects * significantly improve writing & thinking

* inspire creativity that can be applied to all areas of life!

What Can the Dig/Arts do for your Child? Look at the Research!!

Academic Achievement

A three-year study investigated the effects of dramatic and visual arts in elementary school students’ attitudes toward learning. Results indicate substantial improvement as a direct result of the revised

curriculum: standardized language test scores and report card grades in the core subject areas increased significantly. Please go to http://www.nwrel.org/scpd/catalog/Modeldetails.asp?ModelID=12 or to

Catterall’s study at http://www.asu.edu/copp/morrison/public/schools.pdf.

A 15-week study of the effects of theatre arts on second and third graders’ narrative writing skills shows a positive correlation, evidenced by the experimental group’s significantly improved scores over

scores of the control group. To read more, please go to Moore and Caldwell’s study at http://www.artsedsearch.org/summaries/drama-and-drawing-for-narrative-writing-in-primary-grades

Integrating dramatic and visual arts into the curriculum over the course of a three year study, elementary school teachers reported improvements in reading and math, as evidenced by year-to-year scores. Please

see http://www.cehd.umn.edu/carei/publications/documents/Summative2003Rev.pdf.

Self-esteem and Motivation

A two year study of more than 2000 students in grades four to eight were assigned to classifications of “high-

arts” or “low-arts”, depending on the amount and diversity of arts in the school’s curriculum. High arts students

scored significantly higher on measures of verbal expression, creative thinking, cooperation, risk-taking in

learning, and confidence in their own abilities. Please see http://aep-

arts.org/PDF%20Files/ChampsReport.pdf.

The US Department of Education sponsored a three year study of arts-integrated classrooms. Results show

significant improvements in elementary and secondary students’ cooperation, problem-solving, academic

preparation, and initiative for learning. To read more, please go to:

http://72.167.227.108/downloads/reports/nea1.pdf.

Social Skills

Kindergartners in a four-week series of creative arts play showed significant

improvement in conservation and perspectivism, two social cognitive

abilities. To read more, please go to Fink’s study at:

http://www.artsedsearch.org/summaries/role-of-imaginative-play-in-cognitive-development

Among elementary school students in a

three year, state sponsored arts-integrated curriculum study, interaction

improved in areas of group communication, acceptance of leadership roles and goal-

oriented teamwork. Read more at http://www.cehd.umn.edu/carei/publicatio

ns/documents/ElemImages.pdf

2016 MTG SC Parent Handbook 3/10/16

6 Excerpt from a 2013 webinar with

R. Busczynski, PhD, & L. Cozolino, PhD & aurthor of The Social Brain: Why No Brain Heals Alone

The Impact of Storytelling on the Brain Dr. Buczynski: Let’s talk about storytelling. What impact does storytelling have on the brain? Dr. Cozolino: Storytelling is incredibly important because... there’s a high positive

correlation between brain size and the complexity of the social culture that an animal lives in. It takes a lot more brain-power to deal with all the subtleties of relationship than it does to deal with surviving an environment.

We see this complex development [of humans in society], and as that’s gone on, the brain has gotten more intricate and more complicated… where right and left hemispheres are highly specialized. We have very, very specialized systems. For example, one network in our brain just processes the right side of faces!...

The more divergence and diversity among brain systems, the greater the requirement is for the integration of these systems. Some of that is internalized in executive processing,

but as society and communication have become more complex, and social relationships have become more central, some of this integrative work has been offloaded into the group mind in the form of stories.

We have stories that we constantly share with each other that serve to integrate our brains and to remind us of who we are. Stories establish and pass on our role and culture. Stories are also the repositories of social learning. Stories play many, many roles, both for the brain and for society at large.

Elements of a Good Story and Neural Integration Dr. Buczynski: You wrote in your book about the elements of a good story. Let’s go through that and talk about both the elements of a good story and how these elements affect neural integration. Dr. Cozolino: The most basic idea and the key to all of this has to do with the fact that our right and left hemispheres have diverged pretty significantly in the last 20,000 or 30,000 years… The right hemisphere specializes in emotion (in very high levels of arousal – terror and in very low levels of arousal – shame) and is much more connected with the body. The right hemisphere is specialized in things like visual spatial processing. The left hemisphere on the other hand is specialized more with sequential processing and logic and language – where the generic beliefs seem to be holding up. A story is a linear sequence of events (except in Tarantino films) but stories are generally a linear series of events that have some emotional core. There’s an emotional struggle. If I give you a series of events of my day, but nothing particularly interesting happens, you’re not going to want to hear the story. But if I run into conflict, if I get in my car and there’s an alligator in my car, that’s what becomes interesting. That becomes the story, and that’s the right hemisphere.

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How the Narrative Activates the Brain Dr. Buczynski: Now, what’s happening in the brain with the narrative? You write in your book about how it activates the frontal functioning, which then down-regulates the amygdala. Dr. Cozolino: It seems that either telling stories or writing our stories, speaking them or journaling them or how ever we get them out, activates, integrates, and builds the prefrontal cortical parietal structures that allow us to have an internal imaginative reality. We can use these pictures of ourselves. [We can] internalize images and manipulate them in our minds. We can do this and rebuild the sense of self in these regions. We can build a sense of self, disconnected from the environment; we can create other options and opportunities and envision different outcomes. [This helps us problem-solve, invent, spin hypotheses, etc.] All of this cortical processing in turn builds descending inhibitory and regulatory function to the midbrain, to our emotions. [This serves to help us regulate our emotions!]

The prototypic narrative, at a very fundamental level, integrates the time and sequencing of a left hemisphere and the space and the emotion of a right hemisphere. Stories help to constantly keep our right and left hemispheres interacting and integrated with one another. Now, at another level, there’s the narrative that we’re probably all familiar with, which is the narrative of the hero. It’s the person who has some inner conflict and/or some external conflict, or external challenge, and it’s really classically the struggle to go from adolescence into adulthood, …[or the struggle of any level of growth in our lives]. You see this narrative of the hero in …many films… There’s a wonderful new movie out, a Pixar film (2012) called Brave which is all about this young girl whose heroic journey into adulthood involves the resolution of her conflict with her mother. There is no Prince Charming to save her or the mother. The mother and the daughter save each other. [In prototypic stories such as this]…The narrative serves as a blueprint for development and growth. My favorite one is The Little Engine That Could and that is one we all pretty much know from childhood where this little train with a bunch of toys and candy wants to get over a hill so that they can take care of the children. The little train says, “I don’t know if I can. I’ve never done that. I just work around the yard here moving things around.” But they pile in and the train says, “I think I can...I think I can”. When she reaches the top of the hill and goes over the top she says, “Oh I knew I could...I knew I could.” That’s the moment – the memory of that narrative through time is captured when you’re saying, “I think I can...” You also embody the ending, “I knew I could.” The narrative provides optimism. These stories and narratives are incredibly valuable and important. That’s why they’re so essential to our lives.

2016 MTG SC Parent Handbook 3/10/16

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Kinder Works DIGital/ARTS SUMMER CAMP

PARENT’S HANDBOOK

MONTGOMERYVILLE 2016

Dear Parents, Welcome to Kinder Works Dig/Arts Summer Camp! We are a full-service summer camp, with all amenities on site. Thank you for being a patron of the Arts! This Summer Camp Handbook was developed to answer some of your most frequently asked questions. We thank you for reading this Handbook and for helping us by following these Summer Camp policies and procedures. To register, please return your completed Kinder Works 2016 Dig/Arts Summer Camp Registration, Camp Emergency Contact/Policies Signature Form, Civil Rights Compliance Parent Awareness Form, and a *Child Health Report (if required). All of these can be found at the end of this Handbook. Thanks! Also we included a copy of the W-10 FORM; this is not to be filed with the IRS but is to be kept for your own records. In order to claim the tax credit for childcare, you must provide the information given on the W-10 (Provider’s ID #) to the IRS. Yours truly, The Kinder Works Dig/Arts Summer Camp Staff *CHILD HEALTH REPORTS: If you are registering for weeks that span more than a 30 day period, a “Child Health Report” is required (for example, if you are registered for weeks 1 & 7, it is required. If you register for weeks 2 & 4 it is not). You do not need a medical examination if your child is already under a Doctor’s care, and has received a physical or wellness check up within the year. Simply give them the form with a stamped, self-addressed envelope.

2016 MTG SC Parent Handbook 3/10/16

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Kinder Works CAMP DIRECTORS

Nicole Stewart is our Camp Director. Nicole (Nikki) has worked for Kinder Works for over 20 years, including 13 years as a Director. She is happy to meet with you to answer your questions, show you around, and tend to all the details that make our camp the friendly comfortable place it is. You can find Nikki in the Office (or in a classroom or playground!), call her at 215-822-7510, or email her at kinderworksm @kinderworks.net.

April Bass is our Executive Director. April has over 30 years of experience in Education; she founded Kinder Works in 1985. She has designed and developed 48 educational and camp programs, and is a consultant to both the public and private sectors. April’s Bachelors and Masters degrees are from Barnard College and Columbia University.

Joanna McCartney is our Program Coordinator. Joanna graduated from Penn State University with her Bachelors Degree in Elementary and Kindergarten Education. She joined Kinder Works in 2003 with more than 3 years of experience teaching young children in Harrisburg and in the North Penn School District. She is certified as an Early Childhood and Elementary School Teacher by the Pennsylvania Department of Education.

Sue Morgan is our Fiscal Director. Sue joined us in 1995 with 10 years of bookkeeping and business experience. Sue keeps our financial records and accounts straight and manages all of our financial work.

If you would like to contact Sue Morgan regarding a tuition question, or April Bass or Joanna McCartney regarding any concern or question or comment you might have, please call 215-345-0370, or email [email protected]. We are here to serve you.

2016 CAMP TUITION PAYMENTS & PAYMENT SCHEDULE DUE DATES

Summer camp payments are due according to your confirmed “Registration Form,” which is your summer camp enrollment application/agreement. A non-refundable registration fee of $35 (per child), and one week’s tuition is due with Registration Form to hold schedule choices. (Tuition will be credited.) Payments should be made out to Kinder Works, and include the child’s full name on the ‘memo’ line of your check. Registration and payments may be mailed to 595 Bethlehem Pike, Bldg. 500, Montgomeryville, PA 18936, or may be dropped off at the Camp Office.

If you use on-line banking, you can set it up to have checks made out to Kinder Works and sent directly to our Fiscal Office at 1090 Pebble Hill Road, Doylestown, PA, 18901. (We do not accept credit cards because they charge approximately 2.25% on total transactions, and we do not want to pass that cost on to you.)

Please note that our Summer Camp allows for very flexible scheduling, with no maximum or minimum number of weekly sessions. You can “buy by the week!” Because of this great flexibility, no other discounts apply. Tuition payment due dates for each week of camp are listed below.

WEEK DUE DATE WEEK DUE DATE 1 6/20 – 6/24 June 6 6 7/25 – 7/29 July 5 2 6/27 – 7/1 June 6 7 8/1 – 8/5 July 18 3 7/4* – 7/8 June 20 8 8/8 – 8/12 July 18 4 7/11 – 7/15 June 20 9 8/15 – 8/19 August 1 5 7/18 – 7/22 July 5 10 8/22 – 8/26 August 1

*We are closed on Monday, July 4th, and tuition for M-F and M,W,F schedules will be prorated for this week.

Non-payment after due date will result in cancellation of registration. Unfortunately, we cannot reserve a place for your child if you have an unsettled account. We will send you, via email, a late fee notification (a statement of your account), which serves as a warning of service termination. Payment must be made immediately after a late statement is received, or termination will ensue.

2016 MTG SC Parent Handbook 3/10/16

10 There will be a $30 charge for a bounced check. (Sorry! Banks charge us for your bounced checks too!) If your check bounces, we must receive payment plus the $30.00 within 3 days. If there is a second occurrence, you must make all remaining payments by cash, money order, or certified check.

If you would like a receipt for your tuition payment(s) for dependent care, taxes, or for any other purpose, please call our Fiscal Director at 215-345-0370, or you can email her at kinderworks@ kinderworks.net (be sure to include your child's name, and with which Kinder Works Summer Camp you are affiliated: Montgomeryville, Doylestown, or Limerick). We are happy to email payment receipts upon request.

Our Fiscal Director can also fill out dependent care forms, and talk with your dependent care administrators directly, as needed, to meet their various requests for proof of tuition payments. If you request this, please supply the forms and/or contact information.

Parents/guardians of a subsidized child must complete all required CCIS and Kinder Works paperwork, sign the CCIS attendance sheet on time, pay their weekly CO-PAY on time (which is determined by CCIS, not by Kinder Works), and abide by the CCIS agreement as well as Kinder Works policies to continue enrollment at Kinder Works Summer Camp. We are mandated to report to CCIS when a child attends and is absent and when a client does not pay the co-pay. CCIS will communicate with each client about how many days of absenteeism are allowable and they will terminate any client who does not pay their co-pay.

REFUND POLICY: We do not charge for services past your documented last day of enrollment in summer camp. This means that if you require early withdrawal for any reason, before the end of your registered camp dates, we will refund you for any pre-paid unused days of service past the documented last day. (Please note that schedule changes such as “early withdrawals” are subject to a $50.00 processing charge; more info below.)

When your child misses camp due to reasons such as illness or family vacations, we regret that we cannot accommodate switching days to make up lost time or refund money for missed days. Tuition is charged for your registered schedule, whether your child is present or not. We regret we cannot make refunds based on absenteeism. Thank you for your cooperation.

YOUR CHILD’S SCHEDULE

Your camper is enrolled for specific days and times and we rely on you to keep that schedule. The only exception to this is when all children are invited to a special event outside of their registered schedule (such as a “filming session,” talent show, or cast party; you will be given invitations to such events in advance).

Please consider your schedule choices carefully. If you would like to request a schedule change (including adding additional weeks of camp or canceling previously scheduled weeks), a “Request for Change of Schedule” form must be obtained from the Director and completed. All changes involving a drop or a reduction of hours carry a $50.00 processing charge. If the desired change can be accommodated, you will receive a “Tuition Account Summary” and statement that reflects your tuition adjustment. A Kinder Works signature on the request will serve to bind the new camp tuition agreement.

If you wish to have your child stay for additional camp hours for which you are not registered, or to stay for the lunch hour (and s/he is enrolled for only the morning or afternoon session), the charge will be $15.00 per hour. You must ask your Camp Director about this in advance, and she will give you the “Request for Extra Hours” form if your request can be accommodated. Please understand that we have limited availability for this.

TO AVOID BEING BILLED FOR EXTRA HOURS, please be sure to drop off and pick up your child at your scheduled time. The morning program ends at 12:00 Noon, and the afternoon program begins at 1:00 PM.

“Notification of Late Pick-Up”: We offer hours of care to 6:00 PM. Please be advised that we charge a $15.00 late fee for every 5 minutes past 6:00 PM. Lateness causes problems with staffing and insurance, and continual late pick-up is therefore grounds for termination of service. (If campers who are scheduled to be picked up at 12:00 Noon are picked up late, they will be charged for the lunch hour.)

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DROPPING OFF / PICKING UP YOUR CAMPER

At Kinder Works, safety is a priority. Our school is equipped with a security system that includes a keypad-entry. You will receive your confidential access code with your “Camp Welcome Packet” after your registration is confirmed; please share your confidential code only with those adults you authorize to pick up your child. When you enter the building, if you hold the door open for someone else to enter, please be sure that you know that person is involved with Kinder Works. You may be familiar with faces of other parents and staff, or you may know the person, but if not, just kindly tell him or her to ring the doorbell because you don’t recognize him/her. If you are uncomfortable because someone has followed you in, please tell the Director or any of our staff right away. Thank you for keeping us all safe!

At the beginning of each week you will find your child’s name on a group list that is posted in the foyer and and/or Atrium. You will also find information explaining where your child’s “first period” activity area is, the schedule of events for the day, and where s/he can be picked up.

DROPPING OFF: When dropping off your child, please escort him/her into the camp. Please bring your child into his/her scheduled activity area or classroom (refer to posted schedule), so that the Camp Staff knows that your child has arrived. Your child will be supervised at all times. Please note that Kinder Works opens at 7:00AM and closes at 6:00PM; children cannot be dropped off before opening. Children in the afternoon program should be dropped off to their Counselor at 1:00 PM. Please try to arrive as close to the start of the afternoon as possible.

PICKING UP: Parents (and/or guardians) must pick up children from inside the building or playground. (Refer to the schedule of events posted to locate your child at any time.) You must sign your child out on the camp clipboard (your child’s Counselor or Specialist has it). Make sure you watch your children after you have picked them up and signed them out; please don’t let them wander through the building or out in the parking lot! Thank you! Once a parent “signs out” his or her child, the parent is then solely responsible for supervising the child while on agency premises. Please handle all business issues prior to signing out your children. (For Late Pick-ups, please see the section titled “Your Child’s Schedule.”)

RELEASE OF CHILDREN: We will release your child to the parent(s) and/or guardian(s) who sign the “Summer Camp Registration Form” and to those adults for whom you have given written authorization on the “Kinder Works Camp Emergency Contact/Policies Signature Form.” If someone else is to pick up the child, we will not release the child unless you have filled out a “Release of Child Upon Parent’s Oral Designation Form” (please ask the Director for this form), and proper ID is presented. This form should be completed in person, not over the phone. Only in an emergency, this form may be completed upon the oral designation of the parent, if the identity of the parent can be verified by a staff person. All changes and/or additions to the Emergency Contact form and Registration form must be made in writing and be dated and signed. Only custodial parents (and/or guardians) have the right to make changes or additions to this form. All adults acting “in loco parentis” (in place of a parent) must abide by this Parent’s Handbook.

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In cases where an enrolled child is the subject of a court order (ex: Custody Order, Restraining Order, or Protection from Abuse Order), Kinder Works must be provided with a Certified Copy of the most recent order and all amendments thereto. The orders of the court will be strictly followed unless the custodial parent(s) requests a more liberal variation of the order in writing. In the case where both parents are afforded shared/joint custody by order of the court, both parents must sign the request for more liberal interpretation of the order.

In the absence of a court order on file with Kinder Works administration, both parents shall be afforded equal access to their child as stipulated by law. Kinder Works cannot, without a court order, limit the access of one parent by request of the other parent, regardless of the reason. If conflicting court orders are presented, the most recently dated court order will be followed.

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Once presented with a Protection from Abuse Order or a Restraining Order, Kinder Works is obligated to follow the order for the entire period it is in effect. Employees of Kinder Works cannot, at the request of anyone except the issuing judge, allow a Protection from Abuse Order and/or a Restraining Order to be violated. Kinder Works will report any violations of these orders to the court.

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Persons appearing to be impaired by drugs/alcohol at pick-up: The staff of Kinder Works will contact local police and/or the other custodial parent should a parent appear to the staff to be under the influence of drugs and/or alcohol. The parent’s right to immediate access does not prevent Kinder Works from denying a custodial parent access to his or her child if the parent is or appears to be impaired. Any other authorized person who attempts to pick-up a child, and appears to the staff of Kinder Works to be under the influence of drugs and/or alcohol will be denied access to the child. The staff of Kinder Works will contact the child’s parents, local police, and Child Protective Services to notify them of the situation.

THE FIRST DAY OF CAMP & MORE…

On your child’s first day of camp, please look for his/her cubby in the Atrium. This is where you can keep personal belongings, including a change of clothes. PLEASE LABEL all of your camper’s belongings, including extra clothes, lunch boxes, thermoses and water bottles, etc. If your camper stays for lunch, lunch bins labeled for your child’s camp group can also be found in the Atrium. Coat hooks are in the playground hallway, if needed for sweatshirts or raincoats, etc.

At the end of the day, please check your camper’s cubby and the appropriate Camp Group display tables for his/her special creations and belongings daily. Also look in the foyer and Atrium for photos and displays of some of the fun and exciting activities your camper enjoys each day!

PLEASE SEND IN extra clothes, including socks, pants, underpants, and a shirt for your child. (Not just for potty accidents, but in case we get wet, or messy, etc.) We recommend that you put them in a plastic bag labeled with his or her name.

For our youngest campers who are starting summer camp but not quite potty-trained, we want to promote comfort and success. If you’d like your child to wear pull-ups at Kinder Works Summer Camp, please send a supply, which we will store in his or her cubby. Please write your child’s initials on each pull-up; a note will be given to you when you need to replenish your supply. (Note that Kinder Works provides Pampers Sensitive Baby Wipes [and Pampers brand diapers, size 1-6].) Also, please complete “The Potty Paper” (available from your Director or Counselor).

FOR THE VERY YOUNG, a special toy or blanket can be a great comfort, and an important stepping-stone to independence. It is fine to bring a special item to camp. We will protect it, and make sure that other children respect its importance, and store it in the child’s cubby when it is no longer needed. (Please label all items that your child brings.)

FOR OLDER CHILDREN, toys, gadgets, devices and games brought from home are welcome, and can add to the fun when shared. Campers can enjoy using these items in the Game Room, during program time. (Again, please label everything your camper brings to camp!) Please note that we cannot be held responsible for the safety of toys, gadgets, and devices that are brought to Kinder Works by you and/or your child. Please also note that we will not allow children to have access to the internet unless it is specifically supervised by staff.

DIGITAL TECHNOLOGY: We reserve the right to supervise the use of any and all digital devices brought in to Kinder Works. We prohibit taking pictures or video on Kinder Works property without the express consent of the Executive Board. We also prohibit the use of Wifi, unless it is specifically supervised by staff, thus preventing the children from making unauthorized purchases or accessing unauthorized websites. Again, Kinder Works is not responsible for the safety of digital technology brought in from home.

LOST AND FOUND is located in the Atrium or in the Director’s office. Please check it out for lost items!

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13 SUNSCREEN: In order to keep our campers sun-safe, please send them to camp wearing sunscreen. We will reapply sunscreen to full day campers using Water Babies Pure & Simple SPF 50 by Coppertone; we request that you send a bottle of this type of sunscreen to camp with your child. If your child CANNOT use this particular brand of sunscreen (due to medical reasons or otherwise), please notify the Director in writing and supply alternative sunscreen. (You can use the “Medication Dispensing Form,” which can be obtained from your Director.)

SNACKS & LUNCHES

SNACKS: Snacks are provided each morning and afternoon by Kinder Works. However, if you would like to supply a snack for your child’s camp group for a birthday, holiday, or at any other time, please let your child’s Counselor know, and s/he’ll add your name to the group Snack Sign-Up Calendar. Please bring enough to serve 25 (it always helps to have extra), and give snacks to your child’s Camp Counselor or Specialist. Thanks! Here are suggestions for snacks: fruits such as grapes, bananas, or apples, pretzels, natural crackers, cheeses, muffins, or low sugar cookies. Vegetables with dip are always a big hit. (For commonly available “safe snacks,” free of peanuts, tree nuts and eggs, please check out this website on which we are sure you'll find multiple snacks that your child will enjoy: snacksafely.com. And the list [which is updated weekly] can be found at: http://snacksafely.com/snacklist.pdf.) Please see below for information regarding peanut and tree nut allergies; parents of children with severe allergies should provide a supply of safe snacks for their children.

If your child is having a BIRTHDAY during summer camp, you are welcome to provide cupcakes, cookies, or birthday cake for his/her camp group (no candles, please!). Please try to make it as nutritious as possible, and include a list of ingredients.

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WATER: We always have water available for thirsty campers. We serve water at snack time, not milk or juice. We teach healthy hydration with water because recent research shows that many children go all day with too little water and too much juice and soda! Water is essential for good health; it's as important as any vitamin or mineral. Drinking enough water every day is necessary to help keep your child’s body working at its best.

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LUNCH: Lunch should be packed in an insulated lunchbox with a cold pack to keep it fresh. Another alternative is to freeze juice boxes; they thaw by lunchtime and keep everything else cool. Refrigeration is available; please let us know if you need it by labeling the outside of the lunchbox. Please pack food that doesn’t require heating. We recommend using a “thermos” (either stainless steel or plastic) to keep lunch foods warm or cold; this allows your child to be able to start eating his or her lunch immediately, without waiting for any further warming or prepping time. Please note that lunchboxes will be sent home empty of perishable foods; food not eaten and perishables must be discarded for health and safety reasons.

If you pack food that needs to be eaten with a spoon or fork, please include the utensil in the lunchbox. For younger children, please send “finger foods” so the children can practice eating independently. We encourage children to eat healthy foods first, for instance their sandwiches first and dessert last, and we prevent trading foods. We encourage good table manners and self-help skills; we will serve all food in a way that reinforces manners and independence.

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WE PROMOTE A PEANUT- AND TREE NUT-FREE CAMP. Some of our children have severe peanut and/or tree nut allergies; and some of these children can have severe reactions, including life-threatening reactions, to peanut and/or tree nut oils, residue, and airborne particles. Therefore we rely on all of you to help keep our children safe. We rely on you to pack peanut and tree nut-free lunches and snacks. Please check ingredient labels for peanut and nut fragments and/or traces. Please check for and avoid: “may contain nuts or peanuts”, “produced on shared equipment” and “produced in a facility that also processes nuts or peanuts”. People who are allergic to peanuts and nuts also have to avoid foods with these statements on the label, due to the possibility of cross-contamination. Please send your child’s lunches and snacks with original wrappers. We surely want to keep all of our children safe, and we thank you for your cooperation in helping us minimize the risk for allergic children!

We promote a peanut and tree nut-aware environment. All of our children are educated about not sharing food, and washing their hands frequently. Kinder Works as a whole supports children who do have allergies, as well as their families. All staff with a ‘need to know’ are apprised of “Action Plans” for severely allergic children (more information to follow).

If your child has peanut or nut products in his or her lunch, we will safeguard others by having him or her eat in another room or at another table where there are no allergic children, washing hands and face after the meal, and washing the table used with soap. (Soap washes peanut and nut oils away, whereas hand sanitizers & anti-bacterial products do not). We will also send a note home to let you know, so you can avoid sending this food into Kinder Works.

Children with severe allergies will eat at special ‘peanut-free’ or ‘nut-free’ tables as deemed necessary. These tables will be wiped down before and after meals with soap, as a precaution.

ANY FOOD ALLERGIES YOUR CHILD HAS SHOULD BE DOCUMENTED ON YOUR CAMP EMERGENCY CONTACT/POLICIES SIGNATURE FORM. For those parents of children with severe allergies, please understand that although our policy is that “Kinder Works is a Peanut- and Tree Nut-Free Camp”, we cannot guarantee a peanut- and nut- free camp, but we make every effort to ensure your child’s safety. (Please also see the section on “Camper Medication - Allergies/Special Needs - Illness” in this Handbook.)

CAMPER MEDICATION – ALLERGIES/SPECIAL NEEDS - ILLNESS

MEDICATION: Campers who are to receive PRESCRIPTION MEDICATION or SPECIAL MEDICAL PROCEDURES administered by our staff must first have written parental permission and doctor’s instructions on file in the Office (instructions for administration on the prescription label are acceptable as doctor’s instructions). Please complete the “Medication Dispensing Form” (request this form from the Director). Over-the-counter medication (including cough drops, anti-itch cream, etc.) also requires written parental consent for administration. (Again, please complete the “Medication Dispensing Form.”) All medication must be in the original container and labeled with your child’s name. PARENTS ARE RESPONSIBLE FOR PROVIDING KINDER WORKS WITH MEDICINES (INCLUDING EPI-PENS) THAT ARE WITHIN THEIR EFFECTIVE DATES; EXPIRED MEDICINES MUST BE REPLACED BEFORE THEIR EXPIRATION DATES.

NEVER put medication in your child’s cubby, knapsack, or lunchbox! Medications/ drugs must be handed to the teachers or brought directly into the Office by the adult bringing the child to Kinder Works Summer Camp; it will be safely stored in the Office/Kitchen.

In cases where the “Medication Dispensing Form” is not available and administration of the medicine is necessary, the Director may obtain verbal orders from the parent and/or attending physician by phone. Such verbal orders must be documented on the “Medication Dispensing Form” by the Director. In order for the medication to be administered again the following day, a signed “Medication Dispensing Form” must be made available by the parent.

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15 ANY FOOD ALLERGIES/SPECIAL NEEDS (Medical, Dietary, or Other) THAT YOUR CHILD HAS SHOULD BE DOCUMENTED ON YOUR CAMP EMERGENCY CONTACT FORM, and you must verbally notify the Director upon enrollment.

FOR SEVERE ALLERGIES, in addition to the aforementioned “Medication Dispensing Form,” parents must complete the “Authorization & Action Plan for Children with Severe Allergies,” or its equivalent, signed by the physician and the “Release” form. These forms are available from your Director.

FAMILY’S RESPONSIBILITY in cases of severe allergy: 1. Notify Kinder Works in writing on the “Camp Emergency Contact Form,” and the Director in person. 2. Provide written medical documentation, instructions and medications as directed by your physician.

Use the “Authorization & Action Plan” form, or its equivalent, signed by your physician, AND complete and sign the “Release” form. (And, as stated above, provide and maintain the corresponding medications within their effective dates.)

3. Educate your child in self-management (as age-appropriate) by teaching him or her what foods are safe or unsafe and strategies to use in avoiding unsafe exposure.

4. Provide updated emergency contact information on the “Camp Emergency Contact Form.” 5. Supply ‘safe snacks’ to have on hand at camp (in the case of severe food allergies).

FOR SPECIAL MEDICATION ADMINISTRATION OR MEDICAL PROCEDURES OR SPECIAL NEEDS REQUIRING SPECIFIC MEDICAL SERVICES, in addition to the aforementioned prescription form, parents must complete an “Authorization & Action Plan” and “Release” form CREATED SPECIFICALLY FOR YOUR CHILD’S NEEDS. Your Director can give this to you.

Any SPECIAL NEEDS your child might have (ex: diet, allergies, asthma, delays, services, etc.) should be documented on your “Camp Emergency Contact Form.” If your child receives services (from the Intermediate Unit, Early Intervention, or Private Therapy, etc.) for any special need, developmental delay, or otherwise, it is advantageous to provide Kinder Works with a copy of the Individualized Service Plan (or similar plan) so that our staff may help serve your child and increase his/her success. Any information provided will be handled with discretion, maintaining confidentiality, and shared only with those with a “need to know.” Please hand any such information directly to the Director and she will handle the information so as to respect all rights to privacy. (You will be asked to complete and sign an “Authorization to Release Student Records” before any records, observations, or information can be shared, transferred, released, or discussed.)

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ILLNESS: Kinder Works follows all health/communicable disease policies as outlined in the American Academy of Pediatrics Model Health Policies and Procedures Manual. (Information is available on their website).

Please DO NOT SEND A SICK CHILD to Kinder Works! We clean everything regularly, and wash hands regularly, but if your child comes in sick, please consider the other children! Campers will be excluded from the program if they exhibit symptoms of any communicable disease.

Parents are required to pick up an ill child within 45 minutes of notification by phone. If a parent is reached, but cannot pick up his or her child within 45 minutes, it becomes the parent’s responsibility to arrange for alternate pick up with someone listed on the child’s “Camp Emergency Contact Form.” The Director will not continue to call those listed on the emergency contact list once a parent is reached. If a parent cannot be reached, the Director will begin to call the people listed on the “Camp Emergency Contact Form” until arrangements can be made for the child to be picked up.

Children will not be permitted to return to camp until they are no longer contagious. Guidelines for determining the contagious period for a specific illness are based on the recommendations by the American Academy of Pediatrics. Kinder Works reserves the right to refuse to allow a child to return if the Director or her designee believes the child to be too ill to participate in camp.

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If your child will be absent due to a communicable illness, we request that you notify the Director. This enables our Staff to keep track of any illness that might occur at our camp, so that the parents of the children at camp may be notified that a communicable disease is present. This information will only be shared with Staff on a “need to know” basis. Only communicable disease information will be shared. Kinder Works will take all measures necessary to protect your child’s confidentiality. You are not required to disclose this information by law, and your continued enrollment will not be based whatsoever on your decision to share (or not share) the reason for your child’s absence from camp. Certain communicable illnesses, which we must post when they appear in our camp or school population, shall be posted and a flyer shall be placed in your child’s cubby.

Please be alert to any of the following symptoms that may prevent your child from attending camp. Kinder Works recommends that you consult your Doctor and remain at home for any of these symptoms.

FEVER: Children excluded from the program due to fever may not return to the program until they are fever free, without any fever reducing medication, for 24 hours. If your child is sent home due to a fever, s/he is not permitted to return to the program the following day at a minimum. A fever is defined as a temperature reading on a thermometer of at least 101 degrees or more as taken under the arm.

DIARRHEA: Diarrhea can spread very quickly. Therefore, parents will be called immediately with a “liquid” bowel movement, and after the third incident the parent will be required to pick up the child. Children are required to be excluded from the program for loose bowels or diarrhea that occur 3 or more times in a 24 hour period of time. Children may return to the program when normal bowel movements resume; it is necessary for the child to be without any reoccurrence for 24 hours before returning to the Center.

SEVERE COUGHING: Severe coughing is present if a child gets red or blue in the face, makes a high-pitched croup or whooping sound, or has a constant cough.

DIFFICULT/RAPID BREATHING (This is especially important with a child under 1 year.)

PINK EYE: Parents will be called when tears, redness of the eye lining, irritation followed by swelling and/or discharge of pus is observed. After pink eye is diagnosed by a Doctor, the child can return to Kinder Works if the discharge is cleared and medication is being administered. A child must be on medication for 24 hours before he or she is no longer contagious.

VOMITING: Parents will be called immediately if their child vomits, and required to pick up their child if any other symptoms occur with vomiting or if a second incident is reported. It is necessary for the child to be without any occurrences for 24 hours before returning to the center.

BRONCHIAL SYMPTOMS: Sore throats, ear infections, or any illness requiring antibiotic medications require a 24-hour period at home before returning to the Center.

ADDITIONALLY: It is recommended that a child with any of the following symptoms see a Doctor and remain home so that they can be more comfortable and to prevent further illness:

• Unusual spots or rashes • Sore throat or difficulty swallowing • Infected skin patches • Heavy nasal discharge indicative of infection • Unusual dark, tea-colored urine • Grey or white stool • Headache and stiff neck • Unusual crankiness or lethargy • Excessive crying • General discomfort or seemingly unwell • Loss of appetite • Severe itching of body or scalp

At the discretion of the Director, a conference or Doctor’s statement of good health may be requested upon your child’s returning to the Center. For further information on suggested health care for your child, please see the American Academy of Pediatrics’ Recommendations for Preventive Pediatric Health Care on their website.

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NO NIT POLICY: A child who has head lice or nits will be excluded from the program. Parents must pick up a child with head lice or nits within 45 minutes of notification by phone. The child can return only after s/he has been inspected by the Director or her designee, and has been found free of head lice and nits. Please understand that head lice pose a public health problem. Follow your doctor’s instructions or take action recommended by www.headlice.org if you have an infestation. Our standard is the “NO NIT POLICY” at Kinder Works.

To guard against stings, don’t attract bees with fragrant perfumes and shampoos. Staff will show your children how to move away slowly and quietly if a stinging insect buzzes nearby.

Ticks actually pose a greater threat than bees, since they may carry Lyme Disease or Rocky Mountain Spotted Fever. Counselors and Specialists check the children for ticks after playing outdoors; ticks may be no bigger than a grain of sand. If a tick is found, we may use tweezers to gently pull ticks straight out; this will be done by the Director only. You will be notified in writing if this occurs. Call your pediatrician if your child develops rash or flu-like symptoms after a tick bite.

CAMP COMMUNICATION

CONTINUAL COMMUNICATION between parents and Camp Staff is ensured through a variety of modes listed below; the Director is also available to meet with you to answer your questions, show you around, and tend to all the details that make our summer camp the friendly and comfortable place it is. Please feel free to stop by the desk, call, or email us anytime! Feel free to leave notes with your child’s Counselor or Specialist, or drop into the office to speak with the Director with your questions and concerns. (Please don’t take the Staff’s attention from the children for long chats. Thank you!)

Please check your camper’s cubby and belongings everyday. Be sure to take home notes or notices from the Office, lunch boxes, projects, and any soiled clothes. Please empty your camper’s cubby at the end of a session if you are not returning for the next consecutive week.

KINDER WORKS PARENT COMMUNICATION FORMS are used to communicate with parents as needed. These forms are used to describe minor incidents/accidents that require minor first aid (ex: a scraped knee that is washed and a band-aid applied), or behavioral concerns that must be addressed by staff and/or the Director. These forms are also used as “Happy Notes” to share kindness, helpfulness, and “EQ Moments” with families!

If your child demonstrates behavior that is harmful to himself or herself or others, you will receive a “Parent Communication Form” which details the behavior, the teachers’ and Director’s interventions, and the plans to modify behaviors and/or prevent the behavior(s) from recurring. We will consistently use various intervention techniques to help your child use pro-social behavior. If your child presents a pattern of such problematic behaviors, we will document this and call you to enlist your help at home. If the behavior persists despite all efforts, we will call you and document warnings of impending dis-enrollment. We have a Zero Tolerance policy for violence and threats of violence. (Please also see our “Continued Enrollment Policy” section regarding Zero Tolerance.)

Your Child’s Records: While your child is enrolled at Kinder Works Summer Camp, accurate and up-to-date records must be collected and maintained. Your completed “Registration Form,” “Camp Emergency Contact/Policies Signature Form,” and “Civil Rights Compliance Parent Awareness Form” are all due upon enrollment, as well as the “*Child Health Report” (*if required). If you move, change jobs, change doctors, or change insurance companies, please notify us as soon as possible. Also inform us immediately of new emergency contact numbers and/or addresses.

Kinder Works Summer Camp maintains an “open door” policy; parents and grandparents are always welcome to drop by and visit. Please check in the office when you arrive. If we don’t recognize you, please excuse us for stopping you, and checking your ID!

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18 CALL/EMAIL: Our phone number is 215-822-7510, or you can reach us anytime via email at [email protected]. If you want to reach our Fiscal Director, Program Coordinator, or Executive Director, please call 215-345-0370 or email [email protected].

Email is our fastest and most efficient mode of communication, and it’s also environmentally friendly, so we use it whenever possible. In our efforts to “go green,” we will email most correspondence. Please let us know if you would like “hard copies” of anything that is emailed. Also, inform your Director if you update your email address or would like to provide an alternative or additional email address. (Please add us to your list of contacts so our emails don’t land in your “spam” file!)

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Privacy and Social Media: Please note that employees of Kinder Works are strictly prohibited from including any information and/or photographs related to Kinder Works, its employees and/or the children/families served by Kinder Works on any Kinder Works on any website, blog, or internet-based app including but not limited to Facebook, Twitter, Instagram, etc. Any violation of this policy will result in disciplinary action up to and including termination. Further, Kinder Works will pursue all legal remedies available for actions in violation of this policy.

Please note that Kinder Works maintains a Facebook “business page” to share updates, reminders, and interesting blurbs about early childhood education and research, and to communicate dates and times of upcoming events. Kinder Works obtains appropriate releases before posting any pictures to the business page. This page is strictly informational, and is not used for personal interactive exchanges. (In order to see all of our activities and news on Facebook, please “follow us;” go to facebook.com/Kinderworks and "LIKE" us by clicking the "like" tab, thumbs up!)

In the age of camera phones and digital technology, Facebook and other forms of social media, it is important to remember that texting/posting/sharing pictures, blogging, and writing “wall posts,” etc. of or about activities at Kinder Works easily breeches the rights to privacy and confidentiality of employees, children and parents, as such postings can quickly spread through the internet. To protect our children, families, and teachers, Kinder Works advises that parents do not post any pictures or comments of or about Kinder Works, its students, teachers, or property, as this could infringe on privacy rights, reputation, and confidentiality.

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CONFIDENTIALITY of the child’s records is strictly enforced. Parents have full access to their child’s records with the exception of material protected under the provisions of confidentiality statutes. Access is given to the Administrator/Director, and to the Department of Education, and the Pennsylvania Department of Human Services, or DHS (formerly DPW). All other persons requiring access (except the parents) shall obtain written permission from the child’s parents.

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EMERGENCY PROCEDURES

Kinder Works wishes to assure you of our concern for the safety and welfare of our children. Our Emergency Operations Plan (which is posted in every classroom) provides for response to all types of emergencies. We will make every effort to contact you via email and/or phone. We will also post emergencies on our “What’s New” bulletin page on our website. Depending on the circumstance of the emergency, we will use one of the following protective actions:

• Immediate evacuation – Students are evacuated to a safe area on the grounds of the facility in the event of a fire, etc. (Our evacuation location is on the path beyond the playground fence.)

• In-place sheltering – Sudden occurrences, related to weather, hazardous materials, or terrorist threat, may dictate that taking cover inside the building is the best immediate response. We are prepared to take the necessary precautions for in-place sheltering and have supplies on hand at all times for this action.

• Evacuation – Total evacuation of the facility may become necessary if there is a danger in the area. In this case, children will be taken on foot to our relocation facility and notice of relocation will be posted on the front door. (OPTION 1: at Building 100, which is the building located closest to Route 309 in our building complex; OPTION 2: Building 200, which is in our building complex, beside the mailboxes.)

• Modified Operation – This may include cancellation/postponement or rescheduling of normal activities. These actions are normally taken in case of severe weather or building problems that make it unsafe for campers (such as utility disruptions), but may be necessary in a variety of situations. We will email and/or call you or your Emergency Contact persons to alert you so you can pick up your child.

If your child is attending Kinder Works at the time when one of the above actions is taken, every attempt will be made to contact you. We will also notify you when we have resolved the situation and it is safe to pick up your child.

In the event of a local or regional emergency, which is beyond our control and not isolated to the Kinder Works site and results in closing the center, we will not reimburse for loss of service.

The Kinder Works Camp Emergency Contact/Policies Signature Form designates persons who can pick up your child; this form will be used every time your child is released. Please ensure that only those persons you list on the form attempt to pick up your child in the event of an emergency.

We specifically urge you not to make different arrangements during an emergency. This will only create additional confusion and divert staff from their assigned emergency duties.

In order to assure the safety of your children and our staff, we ask for your understanding and cooperation. Should you have additional questions regarding our emergency operating procedures contact your Camp Director at 215-822-7510.

If you are in doubt, call Kinder Works at 215-822-7510 and check the recording or check the “What’s New” bulletin on our website at www.kinderworks.net. We will leave/post a message regarding emergency situations for your information.

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CONTINUED ENROLLMENT POLICY A Special Note: All areas of our camp focus on non-violent, pro-social behavioral skills. We intend to create a safe, non-violent atmosphere, which will enhance your child’s “social and emotional intelligence” (what we call “EQ”) by offering and promoting alternative creative and physical activities and by disapproving of violent expression.

Our policy is zero tolerance for violent, abusive, and/or threatening behavior. Our goal is for every camper to enjoy activities and friendships in a safe and healthy environment.

Continued enrollment at Kinder Works is contingent upon the parent’s (and/or guardian’s), the emergency contact person’s, and child’s adherence to the policies and procedures of Kinder Works Summer Camp as outlined in this Handbook.

ZERO TOLERANCE: Kinder Works has adopted a “Zero Tolerance” policy regarding violent behavior and threats of violence. This means that a child displaying violent or threatening violent behavior must be controlled because he or she is dangerous to himself and/or others. If the behavior or threats cannot be remediated and they are deemed to be dangerous to self and/or others, the parents will be asked to remove the child from Kinder Works. If the child’s behavior continues to be a problem unresponsive to remediation, his or her enrollment will be terminated.

One of the goals of Kinder Works is to provide the most appropriate and safe environment in which a child can grow, learn, and develop. Achieving this ideal environment is not only the responsibility of the employees of Kinder Works, but is also the responsibility of each and every parent or adult who enters the center.

Parents/guardians are required to behave in a manner that fosters this ideal environment. Inappropriate behaviors include but are not limited to those listed below and may be grounds for termination in order to safeguard the children:

§ Swearing and cursing § Threatening of employees, children, other parents or adults associated with Kinder Works § Physical/verbal punishment of your child or other children at Kinder Works § Smoking on Kinder Works property § Violent verbal or physical confrontational interactions with employees, other parents,

or associates of Kinder Works § Violations of the confidentiality policy § Violations of the privacy and social media policies § Violations of the digital technology policies

Adults causing dismissal will not be permitted on Kinder Works property. Kinder Works will dismiss any child whose parent is prohibited from entering upon agency property. Due to the parents’ right to immediate access policy, as well as state and federal regulations, Kinder Works cannot have a child at the agency when the child’s parent is prohibited access. Kinder Works will not agree to any request to maintain a child’s enrollment even if the parent agrees to stay out of the center. Such an agreement is a violation of the law and will not be entertained.

Kinder Works reserves the right to dismiss any parent/guardian or child at any time with or without cause.

Kinder Works recognizes the great responsibility of caring for your children. We endeavor to give you the most dependable and trustworthy professional services possible. In so doing, we have strict policies for our staff regarding observing and interacting with the children. If, for any reason, you think your child has been mistreated by another child or by a member of our staff, please call us.

Please call us anytime: The Director, Nikki Stewart, can be reached at 215-822-7510 and [email protected]. The Fiscal Director (Sue Morgan), the Program Coordinator (Joanna McCartney), or the Executive Director (April Bass), can be reached via phone at 215-345-0370 and via email at [email protected]. We are here to serve you. Thank you.

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Kinder Works Central Office: 1090 Pebble Hill Road, Doylestown PA 18901

Executive Office: 5736 Stoney Hill Road, New Hope, PA 18938 215-345-0370

kinderworks.net This form shall be posted in each Kinder Works Center. SUBJECT: Nondiscrimination in Services TO: All Parents FROM: April Bass, Executive Director Kinder Works in Doylestown: 1090 Pebble Hill Road, Doylestown PA 18901 Kinder Works in Montgomeryville: 595 Bethlehem Pike Bldg 500, Montgomeryville PA 18936 Kinder Works in Limerick: 36 W. Ridge Pike, Limerick PA 19468 Admissions, the provision of services, and referrals of clients shall be made without regard to race, color, religious creed, disability, ancestry, national origin (including limited English proficiency), age, or sex. Program services shall be made accessible to eligible persons with disabilities through the most practical and economically feasible methods available. Any individual student/parent (and/or their guardian) who believes he or she has been discriminated against may file a complaint of discrimination with:

Kinder Works Please use address above Department of Human Services Bureau of Equal Opportunity Room 223, Health & Welfare Building 625 Forster Street Harrisburg PA 17120 U.S. Dept. of Health and Human Services Office for Civil Rights 150 South Independence Mall West Suite 372, Public Ledger Bldg. Philadelphia, PA 19106-9111

PA Human Relations Commission Philadelphia Regional Office 110 N. 8th Street, Suite 501 Philadelphia, PA 19107 Commonwealth of PA DHS Bureau of Equal Opportunity SE Regional Office 801 Market Street, Suite 5034 Philadelphia, PA 19107

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Form W-10(Rev. July 2011)

Department of the Treasury Internal Revenue Service

Dependent Care Provider’s Identification and Certification

Do NOT file Form W-10 with your tax return. Instead, keep it for your records.

Part I Dependent Care Provider’s Identification (See instructions.)

Please print or type

Name of dependent care provider Provider’s taxpayer identification number

Address (number, street, and apt. no.) If the above number is a social security number, check here . . . . . .

City, state, and ZIP code

Certification and Signature of Dependent Care Provider. Under penalties of perjury, I, as the dependent care provider, certify that my name, address, and taxpayer identification number shown above are correct.

Please Sign Here

Dependent care provider’s signature Date

Part II Name and Address of Person Requesting Part I Information (See instructions.) Name, street address, apt. no., city, state, and ZIP code of person requesting information

General Instructions Section references are to the Internal Revenue Code. Purpose of form. You must get the information shown in Part I from each person or organization that provides care for your child or other dependent if:

1. You plan to claim a credit for child and dependent care expenses on Form 1040 or 1040A, or

2. You receive benefits under your employer’s dependent care plan.

If either 1 or 2 above applies, you must show the correct name, address, and taxpayer identification number (TIN) of each care provider on Form 2441, Child and Dependent Care Expenses.

You may use Form W-10 or any of the other sources listed under Due diligence below to get this information from each provider. Penalty for failure to furnish TIN. TINs are needed to carry out the Internal Revenue laws of the United States. Section 6109(a) requires a provider of dependent care services to give to you a valid TIN, even if the provider is not required to file a return. The IRS uses the TIN to identify the provider and verify the accuracy of the provider’s return as well as yours.

A care provider who does not give you his or her correct TIN is subject to a penalty of $50 for each failure unless the failure is due to reasonable cause and not willful neglect. This penalty does not apply to an organization described in section 501(c)(3). See Tax-exempt dependent care provider, later. If incorrect information is reported. You will not be allowed the tax credit or the exclusion for employer-provided dependent care benefits if: • You report an incorrect name, address, or TIN of the provider on your Form 2441 and • You cannot establish, to the IRS upon its request, that you used due diligence in trying to get the required information. Due diligence. You can show due diligence by getting and keeping in your records any one of the following: • A Form W-10 properly completed by the provider. • A copy of the provider’s social security card or driver’s license that includes his or her social security number. • A recently printed letterhead or printed invoice that shows the provider’s name, address, and TIN. • If the provider is your employer’s dependent care plan, a copy of the statement provided by your employer under the plan.

• If the provider is your household employee and he or she gave you a properly completed Form W-4, Employee’s Withholding Allowance Certificate, to have income tax withheld, a copy of that Form W-4.

If your care provider does not comply with your request for one of these items, you must still report certain information on your Form 2441. For details, see the Form 2441 instructions.

Specific Instructions Part I The individual or organization providing the care completes this part.

Enter the provider’s name, address, and TIN. For individuals and sole proprietors, the TIN is a social security number (SSN). But if the provider is a nonresident or resident alien who does not have and is not eligible to get an SSN, the TIN is an IRS individual taxpayer identification number (ITIN). For other entities, it is the employer identification number. If the provider is exempt from federal income tax as an organization described in section 501(c)(3), see Tax-exempt dependent care provider below. How to get a TIN. Providers who do not have a TIN should apply for one immediately. To apply for an SSN, get Form SS-5, Application for a Social Security Card, from your local Social Security Administration office. To apply for an ITIN, get Form W-7, Application for IRS Individual Taxpayer Identification Number, from the IRS. To apply for an EIN, get Form SS-4, Application for Employer Identification Number, from the IRS. Note. An ITIN is for tax use only. It does not entitle the individual to social security benefits or change his or her employment or immigration status under U.S. law. Tax-exempt dependent care provider. A provider who is a tax-exempt organization described in section 501(c)(3) and exempt under section 501(a) is not required to supply its TIN. Instead, the provider must complete the name and address lines and write “tax-exempt” in the space for the TIN. Generally, an exempt 501(c)(3) organization is one organized and operated exclusively for religious, charitable, scientific, testing for public safety, literary, or educational purposes, or for the prevention of cruelty to children or animals.

Part II Complete this part only if you are leaving the form with the dependent care provider to return to you later.

Cat. No. 10437N Form W-10 (Rev. 7-2011)

Kinder Works III, Inc. 04-3664126

595 Bethlehem Pike, Building 500

Montgomeryville, PA 18936

March 1, 2016

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Please enroll my child as indicated below: (Check 2 boxes per week to indicate days and full or half day hours. Please consider your choices carefully. Please write AM or PM as applicable.) DROP OR CHANGE FEE: $50.00

Child’s Name (& Nickname): _______________________________________________ Child’s Birth Date: __________________

Child’s Age: _______ Child’s Sex: _______ School Grade Completed: ______________ Home Phone #: ____________________

Father’s Name: ________________________ Cell #: _____________ Work #: _____________ email: _____________________

Mother’s Name: _______________________ Cell #: _____________ Work #: _____________ email: _____________________

Street or P.O. Box: _______________________________________ Town/City: _____________________ State: ____ Zip Code ___________

Adult(s) to whom child can be released to other than parent: ___________________________________ Phone #: _______________

Send to: Kinder Works of Montgomeryville 595 Bethlehem Pike, Bldg. 500 Montgomeryville, PA 18936 (215) 822-7510 www.kinderworks.net

Kinder Works 2016 DIG/ARTS SUMMER CAMP

REGISTRATION

Date / Time Received _________________ # amt. _______________ form __________ CR __________ FSCL __________ cnfm _________

For Office to Complete Week M – F M, W, F T, TH Full Day Half Day AM or PM Payment Due Dates

1

6/20 – 6/24

June 6

2

6/27 – 7/1

June 6

*3

7/4 – 7/8

June 20

4

7/11 – 7/15

June 20

5

7/18 – 7/22

July 5

6

7/25 – 7/29

July 5

7

8/1 – 8/5

July 18

8

8/8 – 8/12

July 18

9

8/15 – 8/19

August 1

10

8/22 – 8/26

August 1

I agree to pay for the above according to the 2016 Camp Tuition and Payment Schedules. Enclosed is my non-refundable registration fee of $35 plus one week’s tuition (tuition will be credited) to hold my registration schedule choices.

I give permission for my child to walk to the park next door with staff: Yes _____ or No______

Also included is the completed Kinder Works Camp Emergency Contact / Policies Signature Form, the Civil Rights Compliance Form, and Child Health Report (Health Report only required if you are registering for weeks which span more than a 30 day period. For example, if you register for weeks 3 & 8, it is required; if you register for week 5, 6 & 7 it is not.) You will not be processed unless all forms are completed. Approximate time of child’s arrival: ____________________________ Approximate time of child’s departure: ______________________________ Parent/Guardian Signature: ____________________________________________________________ Date: _______________________

The signature below confirms your Registration for summer camp per above. Please note amounts due and credited tuition at left. Kinder Works Signature ____________________________________________________________ Date: __________________________

3/10/16

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Kinder Works CAMP EMERGENCY CONTACT/POLICIES SIGNATURE FORM (Please Note: This form MUST be submitted with Registration Form, before child starts attending.)

Child’s Full Name_____________________________________________________ Date of Birth_____________________

Mother/Guardian____________________________________ Father/Guardian____________________________________

Mother’s Address ___________________________________________________________________________________

Mother’s Work Place______________________________ Work Address_______________________________________

Mother’s Home Phone # ______________________ Work #______________________ Cell #_____________________

Father’s Address____________________________________________________________________________________

Father’s Work Place______________________________ Work Address _______________________________________

Father’s Home Phone # ______________________ Work #______________________ Cell # _____________________

Mother’s Email____________________________________ Father’s Email _____________________________________ Emergency Contact phone numbers AND person(s) to whom child may be released. NOTE: It is mandatory to supply Kinder Works with at least 2 names other than parents. Thanks! ___________________________________________________________________________________________________________ Name Complete Address (Street, City, State, Zip) Phone # ___________________________________________________________________________________________________________ Name Complete Address (Street, City, State, Zip) Phone # ___________________________________________________________________________________________________________ Name Complete Address (Street, City, State, Zip) Phone #

____________________________________________________ Signature of Parent/ Guardian Date

Allergy/Medical/Dietary/Special Needs/Other Info on Child __________________________________________________

____________________________________________________________________________________________________________

Name of Physician ____________________________________________ Physician Phone #______________________

Address of Physician ________________________________________________________________________________

Health Insurance Company ___________________________________ Policy #_________________________________

In case of emergency, the Director will replace the staff person accompanying the child. In case of accident or sudden illness, I/We authorize Kinder Works staff to use the medical services of the nearest hospital. I/We consent to administration of medical care in the child’s best interest.

_______________________________________________________________ Signature of Parent/Guardian authorizing above Date

Parental consent is given to Kinder Works staff to administer minor First-Aid procedures in the child’s best interest.

_______________________________________________________________ Signature of Parent/Guardian authorizing above Date

PHOTO RELEASE: I give permission for Kinder Works Camp Staff to take photos of my child for use in the camp displays and program (bulletin boards, wall décor, memory books, gifts, etc.), & to be included in DVD productions Yes _____ or No _____

I give permission for Kinder Works to use my child’s photo on the website, and for promotional and/or training materials. (Personal information will NOT be included.) Yes _____ or No _____

____________________________________ __________________________________________ Child’s Name Signature of Parent/Guardian Date

I have read the Kinder Works Dig/Arts Summer Camp Parent Handbook and I/we agree to comply with the policies and procedures within it.

____________________________________ __________________________________________ Child’s Name Signature of Parent/Guardian Date

Please return this form with your Camp Registration Form; MAIL TO: Kinder Works, 595 Bethlehem Pk. Bldg 500, Montgomeryville, PA 18936

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Kinder Works Central Office: 1090 Pebble Hill Road, Doylestown PA 18901 Executive Office: 5736 Stony Hill Road, New Hope, PA 18938

215-345-0370 www.Kinderworks.net

SUBJECT: Nondiscrimination in Services/CIVIL RIGHTS COMPLIANCE PARENT AWARENESS FORM TO: All Parents FROM: April Bass, Executive Director Kinder Works in Doylestown: 1090 Pebble Hill Road, Doylestown PA 18901 Kinder Works in Montgomeryville: 595 Bethlehem Pike Bldg. 500, Montgomeryville PA 18936 Kinder Works in Limerick: 36 W. Ridge Pike, Limerick PA 19468 Admissions, the provision of services, and referrals of clients shall be made without regard to race, color, religious creed, disability, ancestry, national origin (including limited English proficiency), age, or sex. Program services shall be made accessible to eligible persons with disabilities through the most practical and economically feasible methods available. Any individual student/parent (and/or their guardian) who believes he or she has been discriminated against may file a complaint of discrimination with:

Kinder Works Please use address above Department of Human Services Bureau of Equal Opportunity Room 223, Health & Welfare Building 625 Forster Street Harrisburg, PA 17120 U.S. Dept. of Health and Human Services Office for Civil Rights 150 South Independence Mall West Suite 372, Public Ledger Bldg. Philadelphia, PA 19106-9111

PA Human Relations Commission Philadelphia Regional Office 110 N. 8th Street, Suite 501 Philadelphia, PA 19107 Commonwealth of PA DHS Bureau of Equal Opportunity SE Regional Office 801 Market Street, Suite 5034 Philadelphia, PA 19107

______________________________________________ ______________________________________ Name of Child/Camper Parent/Guardian Signature ______________________________________________ ______________________________________ Kinder Works Director Signature Date

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CHILD HEALTH REPORT (55 PA CODE §§3270.131, 3280.131 AND 3290.131)

Par

ent/P

rovi

der

fill i

n th

is p

art. CHILD’S NAME: (LAST) (FIRST) PARENT/GUARDIAN:

DATE OF BIRTH: HOME PHONE: ADDRESS:

CHILD CARE FACILITY NAME:

FACILITY PHONE: COUNTY: WORK PHONE:

��I authorize the child care staff and my child’s health professional to communicate directly if needed to clarify information on this form about my child.

PARENT’S SIGNATURE:

Pare

nts

may

wri

te im

mun

izat

ion

date

s; h

ealth

pro

fess

iona

l sho

uld

veri

fy a

nd c

ompl

ete

all d

ata.

DO NOT OMIT ANY INFORMATION This form may be updated by a health professional. Initial and date any new data. The child care facility needs a copy of the form.

HEALTH HISTORY AND MEDICAL INFORMATION PERTINENT TO ROUTINE CHILD CARE AND DIAGNOSIS/TREATMENT IN EMERGENCY (DESCRIBE, IF ANY): ��NONE

DESCRIBE ALL MEDICATION AND ANY SPECIAL DIET THE CHILD RECEIVES AND THE REASON FOR MEDICATION AND SPECIAL DIET. ALL MEDICATIONS A CHILD RECEIVES SHOULD BE DOCUMENTED IN THE EVENT THE CHILD REQUIRES EMERGENCY MEDICAL CARE. ATTACH ADDITIONAL SHEETS IF NECESSARY. ��NONE

CHILD’S ALLERGIES (DESCRIBE, IF ANY): ��NONE

LIST ANY HEALTH PROBLEMS OR SPECIAL NEEDS AND RECOMMENDED TREATMENT/SERVICES. ATTACH ADDITIONAL SHEETS IF NECESSARY TO DESCRIBE THE PLAN FOR CARE THAT SHOULD BE FOLLOWED FOR THE CHILD, INCLUDING INDICATION OF SPECIAL TRAINING REQUIRED FOR STAFF, EQUIPMENT AND PROVISION FOR EMERGENCIES. ��NONE

IN YOUR ASSESSMENT, IS THE CHILD ABLE TO PARTICIPATE IN CHILD CARE AND DOES THE CHILD APPEAR TO BE FREE FROM CONTAGIOUS OR COMMUNICABLE DISEASES? ��YES ��NO IF NO, PLEASE EXPLAIN YOUR ANSWER:

HAS THE CHILD RECEIVED ALL AGE APPROPRIATE SCREENINGS LISTED IN THE ROUTINE PREVENTIVE HEALTH CARE SERVICES CURRENTLY RECOMMENDED BY THE AMERICAN ACADEMY OF PEDIATRICS? (SEE SCHEDULE AT WWW.AAP.ORG)

��YES ��NO

NOTE BELOW IF THE RESULTS OF VISION, HEARING OR LEAD SCREENINGS WERE ABNORMAL. IF THE SCREENING WAS ABNORMAL, PROVIDE THE DATE THE SCREENING WAS COMPLETED AND INFORMATION ABOUT REFERRALS, IMPLICATIONS OR ACTIONS RECOMMENDED FOR THE CHILD CARE FACILITY.

VISION (subjective until age 3)

HEARING (subjective until age 4)

LEAD

RECORD DATES OF IMMUNIZATIONS BELOW OR ATTACH A PHOTOCOPY OF THE CHILD’S IMMUNIZATION RECORD

IMMUNIZATIONS DATE DATE DATE DATE DATE COMMENTS

HEP-B

ROTAVIRUS

DTAP/DTP/TD

HIB

PNEUMOCOCCAL

POLIO

INFLUENZA

MMR

VARICELLA

HEP-A

MENINGOCOCCAL

OTHER

MEDICAL CARE PROVIDER:

ADDRESS:

PHONE:

SIGNATURE OF PHYSICIAN, CRNP OR PHYSICIAN’S ASSISTANT

TITLE:

LICENSE NUMBER: DATE FORM SIGNED:

CD 51 09/08