ON-SITE AFTER SCHOOL CLUBS LIABILITY WAIVER FORM 
Fill out this form if your child is going to join another After School On-Site Club or activity program at Highland Park. We must have documentation stating where your child will be during their normal 3rd Base After-School Club time. (1 form per club)

We love our ASCC 3rd Base families and always strive to provide safe and fun childcare. It is our number one priority to keep all children and staff safe. With such a large group of children, it can be a bit challenging to keep up with each student's schedule.
We want every child to be safe and in the appropriate place at the right time.  

Parent responsibility and commitment to ASCC 3rd Base Program:

1. It is the responsibility of the parent guardian to communicate their child's schedule and fill out the appropriate forms with ASCC 3rd Base Program.

2. A child attending another on-site club activity is absent from ASCC 3rd Base Program. The student must be signed in by the Caring Adult Staff in-charge to an ASCC staff. This is an AISD After School Policy, and a liability to our program when a student is not signed in to ensure that your child has arrived safely to ASCC 3rd Base program.

3. It is the responsibility of the parent to communicate and arrange drop off times with all club program staff members and ASCC staff.

4. I (parents) understand that student(s) will not be allowed to return to ASCC 3rd Base Program after 4:30 pm. If your child does not return to ASCC 3rd Base Program before 4:30 pm they will not be allowed back into our program for the day. Please arrange other plans for your child to be picked up from their on-site club/activity program. I understand that at any time the ASCC 3rd Base program can revoke the on-site club activity program cut off time.

5. ASCC staff members are not allowed to pick up from or take students to an on-site club/activity program.

6. If a parent picks up their child from the club activity program the child can not be dropped off to ASCC.

7. I understand that at any time the ASCC 3rd Base Program program can revoke the on-site club activity program cut off time.

Communication is a key factor between all parties involved when a student attends another club:

1. Parents, we need your help to communicate with the other club program staff members that they are not allowed to let your child walk by themselves to ASCC 3rd Base Childcare. 
This is NOT our responsibility to reach out to the other Caring Adult Staff that your child needs to be escorted back and signed in by making visual contact. If this is an inconvenience from the other Caring Adult Staff in- charge and they are not able to make visual contact drop off, then please pick up your child from the club that they will be attending.        

2. If a Caring Adult Staff drops off an ASCC student to us without visual contact, ASCC has the right to not allow ASCC drop off from that club in the future. You will then be responsible to pick up your child from their club. 
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Email *
Untitled Title
Student Name: *
The name of the after school club or event sponsored at Highland Park. *
The name of the club that is not affiliated with Highland Park. Example - Kula or Soccer shots (write NA if no HP club). *
Name of the Caring Adult Staff in-charge of the club who will be signing in your child to ASCC. Visual contact is not acceptable to sign in a student to childcare. *
Will your child return to ASCC or be picked after club is over? *
Required
I understand if the Caring Adult in-charge can not sign my child to ASCC, I will need to pick up my child from the other club not affiliated with ASCC 3RD BASE PROGRAM. Sign your name in the short answer box. *
What day will your child be in this club or event at HP? *
Month and date club/event starts *
MM
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DD
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YYYY
Month and date club/event ends *
MM
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Electronic Signature
ASCC 3rd Base Program is doing our best to help and accommodate but is not obligated or responsible once a child is signed up to attend another on-site club activity program at HP. We are willing to try to accommodate as long as we feel that we can keep ASCC children and staff safe. 
We have the right to change the on-site club activity program policy if it is no longer a safe option.
We at ASCC 3rd Base Program try to do our best to make sure that students are always counted for and safe but once a student is signed out from the program or does not come straight to ASCC 3rd Base Program from an on-site club activity program you are releasing ASCC 3rd Base Program from any liability that can occur.
I have read and understood all of the above and the following.
I understand that it is my responsibility to make sure that all 3rd party's and HP staff must walk my child to ASCC 3rd Base Childcare and have the Caring Adult sign my child in to ASCC 3rd Base Childcare.
I give my child permission to go to another on-site club activity program not affiliated with ASCC at Highland Park.
As a parent or guardian, I understand that my child will not be allowed to leave Highland Park Elementary or ASCC 3rd Base Childcare without being supervised by another adult.
 I understand that on days when there is an emergency closure, it is my responsibility to arrange for pick up and/or childcare from the other on-site club/activity program that is not affiliated with ASCC 3rd Base Childcare (ex: bad weather days when we must close early or any other crisis that might arise due to unexpected circumstances that involve the safety of the students and ASCC staff members). An ASCC staff member will notify parents ASAP of the closure.
Parental Signature (first & last name) *
Date *
MM
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