http://www.villagelearningplace.org/programs/link-summer/

Authorization for Child Pick Up and Emergency Contact Information

An adult or a family member that is 14 years old or older must pick up children from the program. Please complete the chart below for all individuals to whom you the legal guardian gives permission to provide safe passage home and/or can pick up your child in case of an emergency.

If for any reason these individuals change, then please contact your child's LINK teacher. The LINK staff will not release children to individuals not listed below without verbal or written permission from the child's guardian.

Even if you permit your child to sign themselves out at the end of the program day, LINK Leaders Summer requires students to have at least one emergency contact that is not the primary caregiver on file. More than one emergency contact may be provided.

Self-Identification Data and Collection Form

Please answer the following questions. This information will be used to determine whether the benefits of this program are being made available to all people on a non-discriminatory basis. Further, the information being collected is a requirement by funders of this program, and part of our continued efforts to remain in compliance with their guidelines.

Remaining in compliance is the only way that we are allowed to effectively conduct this service and continue to provide this FREE program to you, your child(ren), and this community.

The Village Learning Place (VLP) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual's income is derived from any public assistance program.


None of this information will be shared outside of our program. We report demographics in terms of numbers, and not attached to identifying information.

Thank you for your understanding. If you have feedback about how we can make this from more inclusive, please share it in the space provided at the end.

Check the box that applies in one of the following two categories.

PERMISSIONS AND ALLOWANCES

• to be photographed or videotaped by the VLP or its partners (e.g. Johns Hopkins/SABES, Single Carrot Theatre, Family League) for marketing, public relations, and educational purposes.
• to access the Internet on VLP devices and under VLP staff supervision.
• to walk to the Margaret Brent Elementary/Middle school playground on an as needed basis, under close supervision of the VLP staff.
• to accompany VLP staff and his/her class on walking field trips in the community surrounding the VLP. Students will not travel unsupervised in the community during program hours.
• to be escorted home by persons that I list on this application as authorized to give SAFE PASSAGE HOME.

• transport my child between the VLP and neighborhood locations within walking distance as needed
• give my child reading and math evaluations and assessments
• access my child’s school records, including test scores, attendance, behavior and suspension records, and applicable information concerning services my child receives such as IEP records, 504 plans, etc.
• conduct and have students complete program evaluations as pre-determined by program funders
• communicate with your child’s teacher or other school staff about academic performance and behavior
• provide on-site minor care for injury or illness
• provide immediate medical attention in an emergency by transporting my child to the nearest hospital or medical facility

I release the Village Learning Place, Inc., its partner organizations, and employees from any and all claims or liabilities for any damages or injuries that may be sustained in connection with this program or in transporting my child to and from or during the program. I understand that VLP is not responsible for any lost belongings. I understand that the program ends at 4:00pm. I will make sure someone picks up my child or that my child can leave on their own by 4:00pm Monday through Friday.

BEHAVIOR, ATTENDANCE, AND DROP OFF/DISMISSAL POLICIES

Respect for children, their unique personalities, and their feelings are important. We use a system of restorative justice to help students who are struggling with behavior.

As your partner, it is our goal to assist your child in developing self-control and socially acceptable behavior. The classroom teacher and Program Coordinator will keep you informed of any behavioral problems concerning your child. Every effort will be made to resolve any problems that occur.

If a student has received a written disciplinary notice, they may be ineligible to participate in Friday field trips or a parent/guardian may be required to attend the field trip in order to ensure the safety of all students. After multiple disciplinary action forms, a parent/caregiver may be required to join VLP staff for a restorative meeting. Please consult the handbook for more information. All serious incidences, regardless of the outcome, will be noted in writing and kept as part of the child’s file.

Due to the structured academic environment of LINK Leaders, consistent daily attendance is required to ensure that your child will receive the maximum benefit from the program. LINK Leaders supports your child’s academic progress in school, and helps to prevent learning loss over the summer summer by providing fun, academic enrichment activities. We understand that there may be issues out of your control; however, it is imperative that you remain in constant contact with the program staff so that we are aware of your situation.

If a leave of absence is necessary for any reason, then please be sure to inform the Program Coordinator. Consistent absences will be immediately addressed. Children who do not attend the program regularly, or who regularly get picked up early may be dismissed so that their space can be given to a child on the waiting list.

The LINK Leaders schedule is Mondays through Fridays from 9:00am until 4:00pm. Breakfast is served beginning at 9:00 am. Programming takes place at the Village Learning Place at 2510 St. Paul Street. The program also utilizes nearby community space including Margaret Brent Elementary/ Middle School, the adjacent basketball court/playground, and the library and classrooms at 2521 St. Paul Street.

AM Drop Off: Classroom doors will open, and breakfast will be served at 9:00am. Students should be in the classroom, ready to begin by 10:00 am Monday-Thursday. Students should arrive by 9:30 on Fridays in order to travel on field trips. Students may not be dropped off early or left to wait on library steps.

Dismissal: To ensure proper supervision and the safety of your child, we request that all students be picked up promptly after their last class daily. Dismissal will take place from students’ afternoon classroom at 4:00 pm. Staff will monitor student dismissal to ensure that only authorized individuals sign out students.

In order to prevent and control the spread of coronavirus, LINK Leaders participants may be required to follow health and safety protocols like occasionally wearing masks, working in smaller groups, and washing hands frequently. Students should stay home from program if they are feeling ill--please let the Program Coordinator know if this is the case!

The goal of these protocols is to prevent a friend, a staff member, or another member of the community from exposure to the virus. Physical distancing, use of face coverings, and good hygiene are critical to resume in-person programming.

Village Learning Place in no way warrants that COVID-19 infection will not occur through entering and/or using VLP facilities, and/or receiving VLP services.

By electronically signing below, this indicates that you have read and understood the above warning concerning COVID-19. You choose to accept the risk of contracting COVID-19 for yourself and/or my minor child(ren) or those minor child(ren) you are a legal guardian of (identified above and collectively referred to as the “Minor”), in order to permit VLP facilities, enter such VLP facilities, and/or receive VLP services. Permitting VLP facilities and receiving VLP services are of such value to you and/or to the Minor, that you accept the risk of being exposed to, contracting, and/or spreading COVID-19 in order to permit VLP facilities, use VLP facilities in person, and/or receive VLP services.

I understand that with my support, my child must follow all policies and procedures contained within this application and within the LINK Family Handbook. I hereby agree to follow all policies in this application, and I certify that all information in this application is true to the best of my knowledge.