Click here to learn more about memberships. Questions? Call Us (712) 252-1088Girls Inc. Parent Responsibility Form Click here to download the PDF version of the Parent Responsibility Sheet. Parent's Name* First Last Email* Phone*Consent & UnderstandingYou must check the box "I understand" to each term, and area specified below. All are required to complete this form.Program Hours:* I Understand Program Hours: Summer hours are Monday-Friday 7:30 am to 5:30 pm. For their safety, girls cannot be dropped off early and left unsupervised in the park. Girls Inc. is closed July 2nd-July 6th. Flexible drop off times from 7:30-9:30, and Flexible pick up times from 4-5:30 Late Policy:* I Understand Due to the number of girls, families are allowed only one late pick up. A late fee of $10 PER CHILD for the first 5 minutes and $1 for every minute after the first 5 will be assessed. Your family will not have another late pick up. If there is a second late, your child will not be able to return for the rest of the summer. There are NO refunds. Families should have a backup plan in place should you think you’re going to be close to 5:30 or at all late. Behavior:* I understand All girls must be able to function in a group setting and abide by Girls Inc. rules in order to attend. This includes behavior on the bus, at the center, or at events with Girls Inc. If your child is not able to behave in a group setting, or requires one-on-one assistance from a staff, the parent will be notified, and the girl will need to be picked up. Should your daughter have a recurring problem abiding by these rules, she may be dismissed from the summer program without refund. If you have any questions, please contact the Program Director or Executive Director. Respect:* I understand At Girls Inc. we strive to treat all staff, girls and parents with respect and courtesy at all times, including using appropriate language, respecting property and equipment and not using verbal or physical aggression towards another person. Should you or your daughter have a recurring problem abiding by these rules, she may be dismissed from the program without refund. Calendars:* I understand Calendars of the month’s activities and field trips are available at the front desk. Pick one up monthly to assure that you know what your daughter will be participating in for the month. Sign in/Sign Out:* I understand You do not have to sign your daughter in, but she must stop at the front desk to sign in. She must be signed out when being picked up every time. Please be sure that you or anyone else who picks her up has a photo I.D. Please notify us immediately if you think someone inappropriate will be trying to pick her up. For their safety, girls cannot walk to or from Girls Inc. without supervision of an adult. No exceptions. Attendance:* I understand In order to go on any field trips, girls must be in attendance 60% of the time (3 out of 5 days a week) before the event. If on Scholarship, girls must be in attendance 80% of the time (4 out of 5 days a week). Attendance is a critical part of measuring progress in programs, which is required by our funders. Vacation:* I understand Families are granted 1 week of vacation per session during the summer program. All other weeks must be paid. The weekly fee is the same for attendance one day or all days of a week. Please notify the front desk of any vacations in advance, to avoid being charged for that week. Cancellations:* I Understand Absolutely no refunds will be given under any circumstance. Payments:* I Understand Pay for any and all session/sessions signed up for. Make arrangements with the Program Director if a financial emergency arises. Weekly payments are due before the end of the day on Friday. The activity fee of $45 for each session and ANY previous balance is due by May 11th, And is required to reserve your child’s spot at Girls Inc. Food:* I Understand No outside food is allowed. We provide breakfast until 9 am, lunch, and an afternoon snack. If your daughter has special dietary needs, please let us know in advance, and we’ll do our best to accommodate her need. Documentation from a medical professional is required. No candy or gum allowed at Girls Inc.! Health:* I Understand For the health and well being of everyone at Girls Inc., please do not send your daughter if she is ill or has any contagious condition such as pink eye, head lice, strep, etc. We do regular lice checks and your daughter will be sent home if nits or bugs are present. When you treat your daughter, and lice/nits are removed she is allowed to come back and will be checked upon her return. Clothing:* I Understand Our program focuses on fun and “hands on learning.” Please send your daughter with appropriate clothing so that she may participate in all activities. Play clothes and shorts are appropriate as they can get dirty and wet without problem. She’ll need to have closed toe shoes (no flip flops or crocs), sunscreen, a swimsuit and towel (that stay at Girls Inc.), and a small bag to keep everything together. Mark EVERYTHING with her name. Check lost and found regularly. Personal Belongings:* I Understand Girls Inc. will not be held responsible for any belongings your daughter brings to or leaves at Girls Inc. Valuables such as electronics (phones, IPods, game boy, etc.) jewelry, and toys should be left at home. Phone Calls:* I Understand Girls are not allowed to use the phone in the center. If a parent needs to get in touch with her daughter, a staff member will take the call and relay a message to her. Cell Phones:* I Understand Cell phones are not allowed at Girls Inc. Girls who choose to bring them, will be required to leave them at the front desk upon her arrival. Girls Inc. is not responsible for lost, broken, or misused cell phones. Confidentiality and Truthfulness of Information:* I UnderstandWe only share information about your girl with the staff who works directly with her. In order to ensure that your daughter has the safest, most productive and FUN time in our summer program, we ask that you be honest when reporting all information about your girl so our staff is able to design and modify programming and other activities to best suit her individual needs. Contributing to Girls Inc.:* I Understand To keep costs low, we ask that every family get involved in our program by giving at least 3 hours of your time. You can do this in a variety of ways as there are many ways to lend a hand. Please contact the Program Director at email@example.com. Parent/guardian support and involvement are vital to successful membership at Girls Inc. and are a requirement of membership. I have I have read and understand these policies. By signing below, I agree to abide by these policies and understand that failure to abide by these policies with result in termination from Girls Inc. I understand that my child must be picked up by closing time, and the Sioux City Police Department will be contacted if parents are more than 30 minutes late. Membership will be revoked for girls whose parents are late more than once during the summer program. There will also be a late fee if you are late picking up your child. I also understand that my child must be able to function appropriately in a group setting. I have read and understand the discipline policy of Girls Inc. I agree to abide by the rules and policies of Girls Inc. and understand that membership may be revoked for failure to abide by these rules and policies. I understand that no fees, dues, deposits and/or advance payments will be returned.Signature*Uses mouse or finger (if on phone or tablet) to sign.Date* This iframe contains the logic required to handle Ajax powered Gravity Forms.