I, the under signed parent/guardian of
do hereby consent to his/her participation in the Yarmouth Association for Community Residential Options March Break Camp.
I acknowledge that participation in this program may expose the above named youth/child to the possibility of injury. I grant Yarmouth Association for Community Residential Options Summer Respite Staff the authority to obtain emergency medical treatment as necessary to ensure that the above named child/youth is safe from further injury.
In consideration of Yarmouth Association for Community Residential Options and the permission to allow this child/youth to participate in its March Break Camp, I agree to waive and release Yarmouth Association for Community Residential Options from all claims for damages that may arise.
Medication will only be administered if it has been prescribed by a qualified medical practitioner, is in its original container and I have a signed permission form with directions.
parent/guardian, authorize Respite Coordinator/March Break Camp Staff to administer
(medication) to my child
with the following instructions:
*The Respite Coordinator will contact you directly to confirm your child’s spot in the March Break Camp.*
YACRO continues to implement health and safety measures in accordance with public health guidelines to reduce sickness among participants and staff. If you or your child are experiencing illness, please stay home and return once well again. If your child becomes ill at camp, you will be contacted to come pick
Staff will ensure all necessary sanitary measures are implemented throughout the day, such as proper hand washing, avoiding sharing, avoiding touching face, regular waste removal, frequent cleaning of highly touched surfaces, and regular cleaning checklists. Masks are not required by participants or staff.
Hours of Summer Day Camp will be 9:00am-4:00pm. Please ensure you arrive no earlier than 9:00am for drop off and no later than 4:00pm for pick up. You must sign in/sign out your child at the beginning and end of the day. Drop off and pick up will take place through the side door of the building located near
the wheelchair ramp.
The cost of March Break Camp is $50.00. Payment will be required upon registration to secure your spot.
Your child will require a packed lunch with snacks and water for each day. Please also send an extra set of clothes and any additional items your child will require throughout the day, ie. car seat, pull-ups, medications, sensory tools, communication devices, etc.
Please note: We do not provide one on one support to individuals. If your child requires this or if you have any other specific concerns, please contact Amy Sarginson at (902)742-9258 or firstname.lastname@example.org
I acknowledge that the above named child/youth will be participating in activities and events organized by the Yarmouth Association for Community Residential Options March Break Camp Staff. I am aware that the participation of my child/youth may be outside the scope of his/her regular routine. I give permission for my child to be driven by March Break Camp Staff/Respite Coordinator to a program location when the daily program activities require transportation.
I acknowledge and confirm that I have read this entire document prior to signing.
There may be activities during the March Break Camp where photos and videos may be taken. To do this we are asking your permission to photograph and/or videotape your child/youth when participating in March Break Camp activities. YACRO hosts a Day Camp Blog on our website located at respite.yacro.com. Some of the photos taken throughout March Break Camp will be used on the blog.
give my permission for my child to be photographed or videotaped in a group or individual setting by the YACRO March Break Camp staff, and used on the YACRO Respite Blog.
* Fill the spaces below ONLY to deny your consent to share photo/video.
DO NOT GIVE my permission for my child to be photographed or videotaped in a group or individual setting by the YACRO March Break Camp staff, and used on the YACRO Respite Blog.
Respite Coordinator, Western Region
Reach out to us for any questions or concerns.
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