I, ___________________________________ (Parent/Guardian name) understand
that Oakland Homeschool Music (OHMI) has arranged to use the facilities at First United Methodist Church of Troy
for music education classes and is completely independent
of First United Methodist Church of Troy
. I acknowledge that OHMI is in no way a ministry of First United Methodist Church of Troy
, and that First United Methodist Church of Troy
does not plan, administrate or oversee any of
the programs or activities of OHMI. I understand that OHMI does not meet all of
the Child Safety Program policies required by
Parent’s signature_________________________________ Date: __________________
Names of children participating: ________________________________________________________________________
________________________________________________________________________
We authorize the
teachers, directors, or coordinators to seek medical attention for a student in
the event of an emergency. If it is life-threatening, 911 will be called,
followed by the parent. If it is not life threatening, attempts will be made to
contact the parents and emergency contact first before seeking medical
attention.
Parent’s
signature: _____________________________________ Date: ___________
Home phone
number:__________________ Cell phone number:____________________
Emergency
contact name :_____________________________________________
Emergency contact number:____________________________________________
If any of your
children have medical issues we should be aware of, please list their name and
condition below. Information will be kept confidential, and be given out only on
an “as needed to know” basis.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Student behavior:
Students will be respectful to all teachers, students and others at all times
and will not be disruptive in class. Students will be given one verbal warning,
after which they will be asked to sit out the rest of the class so as not to be
a distraction. If the behavior continues, parents will be notified, and other
measures will be taken.
Inappropriate behavior, language, or dress will not be tolerated.
Clothing needs to be modest, with shoulders, stomachs, and undergarments covered
at all times. No vulgar or indecent shirts, or extreme clothing styles should be
worn.
Students will be respectful of the facilities, as we are guests in the
buildings, and need to leave the church in the condition it was found in.
Students will also be careful of other student’s instruments & belongings,
and should ask permission before using others’ property.
Students are expected to come to class prepared with all supplies and be
ready to learn. Restrooms should be used before or after class to eliminate
absence from class. We have limited instruction time, and wish to use it to the
fullest. If the restroom has to be used during class, the student should ask
permission from the instructor. Students will go to the restroom unescorted, but
the Hall monitors will be monitoring student & visitor activity from the
hallway.
Students should not be wandering the building at any time. They should be
in class, in the study or social room if they are waiting for another class, or
for a sibling, or should be signed out & leave the building with a parent,
unless they have driven themselves. Students will sign in & out of OHMI, so
in event of an emergency when the building must be evacuated (such as a fire),
we can account for all persons after evacuation. Hall monitors will be assigned
each time block to facilitate this.
Parents:
Are welcome to
sit quietly in the back of class, however, if you have younger siblings with
you, we ask that you take them to the social room and keep them occupied there.
Parents are responsible for all children not enrolled in OHMI’s program.
Parents are also responsible for students who are not in class (i.e. are
finished for the day, but have not gone home). Students 10 and older may stay in
the social or study room, but children under 10 should be supervised by a parent
when not in class.
In an effort to
promote safety for all concerned, OHMI will strive to have 2 adults present in
the classrooms during instruction time.
Waiver of
Liability:
We hold the
teachers, directors, and coordinators of Oakland Homeschool Music, Inc. harmless
for any injury that might result to a student while attending classes and
activities.
Parent’s signature: ___________________________________________
Date:
____________________
Behavior
Agreement:
Any property
damage caused by a student will be the responsibility of, and be paid
for/repaired by the parents.
We have read and
agree to comply with all policies and behavior and safety guidelines of Oakland
Homeschool Music, Inc.
Parent’s
signature: ___________________________________________
Date:
____________________
Student
signature(s):
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Please
print these forms and bring them to the orientation meeting, the first day of
class, or mail them to:
Oakland Homeschool Music Inc.
6761 Rolling
Springfield Township