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Please fill out the Registration Paperwork below for each participant.

IGNITE! 2024 Registration

Participant Information
Parent Information
Medical History
Does the participant have any known allergies? (e.g., food, medication, insects)
Does the participant carry an EpiPen, rescue inhaler or any other emergency medication?
Has the participant ever had a severe allergic reaction (anaphylaxis)?
Does the participant have any chronic medical conditions? (e.g., asthma, diabetes, epilepsy)
Is the participant currently taking any medication?
Has the participant had any surgeries or hospitalizations in the past year?
Is the participant up to date on vaccinations?
Does the participant have any dietary restrictions or special dietary needs?
Does the participant have any physical limitations or disabilities that may affect participation in activities?
Does the participant have any behavioral or emotional concerns that staff should be aware of?

Medications

Prescription or non-prescription medication required by the participant should be administered at home by a parent or by the participant’s medical provider whenever possible. Parents should use every effort to have medication administration set for time periods other than the IGNITE! Summer Intensives program to avoid disruption of the day. However, it may be necessary for a participant to receive medication during IGNITE! Summer Intensives in some instances. When home administration is not possible, authorized E.A Young Academy staff may assist in the administration of medications to participants.

 

A Medication Administration form must be completed should your child need to have prescription or non-prescription medication administered during IGNITE! Summer Intensives operating hours. Please note, all prescription medications must be in their pharmacy container and labeled for your child. Many pharmacies will provide an extra bottle/container for outside of the home use. Please note all non-prescription medication must be provided by parents in the original bottle with name, dosing information, date and parent signature. Recommended dosing will not be exceeded without a written note from your child's physician.

 

The E.A. Young Academy does not administer non-prescription medications “as needed”, even with a phoned in or emailed request from the parent without a completed Medication Administration form on file. If an inhaler or EpiPen is needed, an “Action Plan” form must be completed and on file in the office.

*Please find the Medication Forms on the home page for IGNITE! 

Waivers and Agreements

Please take a moment to carefully review the following waivers and agreements. They contain important information regarding the release of liability and the waiver of legal rights, which may impact your ability to pursue legal action against certain parties. By agreeing electronically, you acknowledge that you have read and understood all the text presented to you during the registration process. Your attention to these details is greatly appreciated.

Medical Release

My child intends to participate in E.A. Young Academy’s IGNITE! Summer Intensives, hereinafter referred to as "IGNITE." I acknowledge the potential for injury or illness during my child’s involvement in IGNITE. In the event of an accident or illness, I authorize E.A. Young Academy to administer necessary medical treatment, including ambulance transportation to a hospital or emergency room if required. I understand that E.A. Young Academy is not liable for any medical expenses incurred, and I accept responsibility for all such expenses, including those not covered by insurance, related to my child's treatment.

 

 

 

 

 

Code of Conduct

E.A. Young Academy expects IGNITE! Summer Intensives participants to conduct themselves in a manner keeping with their levels of development, maturity, and demonstrated capabilities with a proper regard for the rights and welfare of others.

 

E.A. Young Academy believes that standards for participant behavior must be set through interaction among the participants, parents and guardians, staff, and community members of the academy, producing an atmosphere that encourages participants to grow in self-discipline and their ability to respect the rights of others. The development of this atmosphere requires respect for self and others, as well as for the Academy and community property.

 

E.A. Young Academy believes that the best discipline for challenging or disruptive behavior is designed to (1) support participants in taking responsibility for their actions, (2) develop empathy, and (3) teach alternative ways to achieve the goals and solve the problems that motivated the aggressive behavior. Staff members who interact with the participants shall apply best practices designed to prevent discipline problems and encourage the participant’s abilities to develop self-discipline and make better choices in the future.

 

We believe in fostering a supportive and engaging learning environment for all participants. As such, we require participants to adhere to accepted classroom norms to ensure a positive experience for everyone involved.  Participants who demonstrate a commitment to these norms will have the opportunity to fully immerse themselves in our enriching curriculum, make new friends, and develop valuable skills.  However, it is important to note that should a participant exhibit behavior challenges that cannot be effectively addressed within the program, we reserve the right to ask the participant to not return. In such cases, no refund will be available.

 

General Release and Indemnity Agreement

As the parent or legal guardian of "MY CHILD," who is under 18 years old, I agree to the following terms in consideration of E.A. Young Academy allowing my child to voluntarily participate in IGNITE! Summer Intensives, scheduled from June 24, 2024, to June 28, 2024, in Roanoke, Texas. I assume all associated risks and release Baylor University, its regents, officers, employees, students, and agents ("RELEASED PARTIES") from any and all present or future claims, suits, causes of action, or judgments, including those of our heirs, executors, administrators, or assigns, arising from E.A. Young Academy activities, including personal injuries, property damages, or claims for wrongful death, resulting from the acts, omissions, or negligence of RELEASED PARTIES. This release does not apply to injuries caused by E.A. Young Academy’s intentionally or grossly negligent conduct. Additionally, I agree to indemnify and hold harmless the RELEASED PARTIES from any claims, suits, causes of action, or judgments, and to defend, at my own expense, any such claims, arising from personal injuries, property damages (including lost or stolen property), or claims for wrongful death caused by the acts, omissions, or negligence of RELEASED PARTIES. I also accept responsibility for any property damage or personal injuries caused by intentional or negligent acts by “MY CHILD” or me during participation in IGNITE! Summer Intensives.

 

Media Release

I hereby grant to E.A. Young Academy the right to reproduce, use, exhibit, display, broadcast, distribute and create derivative works of E.A. Young Academy related photographs or images of “MY CHILD” for use in connection with the activities of E.A. Young Academy or for promoting, publicizing or explaining the academy or Its activities.

I agree to the Medical Release
I will complete the Medication Administration Form if applicable
I agree to the Code of Conduct
I agree to the General Release and Indemnity Agreement
I agree to the Media Release

Thanks for submitting!

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