Hinsdale Covenant Child Protection Consent Form

Parent/Legal Guardian Consent for Participation and Understanding of Safety Policies at the Evangelical Covenant Church of Hinsdale
 
 
 
 
 
 
 
 
 
Pickup Policy

Please list any parents, guardians or caregivers that have your consent to pickup your child (children) from any of our children’s ministries programs. (Please note, any person(s) listed here must be 18 years or older). The person picking up your child (children) must present the security label(s) provided at check-in before picking up your child each week. In certain cases, ID may be required. Children's dismissed from the sanctuary for Sunday Kids Camp will be escorted by staff/volunteers upon leaving and returning to the sanctuary and will not receive a security label. 
 
 
 
 
Sick Child Policy

It is our desire to provide a healthy and safe environment for all, and parents/guardians are encouraged to be considerate of others when deciding to place a minor in our care. Though we are taking precuations to help keep everyone safe, we cannot eliminate the risk of COVID-19 exposure and need everyone's help. If anyone in your household is sick or experiencing any of these symptoms, we ask that you stay home for 14 days from symptom onset or until you have received a negative COVID-19 test or alternative diagnosis from your healthcare provider: Fever, chills, shortness of breath, difficulty breathing, cough, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea, vomiting, or diarrhea. Children dispalying any COVID-19 symptoms will be separated from the other children and caregivers will be contacted to pick-up their child. If you, your child, or anyone in your family has been exposed to or diagnosed with COVID-19, we ask that you follow the safety protocols established by your health-care provider and stay home. Thank you for your compilance with these policies and procedures that will help protect us all and allow us to gather in worship together. 


Please select all that apply.
 
Allergy or Health Concerns

 
 
 
 
Accidental Injuries

In the event a minor is injured while in our care, the following steps should be followed:
1. For insignificant injuries, scrapes, and bruises, workers will provide first aid as appropriate and will notify the minor’s parent or guardian of the injury at the time the minor is picked up.
2. For injuries requiring medical treatment beyond simple first aid, the parent and/or guardian will immediately be summoned. If warranted by circumstances, an ambulance can be called by parent/guardian or worker.
3. Once a minor has received appropriate medical attention, an Accident/Injury Report Form will be completed and kept on file at the church.
Please select all that apply.
Restroom Guidelines for Adults Caring for Children in the Nursery/Little Lambs

Because the Evangelical Covenant Church of Hinsdale seeks high safety standards to protect the children who participate in our programming, we are requesting your informed consent regarding your child's restroom or toileting needs when he/she is under the care of the nursery/toddler room. The members of the staff of these rooms have been instructed and trained according to the Restroom Guidelines below. The staff and volunteer workers will take every reasonable precaution to provide a safe and healthy environment for all children while they are involved in the ministries of the church.

It is the policy of the Evangelical Covenant Church of Hinsdale that no staff worker, no adult volunteer, or teenage volunteer will change diapers.  Parents will be notified via text message that a diaper change is necessary.
Please select all that apply.
Permission for Restroom Care for Toilet-Trained Children

Parents/guardians are encouraged to ensure their child (children) has used the bathroom prior to signing their child (children) into our programming. If a child needs assistance in the bathroom, parents will be notified via text message or asked to step out of service to assist. 

Please select all that apply.
Responsibilities of Parents

Parents should take their children to the bathroom immediately prior to a scheduled church activity. If the child is not toilet trained: - Please make sure your child’s diaper/pull-up is dry before dropping off your child. - You will be notified via text message to come and change your child’s diaper. - In the event your child has a wetting accident, you will be notified via text message to change your child’s clothes. If the child is toilet trained: - Parents will be notified via text message if your child needs assitance in the bathroom.
Please select all that apply.
Responsibilities and Restroom Guidelines for Staff and Adult Volunteers

Staff and adult volunteers will not change diapers/pull-ups or provide restroom help to toilet-trained children. If a child needs assistance in the bathroom, parents will be notified via text message or asked to step out of service to assist.
Please select all that apply.
Consent to the above policies and guidelines

Please select all that apply.

Description

Parent/Legal Guardian Consent for Participation and Understanding of Safety Policies at the Evangelical Covenant Church of Hinsdale