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Recreation Contract Esign Form

Parent / Guardian Full Name:

Parent / Guardian Phone:

Parent / Guardian Email:

Address:

Emergency Contact Name:

Emergency Contact Phone:

County of Residence:

Child #1

Child's Name:

Child's Birthdate:

Child's Gender:

Child's Tribal Affiliation:

Child's School:

Child's Allergies & Medical Conditions:

Child #2

Child's Name:

Child's Birthdate:

Child's Gender:

Child's Tribal Affiliation:

Child's School:

Child's Allergies & Medical Conditions:

Child #3

Child's Name:

Child's Birthdate:

Child's Gender:

Child's Tribal Affiliation:

Child's School:

Child's Allergies & Medical Conditions:

Child #4

Child's Name:

Child's Birthdate:

Child's Gender:

Child's Tribal Affiliation:

Child's School:

Child's Allergies & Medical Conditions:

BEHAVIOR POLICY

Upon signing this contract, I am recognizing my commitment to the Oneida Recreation Department and understand it is a privilege to attend. If at any time I or any individual listed in Child #1, Child #2, Child #3, or Child #4 break the contract, I understand there will be consequences.

ONEIDA RECREATION DISCIPLINARY POLICY

If any participant of the Oneida Recreation Department is involved in any of the following activities, disciplinary action will be taken according to this policy.

MINOR INFRACTIONS

* Inappropriate/profane language or talking back to staff

* Disrespecting staff, others or equipment

* Insufficient participation

* Not listening/unable to keep hands to self

* Misbehavior on the van/bus/Transit

CONSEQUENCES for the above infractions are:

1. First Offense: First Mark on Behavior Log/Verbal Warning

2. Second Offense: Second Mark on Behavior Log/Verbal Warning
NOTE: If member receives two warnings on the same day – he/she will be suspended for one week.

3. Third Offense: Third Mark on Behavior Log/Phone Call or Letter home to parents/suspension for one week.
* NOTE: If a pattern develops (continually suspended each week), longer suspensions will be issued based on staff recommendations and may involve revocation of Recreation membership.

MAJOR INFRACTIONS – The Oneida Police Department will be contacted immediately for all major infractions that occur.

* Fighting. All youth involved in a fight will be held liable for all damages and injuries.

* Weapons. Any and all types of weapons will not be allowed at any time. A weapon is defined
as any object that can be used to hurt another individual.

* Destruction/Theft of Property or Personal Belongings. Anyone involved in damaging
or destroying equipment or personal belongings will be held responsible for all repairs and/or
replacement.

* Alcohol, Tobacco & Drugs. The use and/or possession of alcohol, tobacco or illegal drugs within or around the facility is strictly prohibited. This policy is in effect for all Recreation sponsored events and field trips as well.

CONSEQUENCES for any major infraction include immediate suspension for at least one month. Suspension could be longer or may involve revocation of Recreation membership. Consequences for major infractions will be decided on any individual basis depending on the severity of the situation and the member’s history.

PARENTAL ACKNOWLEDGMENT

As a parent, I agree to and understand the stated disciplinary policy for the Oneida Recreation Dept. I have read the policy, reviewed it with my child and support the disciplinary policy. I will assist my child in abiding by these expectations.

PHOTO RELEASE AGREEMENT

Oneida Recreation reserves the right to take photographs of children participating in our programs to be used in promotional literature.

TRANSPORTATION AGREEMENT

We, as parents, agree to and understand that participating in the After-School Program is a privilege. We allow Oneida Recreation to transport our child(ren) in correlation with the After-School Programs, between facilities (namely the Civic Center and the Cty. H Family Rec.) for special programming at designated pick-up/drop-off locations. By signing this form, we support the Oneida Recreation Policy of no tolerance for violence, drugs, alcohol, and disrespect of staff as well as peers.

7-12 Year Old Pick Up: Each night, Recreation facilities will be closed at 7 p.m. for all members between the ages of 7-12. If you have recreation members within this age group, please make sure they are picked up prior to 7 p.m.

13-18 Year Old Pick Up: The facilities will be closed to the older age group at 9 p.m. Members must be picked up prior to 9 p.m.

In the event that a member is not picked up at 7 p.m. or 9 p.m., the Emergency Contact will be notified immediately.

HOLD HARMLESS AGREEMENT

I and my heirs hereby release the Oneida Nation and all its employees, officers, departments, enterprises and agents from any liability for damage to or loss of personal property, sickness, and injury from whatever source, legal entanglement, imprisonment, death, loss of money, etc. for which the Tribe is not culpable, which might occur while participating in the Oneida Recreation After-School Program.

INFORMED CONSENT AND RELEASE

I, warrants and represents that I and my heirs have no disability, impairment or ailment preventing him or her from engaging in active or passive exercise or that will be detrimental to his or her health, safety, or physical condition if he or she does so engage or participate. acknowledges that there are inherent risks involved in the use of the Oneida Recreation facilities and assumes all risks associated with the use of the facilities. Oneida Recreation and the Oneida Nation of Wisconsin will not be held liable for any claim, demand, injuries, damages, actions, or causes of actions whatsoever to member, guest or property in connection with the use of Oneida Recreation. hereby releases and discharges Oneida Recreation from all such claims, demands, injuries, action or causes of action.

I, the undersigned, , do hereby enter into this contract for recreation with the Oneida Nation, and by my signature below understand and agree to the terms of this contract.

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May 18, 2021 11:21 am CST

Recreation Contract Esign Form Uploaded by Oneida Nation - webmaster@oneidanation.org IP 74.62.93.29

August 24, 2021 1:44 pm CST

Recreation Department - oneida_rec@oneidanation.org added by Oneida Nation - webmaster@oneidanation.org as a CC'd Recipient Ip: 74.62.93.27