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Babysitting Service
Fall Hours of Operation
(beginning 8/24)
Monday - Friday 9:00 am to 11:00 am
Monday - Thursday 4:30 pm to 7:30 pm
Friday 4:30 pm to 6:30 pm
Saturday -
Sunday 9 am to 11 am
Informed Consent
I grant my informed consent for (child’s
name)______________________(please print)
to participate in the structured babysitting
service at Family Fitness Zone (FFZ).
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I understand that the FFZ
babysitting service is supervised for mixed age groups between 6 weeks and 3
years of age, and that my child may interact with other children in this age
group,
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I agree to complete a Medical
Information Form the first time my child uses this service and to update the
form if the information it contains changes.
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I understand that the FFZ
babysitting service is to be used exclusively by FFZ members, registered
guests, and employees.
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I agree to sign my child in and
out of the Baby Zone each time he/she uses it.
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I agree to remain on the
premises while my child participates in the service.
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I understand that the maximum
time allowed in the Baby Zone is 2 hours. If, however, your child becomes
uncomfortable or irritable during the second hour you will be asked to
retrieve your child.
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I understand that my child may
not enter this service if he/she has a fever, a contagious illness, poses a
health risk to others, or is deemed by the FFZ supervisor to be too ill for
group play.
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I understand that the same
individual, who checks in the child, must also pick up the child. A photo
Id is required.
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Please change your child’s
diaper before entering the Baby Zone. Potty-trained children should use the
restroom prior to entering the Baby Zone. The parent/guardian will be
contacted for diaper changes or restroom visits.
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I understand that I will be
contacted in the event of illness, accident, or injury to my child, or if
the child needs to use the restroom or requires a diaper change. I also
consent to any emergency medical procedures personnel reasonably believe are
necessary under the circumstances.
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To the best of my knowledge, my
child has no condition, which restricts his/her full participation. I have
informed the babysitters of any special needs my child has on the Medical
Information Form.
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I understand that FFZ reserves
the right to require that my child be picked up from or refused entrance to
this service if, in the judgment of FFZ he/she is ill, poses a risk to
others, or is unable to function within any other guidelines of the
operation.
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I understand that my child may
participate in some movement exercises such as dancing, climbing, and
hopping. I acknowledge and accept the risks inherent in the use of this
service and voluntarily assume the risk of injury, accident, death, loss,
cost or damage to his or her person or property which might arise from the
use of the service. Member further certifies the child is in good physical
health and is able to undertake and engage in the physical activities.
Member assumes all responsibility for updating the club of changes in
physical condition and for reporting all injuries to the staff on duty at
the time. Family Fitness Zone will make no evaluation or recommendation
whether the child is physically fit to participate in any activity, program,
or event. It is always advisable to consult your physician prior to
undertaking any physical exercise program. The member agrees to waive any
claims or rights to sue Family Fitness Zone, LLC , their officers,
officials, agents and/or employees, other participants, sponsoring agencies,
sponsors, advertisers, owners, and lessors of the premises with respect to
any and all injury, disability, death, or loss or damage to person or
property, whether arising from negligence or otherwise, to the fullest
extent permitted by law.
Parent's Name (print)_________________________________ Date____________
Parent's Signature_____________________________Member
Id______________
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