General Registration

General Registration

Parent First Name *

Parent Last Name *

Address *

City *

State *

Zip Code *

What is your primary language? *

Cell Phone Number *

Can we text you about new resources that may be available? *

Yes

No

Email *

What is your preferred method of contact? *

What is your Facebook name? *

If we can not reach you through your preferred method of contact we will reach out to you through your Facebook

The following questions are used to help fund the programs at our South Franklin Center. All information that is given will be confidential.

What is your sex? *

What is your race/ethnicity *

What is your country of birth? *

What is your family income? *

What is your highest level of education? *

What is your native language? *

Please indicate your marital status: *

What is your spouse's/partner's country of birth? *

What is your spouse's/partner's highest level of education? *

What is your spouse's/partner's first name? *

What is your spouse's/partner's last name? *

What is your spouse's/partner's date of birth? *

What is your spouse's/partner's phone number? *

What is your spouse's/partner's sex? *

Who will be your emergency contact? *

What is your emergency contact's complete name? *

*please provide an emergency contact that is local*

What is your emergency contact's relationship to you? *

What is your emergency contact's phone number: *

Do you have computer or internet access? *

Do you have children? *

How many children do you want to enroll? *

Please fill in the information regarding your children who will be participating in South Franklin Community Center activities and programs.

Child 1

What is your child's first and last name?

What is your child's date of birth?

What is your child's sex?

How well does your child speak English? (On a scale of 1 to 5, 1 being not at all and 5 being fluently)

Child 2

What is your child's first and last name?

What is your child's date of birth?

What is your child's sex?

How well does your child speak English? (On a scale of 1 to 5, 1 being not at all and 5 being fluently)

Child 3

What is your child's first and last name?

What is your child's date of birth?

What is your child's sex?

How well does your child speak English? (On a scale of 1 to 5, 1 being not at all and 5 being fluently)

Child 4

What is your child's first and last name?

What is your child's date of birth?

What is your child's sex?

How well does your child speak English? (On a scale of 1 to 5, 1 being not at all and 5 being fluently)

Child 5

What is your child's first and last name?

What is your child's date of birth?

What is your child's sex?

How well does your child speak English? (On a scale of 1 to 5, 1 being not at all and 5 being fluently)

Child 6

What is your child's first and last name?

What is your child's date of birth?

What is your child's sex?

How well does your child speak English? (On a scale of 1 to 5, 1 being not at all and 5 being fluently)

South Franklin's Code of Conduct

Expected Behavior:

Only respectful and safe behavior is permitted in the building. Any outbursts from children or adults will result in proper disciplinary action, including, but not limited to:

- A discussion with a building supervisor to create a behavioral plan.
- Temporary suspension from classes.
- Removal from the specified program.
- Discontinued admittance into the building and participation in all programs.

Respectful and Safe Behavior is:

- Following directions without complaint.
- Respecting staff and volunteers.
- Arriving and leaving classes on time.
- Cleaning up after yourself and/or your children.
- Using inside voices.
- Treating others with kindness.

We want to create an enjoyable experience for all. It is at the volunteer's and staff discretion whether or not you are allowed to participate in the class they are in charge of. If you do not meet class standards, they may ask you to leave. Registration is on a first come first serve basis with number one priority given to those who live within the South Franklin neighborhood. Registering does not guarantee you a spot in any class. Certain classes have prerequisites or age limits that must be filled in order to participate. Individual classes and programs will each have their own set of policies and procedures that will need to be followed.

Building Use:

Building use is only for those participating in a program. Unaccompanied minors will be asked to leave the building if they are here outside of their scheduled program time.

If you are a parent/guardian waiting for a student/participant in the building, we ask that you keep noise levels to a minimum and monitor the behavior of your children to do the same.

Be respectful of the property and only use items for their intended use. You are responsible for any damages or vandalism caused by you are your child, unless otherwise stated by the building manager.

Please leave the building in the manner in which you found it. Be mindful that the building is for the use of everyone, so be sure to pick up after yourself and your children. Be respectful and try to keep the mess to a minimum when participating in the class or program. Please propoerly dispose of any outside food/beverages you bring into the center. We ask that food and drinks only be allowed in teh kitchen, classroom, and multi-purpose room. Bottled water is acceptable in all rooms. If you or your child has an accident in or on building property, you are expected to clean up after them. We can provide any cleaning supplies as needed.

Service animals are the only animals allowed in the building. No pets are allowed indoors. Please clean up after your service animals.

Internet access is a privilege. Please conduct internet searches, videos, and all content in a safe manner. Any inappropriate use (deemed by us) could result in the proper disciplinary action and/or proper authorities being informed.

Failure to comply with any of the above stated rules could result in you being asked to leave. Failure to leave when asked will result in the involvement of the proper authorities. Since we are located on the Boulders property, you put yourself at risk for eviction or other disciplinary actions the Boulders management wishes to pursue.

Please select if you understand and agree to South Franklin's Code of Conduct

South Franklin's Liability Agreement

Liability Agreement

I agree to participate in any activity held at the South Franklin Community Center. I also give permission for all named minors listed on this form to participate at the South Franklin Community Center. I understand that I, and any other participants listed on this form, will be working with South Franklin Community Center members and volunteers. Furthermore, I acknowledge that there may be unseen risks that may take place in the participation of these activities. I, along with any participants listed, agree to the following statements below.

1. I understand that I cannot hold South Franklin Community Center, volunteers, and/or other participants responsible for any unforseen risks/damage that may take place during the participation of any activity.

2. I understand that I, as the parent/guardian/responsible party of the participants named in this form, will be held liable for any premeditated damage that my participants might cause at the South Franklin Community Center.

3. I understand that some of the activities at the South Franklin are only appropriate for adults. Due to this, I, as the adult, will only let the underage applicants participate in activities that are age appropriate. I also understand that if any named minor wants to attend an activity that is not age appropriate, an adult must accompany him/her.

4. I understand that when South Franklin Community Center staff, volunteers, or participants have "reason to believe that a child has been subjected to abuse or neglect" or "observes a child being subjected to conditions or circumstances which would reasonably result in abuse or neglect" then that person is required by law to "immediately notify the nearest peace officer, law enforcement agency, or office of the division" (Utah Code; Title 62A, Chapter 4a, Part 4, Section 403).

5. I understand that I am responsible for the children I bring to the Center. The volunteers and staff at South Franklin will not be responsible for the well being of the children I bring. It is on me to make sure the kids I bring do not leave the center, that they are not running around or making excessive noise, and that they are participating in the activities. I understand that the kids can not be hanging around the center unless they are registered for and attending an activity. Staff and volunteers are NOT able to look after my kids while they or myself are here at the center for an activity. The only exception is volunteers that are specifically there for childcare, however they are still not liable for your children. Childcare is only for children ages 9 and under, unless stated otherwise. I understand that myself and/or my kids may be asked to leave if they can not follow the rules.

Liability Agreement *

Please select if you understand and agree to South Franklin's Liability Agreement

Photo Agreement

Photo Agreement

I agree to allow use of my image and/or that of the named minor(s), which may be captured through video, photo, digital camera or other media, for South Franklin Community Center promotional materials and publications. I have had all my questions answered to my satisfaction, and I voluntarily agree to participate and/or let my child participate in an activity at the South Franklin Community Center.

I agree

I disagree

Phone

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