Are you ready for Spring Break for ISAIAHS HUB? Use the form to register your child Today! Full Name Phone Number Email Address Child Name (Full Name) Child Age Child Name (Full Name) Child Age Child Name (Full Name) Child Age (If registering more than three children, please attach additional names.) (If different than Parent) Full Name Phone Number Relationship To Child Does your child have any allergies, medical conditions, or special needs? (If yes, please explain. Does your child require medication during program hours? (Y/N) , If Yes Please List Below. By signing below, I acknowledge that Isaiah’s Hub is providing a free Spring Break Program for community youth. I understand that my child(ren) will be supervised in a safe environment, but I accept full responsibility for any injuries, accidents, or unforeseen incidents that may occur. I hereby waive any liability against Isaiah’s Hub, its staff, volunteers, and affiliates. Additionally, I understand that Isaiah’s Hub reserves the right to deny participation to any child who does not meet the program’s behavioral expectations. If a child’s actions disrupt the program or create an unsafe environment for others, Isaiah’s Hub may remove them from participation. Spring Break Program Policies: • Behavior Expectations: All participants must follow instructions, respect staff and peers, and engage positively in activities. Disruptive or unsafe behavior may result in removal from the program. • Drop-Off & Pick-Up: Parents/guardians must drop off and pick up their children at designated times. Late pick-ups may result in dismissal from the program. • Health & Safety: If a child is sick, they should not attend the program. Isaiah’s Hub reserves the right to send a child home if they show signs of illness. • Personal Belongings: Isaiah’s Hub is not responsible for lost or stolen items. We recommend leaving valuables at home. • Emergency Situations: In case of an emergency, parents/guardians will be contacted immediately. If necessary, emergency medical care will be sought. By signing below, I confirm that I have read and agree to the above terms and policies. Signature ❌ Send
