http://cm2wflc.neworg.com/compformdisplay.asp?pagenum=112&formnum=25&cn=&can=&sid=407002199
GCGR Parent Info (New)
 

If any questions, please call in at 203-458-6699.
 
 
2020 Girls Coach Girls Run Information for all students in grades 4, 8, 11 and 12

Page 1: Parent/Guardian Information

Parents/Guardians: If you have any questions, please contact Beth Skudder, Program Coordinator, at bskudder@womenandfamilylife.org or (203) 458-6699 ext. 103.




 
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Review our Policies and Permissions Agreements: Once read, please indicate you agree to the four (4) policies and agreements stated below as they pertain to your student's participation in Girls Coach Girls Run 2020 by selecting "I agree" and date below.

Publicity Policy:
I understand that Women & Family Life Center may publish my student's image (photographic or video) in any medium for marketing and grant reporting purposes. The Center will never use my student's name.

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Attendance Agreement:
My student will attend all Girls Coach Girls Run 2020 program dates barring illness or emergency.

*High School student Training dates:
Thursdays, 3:00 - 5:00pm;
Jan 9, 16, 23, 30;
Feb 6, 13, 20, 27;
March 5, 12, 19, 26;
April 2; and Tuesday, April 21

*8th grade student Trianing dates:
Thursdays, 3:00 - 5:00pm;
March 5, 12, 19, 26;
Apr 2; and Tuesday, April 21

*Program dates for all girls, grades 4, 8, 11 and 12:
Tuesdays and Thursdays after-school
April 23, 28, 30;
May 5,7,12, 14, 19, 21, 26, 28;
June 2;
5K Fun Run: Wednesday June 3 (Rain Date Thursday June 4)

Running Agreement:
I give permission for my student to participate in supervised running activities that may include running/walking on sidewalks and along local roads and safely crossing streets during activities. I will remind my student to immediately follow all directions and instructions related to safety during activities, on roads, walkways and crosswalks during the program.

Permission and Liability Agreement:
I give my student permission to participate in Girls Coach Girls Run 2020. I hereby release Women & Family Life Center, its employees, and its coaches and instructors from any and all liability, claims, suits, damages, losses and expenses, including but not limited to medical expenses and attorney fees, arising from my student's participation in this program by reason of any injury to said student or to any person or property occurring during said participation, or from any cause whatsoever. I expressly waive any claim for damages arising therefrom. In the event of an emergency, I give permission for my student to receive basic first aid and to arrange for transportation to a hospital to receive emergency medical treatment if warranted. I will assume all costs for medical care. My student is physically able to participate in activities without limitations (unless otherwise stated). It is my responsibility to inform Women & Family Life Center of any changes in my student's health prior or during the program.

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Review our Confidentiality and General Liability Agreement below. Once read indicate your agreement by selecting "I agree" and date below.

Women & Family Life Center (WFLC) Waivers and Agreements

Confidentiality Statement:
I understand that all information shared and discussed with Women & Family Life Center staff is confidential. Information will not be disclosed to outside persons unless there is suspicion of or evidence of child abuse, elder abuse (age 60 and over), abuse of persons with disabilities and/or the participant is a risk to oneself or others. The Center's staff are mandated reporters and have a legal and ethical obligation to report the above information to the proper authorities.

Scope of Services and Program Liability Statement:
I understand that when working with any program facilitator, said professional is representing Women & Family Life Center and not a private business. Some examples include the social workers, financial advisors or attorneys who facilitate programs. These individuals are not selling any particular goods or services. They will give general information for educational purposes and are not treating me therapeutically, representing me legally or managing my affairs financially. The Center's staff and facilitators may provide with me referral information on a variety of public and private resources. Providing this information does not construe an endorsement of individual providers or indicate eligibility for services. It is my responsibility to ascertain the appropriateness of utilizing any of the recommended resources. I agree to hold WFLC and its facilitators harmless from liability for any claims related to the issues discussed during programs. I also understand that WFLC is not responsible for any outcomes or lack thereof from referrals.

General Liability Statement:
I understand that all participation in physical activity is by my own choice and at my own risk. WFLC and its facilitators are in no way liable to me for any claims, demands, injuries, damages or actions arising due to injury of my person or property at the premises. I agree to hold WFLC and its facilitators harmless from any and all claims which may be brought against WFLC and its facilitators for any such injuries or claims.

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Household size (number of people counted in your taxes) Gross income (before taxes) for all household members combined
1 $18,210
2 $24,690
3 $31,170
4 $37,650
5 $44,130
6 $50,610
7 $57,090
8 $63,570