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SOARS CAMP 2022

Registration & Enrollment Packet
Ages 6-12


PLEASANT GROVE SOARS - In Person

Trinity River Audubon Center, 6500 S. Great Trinity Forest Way, Dallas, 75217
Mondays - Fridays |  June 6 - June 24   |   9:00am - 3:00pm 
8:30am - 9:00am Breakfast   |   3:00pm - 3:30pm Pick Up
Limited to 40 Students  |  No Cost to Attend


WEST DALLAS SOARS - In Person

West Dallas Multipurpose Center, 2828 Fish Trap Road, Dallas, 75212 
Mondays - Fridays |  July 11 - July 29   |   9:00am - 3:00pm 
8:30am - 9:00am Breakfast   |   3:00pm - 3:30pm Pick Up
Limited to 40 Students  |  No Cost to Attend

 
Thank you for your interest in the Dallas City of Learning SOARS Camps.  Enrollment for each Camp is limited to 40 students on a first come, first served basis.  Breakfast will be provided from 8:30am - 9:00am and Pick Up is from 3:00pm - 3:30pm. 

To help ensure the success and safety of all participants, the SOARS Camp will comply with Dallas ISD policies and procedures. Please visit the District's website at 
https://www.dallasisd.org/scoc to review the Student Handbook and Student Code of Conduct.

On the following pages you will find forms that must be completed by a parent or guardian in order for your child to be enrolled in the program.

Please note: your child will not be allowed to attend the program until all required documents have been received by the SOARS Camp staff. Please complete all pages in this form as soon as possible as enrollment is limited and offered on a first-come, first-served basis. 

Also, a separate application must be filled out for EACH child to be enrolled.

If you have questions about the program, please contact Big Thought at DCOLSoarsCamp@bigthought.org or 214-520-0023.
List of Items Needed to Complete Form
To complete this application you will need to have the following information ready:
  1. Your student’s school ID number
  2. Health insurance information for the child, if available (Insurance Company name and phone number)
  3. Emergency contact information (Name, phone, and email address)
  4. Approved persons who can pick up the student (Name, phone, and photo ID information)
Camp Location

Enrollment Update!
Currently, due to the number of students previously enrolled, which we satisfy on a first-come, first-served basis, In Person SOARS Camp has reached the maximum capacity, and your student will be placed on a waitlist for our program. If a spot becomes available, we will be sure to notify you and provide you with more information going forward. Please complete this application in order to have your student placed on the waitlist. 

DCOL Partner Orgs Logo
Please complete all pages.  When you have finished you will submit your e-signature and then receive an email asking you to verify your email address.  Please click the link in the email to confirm it and then you have completed the application process.
Student Information











* Student ID number is available at the school's main office.

(MM/DD/YYYY)




Emergency Information
The following information is helpful in case of emergency. The Health and Medical form will be transported with your child to the nearest clinic/hospital to assist the paramedics and hospital staff. 








In case of a medical emergency, whom may we contact?















Health Information
* All medical documentation and information noted on and/or connected to this questionnaire will be handled and maintained as confidential. This information could be shared on an as needed basis.  Again, confidentiality will be maintained. 


If yes, additional information is requested on the next page

Student's Present / Past Medical History




I, the undersigned, hereby authorize Big Thought staff to contact the person(s) and healthcare provider(s) named on this form and to authorize the named physicians, clinics, hospitals, and others to provide emergency transport and healthcare to said student. In the event that the physicians, parents/guardians, or any persons named on this form cannot be contacted, Big Thought staff and school personnel are hereby authorized to take whatever action is deemed necessary to provide emergency care to said student. (paraphrase of Section 35.01, Texas Family Code). I HEREBY AGREE TO WAIVE, RELEASE, INDEMNIFY, AND HOLD HARMLESS BIG THOUGHT AND DALLAS CITY OF LEARNING, its respective officers, affiliates, owners, directors, contractors, agents, and employees from any claims, liabilities, and causes of action asserted against BIG THOUGHT AND/OR DALLAS CITY OF LEARNING by reason of the acts, omissions, or neglect of BIG THOUGHT AND/OR DALLAS CITY OF LEARNING, its employees, or agents. I certify I am a parent with the legal control of the student, the student’s legal guardian, or have other court ordered control of the student. I understand that I must notify the Program in writing to change any information on this form or to revoke any consent given herein. I understand it is a penal code offense to falsify information for enrollment. I testify all information on this document to be true and correct.

Page 4

Food Allergies
Please check the foods that have caused an allergic reaction in your child.
Mild = reaction is barely noticeable or causes minor irritation;
Moderate = reaction may require medication or other non-emergency intervention;
Severe = reaction is potentially life threatening if not treated immediately (e.g., ambulance or immediate ER visit)
Mild Moderate Severe




(Please describe)

(Please describe)

AUTHORIZED ADULTS
The Parent/Guardians listed below, as well as the three Contacts listed on the next page, will be allowed to pick up a student. The information listed below will replace all existing information on pick-up contacts at the time this form is received by SOARS Camp staff. Older siblings may pick up provided there is a signed permission letter on file with the SOARS Camp staff on campus.  
Please Note: If child cannot be released to non-custodial parent, we must have legal documentation on file.
CUSTODIAL PARENT OR GUARDIAN (Required)










SECOND PARENT OR GUARDIAN (Optional)










AUTHORIZED ADULTS, Continued
Please list up to three (3) additional contacts who may pick up your child or be contacted in an emergency (at least one (1) is required).  
Contact 1 (Required)




Contact 2




Contact 3




Enhanced Health and Safety Protocols
I understand that Big Thought staff and the facility are engaging in certain activities to work to keep everyone safe during this public health crisis. I commit to adhering to these enhanced health and safety protocols, and to any further enhancements to these protocols as they are made.

THE FACILITY WILL NOT PERMIT ENTRY TO ANYONE WHO:
  • Has a temperature of 100.4°F or above;

  • Has signs or symptoms of a respiratory infection, such as a cough, shortness of breath, sore throat, or low-grade fever;

  • In the previous 14 days has had contact with someone:
with a confirmed diagnosis of COVID-19; 
under investigation for COVID-19; or 
ill with a respiratory illness; or
  • In the previous 14 days has travelled outside the state of Texas or internationally. 

I WILL IMMEDIATELY NOTIFY THE FACILITY if I, any member of my household, or anyone my household has been in close contact with:
  • A suspected or confirmed case of COVID-19 (for example – close contact at home, work, religious service, social gathering).

  • For medical professionals: If contact occurs while wearing recommended personal protective equipment or PPE (e.g., gowns, gloves, NIOSH-certified disposable N95 respirator, eye protection), that contact will NOT be considered close contact for purposes of this protocol.

I WILL BE FAMILIAR WITH AND CONFORM TO ENHANCED PROTOCOLS. These include:
  • At arrival, a staff member will take the temperature of each child being dropped off. If the child does not have a temperature of 100.4°F or above or other symptoms of a respiratory infection, the staff member will guide the child into the program area.

  • At pick up, a staff member will guide each child from the entrance of the facility to your vehicle.   

  • I will not enter the facility unless specifically invited by facility staff. I agree to have my temperature taken prior to any invited entry to the facility. 

  • I understand that SOARS CAMP runs through 3:00p.m. I will pick up my child between 3:00 and 3:30pm AND call the facility should there be a situation that requires me to be early, so staff can meet me at my vehicle, or late and other arrangements have been made for pick up.  A courtesy call 15 minutes before pick up is strongly encouraged to ensure expedient pick up service.

  • Big Thought and the facility will permit children to bring a change of clothes with them in a sealed Ziploc bag, to keep at the facility on an as needed basis. The bags will be wiped down by staff before being brought inside the facility. Children may not bring any other possessions with them. 

I also understand that the Texas Health and Human Services Commission shall have the authority to interview children, or staff, and to inspect and audit child and facility records without prior consent. The facility shall make provisions for private interviews with any children or staff member; and for the examination of all records relating to the SOARS CAMP program. 
General Parent/Guardian Letter of Understanding
1. To help ensure the success and safety of all participants, the SOARS Camp will comply with Dallas ISD policies and procedures. Please visit the District's website at 
https://www.dallasisd.org/scoc to review the Student Handbook and Student Code of Conduct. 

2. Each student is permitted ONE written warning about unacceptable behavior.  Should unacceptable behavior occur again, the student will be dismissed from the program.

3. Fighting is not allowed in the Program. Depending on circumstances, children may be dismissed for fighting.

4. All children are encouraged to stay to the end of the Program day to receive full benefits of the Program activities.

5. As stated, only Authorized Adults are permitted to pick-up children.  

6. I understand that Big Thought conducts an annual evaluation of SOARS Camp, and as part of that evaluation Big Thought may administer surveys to my child, administer academic and/or social and emotional learning assessments to my child and may access student records in compliance with FERPA regulations. I understand that Big Thought will:

• Keep all individual information confidential to the extent allowed by law.

• Never report on a child by name or identifying information and will only share information in the aggregate (meaning overall results), so that there will be no personally identifying information released about a child from Big Thought.
 
• I also understand that my consent is voluntary. My decision whether or not to allow my child to participate in the program assessment will not prejudice my present or future relations with Big Thought or my child’s School teacher or other School official. If I permit my child to participate, I am free to discontinue participation at any time without prejudice. I understand that if I withdraw my student from the project, my student’s information will be removed from the project results.  I understand that I can request copies of the evaluation tools by contacting Big Thought at Robert.Hu@bigthought.org. 

7. As part my child’s experience in SOARS Camp, my child will participate in Dallas City of Learning (DCoL), an education initiative and online platform designed to help students discover new interests, develop skills and earn recognition for their learning achievements. DCoL is a partnership with the Dallas Mayor’s Office and Dallas ISD, and is managed by Big Thought. A portion of data that has been provided, including the child's name, birth date, and Parent/Guardian email or phone, will be shared with DCoL to enable your child’s participation.
permission for my child to participate in Program Assessment as outlined in Item #6
Informed Consent and Publicity Release
I, the undersigned, for good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, hereby (1) authorize Big Thought, A Learning Partnership (“Big Thought”) and its Board of Directors, officers, employees, agents, representatives and associates of their respective staff and anyone authorized by them (collectively, “Big Thought”) the unrestricted and irrevocable right to photograph, video and record me in connection with Big Thought program(s) in which I am participating, have participated or will participate (“Programs”) and (2) grant to Big Thought the unrestricted and irrevocable right to use, publish, reproduce, edit, adapt, modify, exhibit, project, distribute, and display such photographs, videos and recordings, and my name, image and likeness, voice and statements and story (collectively, the “Content”), in any form of media now known or later developed (including without limitation print, digital, electronic, visual, broadcast, Internet and social media, or otherwise), individually and in conjunction with other content, throughout the world and beyond into perpetuity.

Big Thought will own all of the Content and any other results generated by myself as part of my participation in Big Thought Programs, and any physical material to which such Content is affixed, including but not limited to any videotapes, photographs, print materials, canvas, poster boards or digital media. I release and waive any claims whatsoever in connection with the use of the Content as expressly authorized above, including, without limitation, any claim of rights of privacy, publicity, copyright infringement, defamation, so-called “moral rights,” or credit. I also release and waive any right I may have to inspect or approve the Content or any use thereof as expressly authorized above. Additionally, I waive the right to any royalties or other compensation relating to the use of the Content.

I hereby hold harmless and release and forever discharge Big Thought and all persons, corporations or legal entities acting with its permission or upon its authority, from any and all claims, demands, and causes of action which I, my heirs, representatives, executors, administrator’s, or any other person acting on my behalf or on the behalf of my estate have or may have by reason of this agreement or the use of the Content as expressly authorized hereunder.

I acknowledge that Big Thought is conducting its activities in express reliance upon the foregoing, and I represent and warrant that I am not a party to any other existing agreement which would prevent me from entering into this agreement or granting the above rights to Big Thought or which would cause the terms of this agreement not to have full force and effect.
FOR MINOR CHILD OR WARD: I, the signer of this document, represent that I am the parent and/or guardian of the minor named below. I represent that I have the legal authority to, and hereby do, execute the preceding consent and release on behalf of such minor.
permission for Big Thought to use my child's photo or likeness as described above.
SOARS Camp Behavioral Contract
Your student will receive this during the first few days of programming.  By initialing below you acknowledge you have reviewed this document:

As a participant in the SOARS Camp program, I understand that I must:
  1. Follow all rules of the program.
  2. Follow rules I have during the school day.
  3. Treat all adult leaders with respect.
  4. Treat all students with respect.
  5. Report directly to the program each day.
  6. Ask for permission to leave any designated area.
  7. Fully participate in all activities offered to me.
  8. Encourage my parent/guardian to attend events.
  9. Have fun!!!!
Final Acknowledgement
The SOARS Camp program is not licensed by the State of Texas.

Big Thought operates in accordance with the US Department of Agriculture and Texas Health and Human Services Commission policy, which prohibits discrimination on the basis of race, color, national origin, sex, sexual orientation, age or disability.

I, the undersigned, do hereby authorize Big Thought permission, for the purpose of program evaluation, as outlined in parent handbook, to administer surveys to my child, administer academic and/or social and emotional learning assessments to my child and access student records in compliance with FERPA regulations.

I agree to waive, release, discharge, and hold harmless Big Thought and its directors, officers, Trustees, employees, agents, and assigns, from any and all liability, claims, demands, suits, judgments, losses, or expenses which might arise from or out of, or relate directly or indirectly to, my child's participation in the SOARS Camp program. This includes, but is not limited to, any medical care, whether emergency or otherwise, required which arises out of an accident or injury incurred by my child or contraction of COVID-19 while participating in the Program.
E-Signature
This form uses e-Signature to accept your approval of, and agreement to, the forms described above and in detail on the preceding pages, in relation to the student named below. 

Please click "e-Signature" to go to the final page and sign the document.

PLEASE NOTE: After you sign the document, you will be sent a VERIFICATION email.  You MUST click the link in that email to complete the e-Signature process!