First Baptist Lee’s Summit Parent Day Out
First Baptist Church Lee’s Summit
2 NE Douglas, Lee’s Summit, MO 64063
(816) 525-0700
Registration Information
Purpose:
Parent Day Out (PDO) is a ministry of First Baptist Church Lee’s Summit, providing a
Christian environment in which young children can learn and grow. We teach Biblical
truths, while preparing children for school.
Objectives and Philosophies:
We provide for the spiritual growth and social advancement of each child.
We help children in the development of language, math and motor skills while
encouraging independence and self confidence.
We teach an appreciation for God, family, school, church, and community.
We help each child begin to know and appreciate God as our Creator and Lord, and to
recognize the joy of being a child of God.
We facilitate social experiences through which children can learn to respect self and
others and learn to solve problems acceptably.
Class Information:
Classes are grouped by birthdates and/or the developmental needs of the students. We
offer classes for children from 2 years of age through pre-kindergarten age.
Schedule:
2 day option classes are held on Mondays and Wednesdays A 3-day option will also meet
on Fridays. We begin at 9:00am. Dismissal is between 12:55 and 1:00pm. PDO follows
the vacation and holiday schedule of the Lee’s Summit School District. PDO will not be
in session if the Lee’s Summit School District cancels school due to inclement weather.
If the school district releases school early due to weather conditions, we will also close
early. We will not be affected by the district’s scheduled early release days.
Enrollment:
This program is open to children in the proper age categories regardless of race, color, or
creed.
3/13
Fees:
The fees for the 2013-2014 school year are as follows:
A $25.00 non-refundable enrollment fee is due at the time of registration. $10 for second
child.
The fee for the 2-day option is $160.00 per month. The 3-day option fee is $240.00 per
month.
Tuition is due at the beginning of each month. Failure to pay by the 5th of each month
will result in a late charge of $5.00 for each day after the 5th of the month. There is no
reduction of fees for illness or absence. After 1:05 pm, there will be a $5 dollar tardy fee
charged. After 1:10 pm a $10 dollar tardy fee will apply. There will be an additional $5
dollar charge for every five minutes after that. Tardy fees are to be paid that day upon
arrival of the parents. This policy will be enforced. Please make checks payable to First
Baptist Church Lee’s Summit.
Supply/Activity Fee:
There will be a non-refundable, one time supply and activity fee of $50.00 due with first
month tuition, August 14. This fee provides for classroom school supplies, paper
products, and special events.
Items To Bring To PDO:
A blanket or towel is needed for quiet time. All children should bring a change of
clothes, including underclothes, in case of an accident or spill. All personal items should
be clearly marked with the child’s name. Children should bring their lunches, including a
drink, each day with a cold pack to keep food fresh.
Car Pools:
Children are released only to the parent(s), unless written authorization was previously
given to the director. Car-pools are beneficial and encouraged; however, the director
must be informed of your arrangements so that your child will be released to the proper
caregiver(s). The PDO Office will keep a list of all car-pools on file. In case of
emergency, call the PDO Office and give verbal authorization to the director. Be aware
that the person picking up your child will be asked to give proper identification, i.e.
driver’s license, before the child will be released.
Other Ministries Available:
Church Services – Sundays, 8:30 a.m., 9:45 a.m., 11:00 a.m., 6:30 p.m.
Bible Fellowship (Sunday School) – Sundays, 8:30 (Babies-3s only), 9:45 a.m., 11:00
a.m. (all ages)
Children’s Choir – 3 yrs to 6th grade – Wednesdays, 6:00 p.m. – 7:00 p.m.
TEAM KID – 3 yrs to Kindergarten – Wednesdays, 7:00 p.m. – 8:00 p.m.
1st Kids – 1st grade to 6th grade – Wednesdays, 7:00 p.m. – 8:00 p.m.
Adult Bible Studies and Adult Choir – Wednesdays evenings
3/13
Infection Control Guidelines: Parent Copy
These guidelines benefit our children, as we work together to do everything necessary to
keep communicable illness or disease at a minimum.
Do not bring a child to PDO when he or she displays the following symptoms:
a. coughing, sneezing, runny eyes or nose (children with green, yellow, or
cloudy runny noses are considered contagious)
b. temperature of 100.5 degrees orally or 101.5 degrees rectally within the
past 24 hours
c. reddened mouth or throat
d. vomiting (if a child vomits twice within a 24 hour period he or she needs
to remain at home for 24 hours after the symptoms disappear)
e. diarrhea (if there are two occurrences within a 24 hour period of abnormal
bowel movement, your child needs to remain at home until asymptomatic
for 24 hours)
f. unusual fatigue or irritability and listlessness
g. contagious skin diseases (if your child has any contagious disease such as
whooping cough, herpes, chicken pox, mumps, measles, diphtheria, or
scarlet fever, please report it immediately to the director)
h. red, glazed or discharging eyes (conjunctivitis or “pink eye” is highly
contagious) remain home until discharge stops or child is on authorized
medication for 24 hours
i. if a child has ringworm, lice or impetigo, he or she should remain home
until adequate treatment has controlled the spread
**When any of these symptoms appear in a child, we will call a parent to take
him or her home immediately.
Teachers take the following precautions to clean and disinfect the facilities and
equipment:
a. Sheets are removed after each use (by one child)
b. Beds are sprayed with disinfectant spray after use. We will not use spray
while child is in the room.
c. Trash is removed after each session.
d. Bathrooms are cleaned and disinfected after each session.
e. Toys are cleaned daily with soap and bleach water.
f. Antimicrobial soap has been placed in each bathroom.
g. Disposable gloves are used for each diaper change. Antimicrobial topical
gel is used after each nose wipe and feeding.
h. Hands are washed thoroughly before each session begins and before lunch
or snack time.
i. Wax paper is used under each child during a diaper change and changing
table is cleaned with soap and bleach water after each use.
3/13
Ratio Requirements
Parents:
Our classes are set up as listed below. These numbers should stay the same throughout
the year.
Two years:
Three years:
Four/Five years:
2 staff member for every 8 children
2 staff member for every 8 children
2 staff member for every 8 children
Please note that our ratios are frequently smaller than those required by licensed facilities.
Please Keep the First Two Sheets for Future Reference
Please sign and return the attached forms as soon as possible
so your child’s file will be complete. Thank you for your
prompt attention.
Completion of all the attached forms is
required before acceptance to First
Baptist Church Lee’s Summit Parent
Day Out
2013-2014 School Year
Registration Form
Please complete and return with your $25.00 enrollment fee.
3/13
Parent Day Out
First Baptist Church Lee’s Summit
Enrollment Date___________
Enrollment Fee Paid___________
Activity Fee Paid __________
Immunization Record __________
Physician Form ___________
Infection Control Guidelines _________
Photo Consent ________ Notarized Agreement and Registration Form_______
To be filled out by FBCLS Parent Day Out Staff-Thank you
Please check one:
2-day program (M,W)
3-day program (M,W,F)
Child’s Full Name________________________________________________Sex_____
Name Child Prefers To Be Called___________________________________________
Home Address__________________________________________________________
______________________________________________________________________
(City, state, and zip code)
Home Phone________________________
DOB______________________________
Father’s Name________________________________ Occupation_________________
Work Address_________________________________ Work Phone________________
Work Schedule_________________________________ Cell Number_______________
Mother’s Name________________________________ Occupation_________________
Work Address_________________________________ Work Phone________________
Work Schedule________________________________ Cell Number________________
Child Lives With_________________________________________________________
(relationship)
Email Address___________________________________________________________
Which parent should be contacted in case of an emergency or illness?________________
3/13
Person to call in case of emergency when parents cannot be reached
1. Name_________________________________Address_________________________
Phone_________________________________ Relationship_____________________
2. Name_________________________________Address_________________________
Phone_________________________________ Relationship_____________________
Name
Siblings or Other Household Members
Age
Relationship
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Authorized Persons for Car Pools
I/We give permission for the following persons to provide transportation for
_____________________ from FBCLS Parent Day Out to my/our home or designated
location.
Name
Relationship
Phone
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Signature of Parent
Date
3/13
Student Information
Child Care Center previously attended_________________________________________
What are your child’s interests?______________________________________________
_______________________________________________________________________
How does your child relate to others his or her age?______________________________
_______________________________________________________________________
What are your child’s strengths?______________________________________________
________________________________________________________________________
Is there any other information regarding your child that you would like for us to know?__
_________________________________________________________________
What goals do you have for your child this year in preschool?
_________________________________________________________________
Field Trips/ Visiting Groups Permission Slip
I hereby grant permission for _____________________________________ to take part
in walks, field trips, and in visiting activities under the supervision of staff members of
FBCLS PDO.
________________________________________________________________________
Signature of Parent
Date
How did you find out about our program?______________________________________
Religious Preference
Does your child attend Sunday School?________________________________________
If yes, where?____________________________________________________________
What is your family’s religious preference?_____________________________________
Is your family affiliated with a church in the community?_________________________
If yes, which church?______________________________________________________
3/13
Photo Consent
I,___________________________________________, the parent or legal guardian of
___________________________________________,
_________do hereby give permission for my child’s picture to be
published in FBCLS newletters and website.
_________ do not give permission for my child’s picture to be published
in FBCLS newletters and website.
________________________________________________________________________
Signature of Parent
Date
________________________________________________________________________
Signature of Parent
Date
3/13
Infection Control Guidelines
These guidelines benefit our children, as we work together to do everything necessary to
keep communicable illness or disease at a minimum.
Do not bring a child to PDO when he or she displays the following symptoms:
a. coughing, sneezing, runny eyes or nose (children with green, yellow, or
cloudy runny noses are considered contagious)
b. temperature of 100.5 degrees orally or 101.5 degrees rectally within the
past 24 hours
c. reddened mouth or throat
d. vomiting (if a child vomits twice within a 24 hour period he or she needs
to remain at home for 24 hours after the symptoms disappear)
e. diarrhea (if there are two occurrences within a 24 hour period of abnormal
bowel movement, your child needs to remain at home until asymptomatic
for 24 hours)
f. unusual fatigue or irritability and listlessness
g. contagious skin diseases (in your child has any contagious disease such as
whooping cough, herpes, chicken pox, mumps, measles, diphtheria, or
scarlet fever, please report it immediately to the director)
h. red, glazed or discharging eyes (conjunctivitis or “pink eye” is highly
contagious) remain home until discharge stops or child is on authorized
medication for 24 hours
i. if a child has ringworm, lice or impetigo, he or she should remain home
until adequate treatment has controlled the spread
**When any of these symptoms appear in a child, we will call a parent to take
him or her home immediately.
Teachers take the following precautions to clean and disinfect the facilities and
equipment:
a. Sheets are removed after each use (by one child)
b. Beds are sprayed with disinfectant spray after use. We will not use spray
while child is in the room.
c. Trash is removed after each session.
d. Bathrooms are cleaned and disinfected after each session.
e. Toys are cleaned daily with soap and bleach water.
f. Antimicrobial soap has been placed in each bathroom.
g. Disposable gloves are used for each diaper change. Antimicrobial topical
gel is used after each nose wipe and feeding.
h. Hands are washed thoroughly before each session begins and before lunch
or snack time.
i. Wax paper is used under each child during a diaper change and changing
table is cleaned with soap and bleach water after each use.
**I have read, understand, and agree to the PDO Infection control guidelines.
Signed ___________________________________________________ Date__________
3/13
Agreement and Registration
For
FBCLS Parent Day Out
(This form must be signed in the presence of a notary.)
Registration Date_________________________________________
We, the undersigned parents or guardians, hereby register our child,
_____________________________________________ for the 2013-2014 school year in
the Parent Day Out program at First Baptist Church Lee’s Summit, Missouri.
We understand that our child may be withdrawn and payment stopped after a two week
notice is given to the director. We also understand and agree that failure to pay by the 5th
of each month will result in a late charge of $5.00 for each day after the 5th of the month.
No refunds will be made.
In case of accident or illness requiring immediate medical attention, a representative of
the FBCLS Parent Day Out Program is authorized to call a physician or ambulance. I
also give my authorization to the attending physician to administer medical attention.
Intending to be legally bound hereby, I agree to pay all expenses incurred.
Signed:
_______________________________________________________________________
Parent or Guardian
Date
Notary__________________________________________________________________
Date
3/13
Child’s Health Record Form
Due before child may attend.
First Baptist Church Lee’s Summit Parent Day Out
Office 816-525-0700
This section to be completed by Parent or Guardian:
Child’s full name ___________________________________________________
Date of Birth _________________________
Any evidence of: Hearing loss or difficulties? __________________________
Vision difficulties? _________________________________
Speech difficulties?_________________________________
List any:
Hospitalizations _________________________________________
Operations _____________________________________________
Other serious illnesses ____________________________________
Current medication taking _________________________________
Allergies _______________________________________________
This Section to be completed by Physician:
All immunizations are up-to-date _________Yes _________No
If no, indicate reason ________________________________________________
Results of tuberculin skin test (if needed) ________________________________
Other remarks regarding physical condition ______________________________
I have examined the above-named child and verify that this child’s medical history
and current state of health are  are not satisfactory for participation in a
Parent Day Out/child care Program
The above information is correct as of (date) _____________________________
Signature of physician ___________________________Phone ______________
Address __________________________________________________________
Immunizations (dates of latest inoculation or provide certificate of
immunization)
DPT
_______________
Hib/hepB
_______________
MMR
_______________
Polio IPV
_______________
Varicella
_______________
Prevnar
_______________
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1MANDATORY
MEDICAL INFORMATION
I understand that in case of an accident or injury to my child, I will be notified
immediately. If my child requires emergency medical care, the physician and preferred
hospital to be used are:
Name of Child’s Doctor/ Clinic____________________________ Phone_____________
Preferred Hospital_______________________________________Phone_____________



This certifies that my child is, to my knowledge, in good health and free of
disabilities that would endanger him/her or other children in 1st Kids Parent Day
Out.
I have been informed of the required health and safety inspections and that the
inspection forms are available for review.
When my child is ill, I understand and agree that my child may not be accepted
for care.
________________________________________________________________________
Signature of Parent
Date
3/13