In order for our staff to better help your child, input your Infinite Campus login ID and password (Parent Portal).
If your child will be riding the bus, list their regular bus pick up and drop off locations.
Please describe other income sources: Include income type and amount for EVERY PERSON living in the home, regardless of age or type of income.
I understand that the Boys & Girls Clubs of Appalachia has an open door policy where members are allowed to come and go as they please. Should a member leave the Club, they will not be granted return access unless approved by the Club Unit Director. We assume no responsibility for members who choose not to attend on a particular day or who choose to leave early.
I, the parent/guardian of the minor child on this application, on behalf of the minor child listed herein and for ourselves, our heirs, executors and administrators, hereby release, waive acquit and forever discharge the Boys & Girls Clubs of Appalachia (BGCAPP) and Boys & Girls Clubs of America, their representatives, successors, insurers, assigns or any other person or entity associated with any of the above organizations such as staff, directors, or volunteers, from all liability, claims, demands, or causes of action for any and all loss, damage injury, or death and any claim of damages resulting from use of facilities owned or controlled by the above organizations, or participation in activities of said organizations wither at or away from the Club.
By typing your name, you confirm that you agree to the above statement and have supplied true and accurate information in this application.
Your application is not complete until you read and sign the handbook.
Dear Parent or Guardian,
Thank you for trusting us with the physical, emotional, and educational wellbeing of your child. Please read over the attached handbook and learn what the Boys & Girls Club is all about. This is an important step in ensuring that your child has a successful year at the Club. All members and their guardians will benefit from the information enclosed in this booklet and you are expected to be familiar with what is outlined in the following pages. We are here to help you if you have any questions at all concerning this handbook. Our first and foremost priority is your child’s safety, and for us to be able to operate safely, we will everyone’s full cooperation.
Please stay on the lookout for frequent updates which will be posted on our Facebook page or on the door of the Club. We have also implemented an all-call system for times when we need to get a single message out quickly. Please make sure you fill out the packet completely so we have the correct phone number for our files, or else you may miss out on important information (field trips, parties, giveaways, closings, health notices, etc.) that can affect your child.
Our mission is to inspire and enable all young people to realize their full potential as productive, responsible, and caring citizens. We can only achieve this mission with your help and support. Our partnership with you has never been more important than it is now. During these uncertain times, we must work harder than ever to ensure that your child is getting the help and guidance he or she needs. We are here for you. We want to be an advocate and an ally for your family. If there is ever anything we can do to assist you, please let us know.
Looking forward to a great year!
Best regards,
Kateena Haynes, CEO
Boys & Girls Clubs of Appalachia
Membership
School year: Membership is open to youth between the ages of 6 and 18. However, members may be younger (min. age 5) or older (age 19) if they are enrolled in school. Birth certificate and proof of school enrollment may be requested for any member first enrolling in the Club. A membership form must be completed and signed by a parent or guardian each year (even if you are simply renewing your membership). Membership in the afterschool program is free, but financial donations to help offset the cost of supplies and materials are welcome and appreciated. Some activities (such as field trips) may require a small fee.
Summer: Fees for our summer educational enrichment camps are $50 per week. However, scholarships and payment plans based on household income are available. Our goal is to always keep costs associated with Boys & Girls Club membership as low as possible to not exclude anyone based on economic circumstances.
The information you provide us on the membership application is critical.
We ask that every effort be made to present contact information that is both current as well as accurate. It is the parent's/guardian's responsibility to notify us of any changes to your telephone number (home, work, emergency contacts, etc.) and/or address information as soon as such changes occur. Failure to provide current contact information will result in member suspension or possibly termination. Membership in the Boys & Girls Club is a privilege, not a right. The Boys & Girls Club reserves the right to refuse membership to any child at any time, with or without cause.
Orientations are offered to all new members and their parents. Please take advantage of the opportunity to see and hear what your Boys & Girls Club is all about and how you can give back to the Club to make it a better place for all of our kids. To sign up for an orientation, please contact the Unit Director at your child’s Club.
Locations & Contact Information
Cawood Ledford Boys & Girls Club, Unit Director- Jordan Turbyfill
Office phone- 606-573-0960
Email- jturbyfill@bgcapp.club
Monday - Friday from 2:30 pm until 6:00pm
Contact Unit Director for teen-only hours.
Dr. Marcia Hawkins Boys & Girls Club at Union Commonwealth University, Unit Director- Erica Pearson
Office phone- 606-546-1712
Email- epearson@bgcapp.club
Monday - Friday from 2:30 pm until 6:00pm
Contact Unit Director for teen-only hours.
Harlan Independent 21st CCLC Teen Club, Unit Director- Jacob Farmer
Mobile phone- 606-273-4000
Email- jfarmer@bgcapp.club
Monday - Thursday 3:20 pm until 5:40 pm
Black Mountain Boys & Girls Club (A 21CCLC Program), Unit Director- Teresa Ball
Office phone- 606-837-2214
Email- tball@bgcapp.club
Monday - Thursday 2:40 pm until 5:00 pm
Tri-City Boys & Girls Club (A 21CCLC Program), Unit Director- Aubrey Purgitt
Office phone- 606-589-2511
Email- apurgitt@bgcapp.club
Monday - Thursday 2:40 pm until 5:00 pm
Cowan Boys & Girls Club (A 21CCLC Program), Unit Director- Krista Terry
Email- kterry@bgcapp.club
Monday - Thursday 2:55 pm until 5:15 pm
Letcher Elementary Boys & Girls Club (A 21 CCLC Program), Unit Director- Tiffany Reedy
Office phone- 606-633-2524
Email- treedy@bgcapp.club
Monday - Thursday 2:55 pm until 5:15 pm
Hazard/Perry County Boys & Girls Club, Unit Director- Chris Campbell
Email- ccampbell@bgcapp.club
Monday - Friday 2:30 pm until 6 pm
Pineville Boys & Girls Club ( A 21CCLC Program), Unit Director- Rachel Adkins
Email- radkins@bgcapp.club
Monday-Thursday 3:05-5:25 pm
School Programs Coodinator- Miranda Jeffers, mjeffers@bgcapp.club
Chief Operating Officer- Kendra Calhoun, kcalhoun@bgcapp.club 606-273-5357
CEO- Kateena Haynes, khaynes@unionky.edu 606-273-6191
Please be sure to pick-up your child by the posted closing times. Late fees of $1 per minute will be assessed after 10 minutes. Late fees must be paid before the member(s) will be allowed to return. The Boys & Girls Club reserves the right to contact the appropriate authorities for assistance when members are not picked up by a reasonable time and after all emergency contact alternatives have been exhausted.
Supervision
Our staff members are trained Youth Development Professionals. Screened volunteers often support our staff. A staff member will oversee each of our designated program areas. ALWAYS take the time to remind your child of the need to follow Club rules and directions whether said directions are given by a staff member or a volunteer. Please note that youth are not allowed on the Club's grounds during operating hours unless they are signed in and participating in Club activities. Members should NOT be dropped off prior to the start time of Club activities, as the Club cannot be held responsible for the supervision of such youth. Also, once a child leaves the Club, he or she will not be allowed to return until the following day.
Code of Conduct
One of the Club's core beliefs is to provide a safe place to learn and grow. Positive attitudes keep the Club fun. Below are some simple guidelines members are expected to follow:
Dress Code
Youth should dress comfortably and wear clothes that allow them to participate in typical Boys & Girls Club activities and programs. We will expect the following...
Footwear: Shoes and socks must be worn at all times. Flip-flops and sandals are allowed but discouraged, as are any other open-toed shoes for safety reasons. Club members may not be allowed to participate in certain activities if open-toed shoes are worn. The best advice is to wear tennis/walking shoes every day.
Clothing: Inappropriate clothing of any kind is NOT allowed in the Club. Members wearing clothes that are see-through, too short, too tight or too revealing in any way, or clothes with questionable or distasteful advertising will be asked to change or leave immediately. This judgment will be left solely to the discretion of the Club staff. Spaghetti straps are not allowed, nor are shorts that are shorter than mid-thigh.
Masks: During peak Covid times, we may ask that children be sent to the Club with an easily identifiable mask. We recommend writing the child’s name on the inside of the mask.
Field Trips
The Boys & Girls Club provides a variety of opportunities for our members to participate in activities off Club property that support our core beliefs and programs. Each excursion requires a signed permission slip and any necessary fees prior to departing. To participate in a Boys & Girls Club Field Trip, a child must be an active member of the Boys & Girls Club for at least 2 weeks and attend the Club for at least 4 days during that time period without any Club suspensions. Most sign-ups are taken on a first-come, first-served basis (meaning eligible members who return the required permission slip). Members and parents are reminded that all of our Club rules extend to field trips. Members who fail to follow our rules and general Club expectations for appropriate behavior will prompt an immediate call to a parent or guardian to remove that member from the field trip at their own cost. A parent or guardian MUST be available by telephone at all times during any Club sponsored field trip in the event that the staff needs to contact you.
Discipline Policy
Rules and Regulations
1. Parents must keep up to date emergency contact info on file.
2. All members and parents are expected to know the rules and follow them.
3. Members are expected to follow the instructions of the staff and volunteers and to be respectful to them and other Club members.
4. Members are to keep their hands to themselves and respect one another's personal space.
5. Anyone receiving a "Red Card" will not be allowed to return to the Club until the parent(s) or guardian(s) meet with the Director of Operations to formulate a behavior plan.
6. Improper language is not permitted. This includes cursing, inappropriate discussions, racist remarks, etc.
7. Fighting, wrestling, and bullying are not permitted.
8. Running is only allowed when permission is given by a staff member as part of a game or activity.
9. Only one Club member in the restroom at a time.
10. Eating is only permitted in designated areas.
11. Shoes must be worn at all times.
12. Members are only allowed in supervised areas.
13. We cannot be held responsible for items that are lost, stolen, or damaged. Members are encouraged to leave personal items, such as mobile phones, at home.
14. All members are expected to clean up after themselves.
15. All Club members should be picked up by the close of Club each day. A fee of $1 per minute will be assessed for late pick-ups.
16. All members are always to conduct themselves with dignity.
17. Destruction of property will not be tolerated. This includes, writing on walls, desks, chairs, etc. This also includes intentional destruction of games equipment or using equipment for purposes other than those intended. Parents will be charged for damaged property.
18. Once a member leaves the Club, he or she will not be admitted again until the next day.
19. No one under the influence of drugs or alcohol will be allowed to participate in the Club or in Club activities. Tobacco us is also not permitted. We enforce a zero tolerance policy.
20. Weapons or look-a-like weapons will not be allowed on Club property or at any Club activity
21. In addition to the Boys & Girls Club rules, Club members at Union College must also follow the rules of Union College and Club members at the 21CCLC sites must also follow the rules of that school district.
The safety of all members is of utmost importance to us. Any member who disrupts programs or creates a dangerous situation will be disciplined appropriately. Members who do not follow rules can expect to face consequences. Offenses will be handled based on their severity. Parents will be called to remove any member who has failed to curb his or her disruptive behavior and/or is behaving in an manor that creates a dangerous situation for themselves, fellow members, staff or visitors.
Disciplinary actions may include, but are not limited to, the following:
Verbal counseling
Time-out
Suspension from program area
Loss of club privileges
Suspension (one day to two weeks)
Indefinite suspension (until the situation can be resolved or the parent/guardian is consulted)
Expulsion (i.e., permanent suspension)
Contacting the proper authorities
Members are expected to respond to discipline without incident. Failure to do so will almost always increase any action taken in time or severity. Staff members are trained and fully expected, by policy, to maintain full control of any situation that occurs in their program area and will NOT tolerate anything that threatens that control, in appearance and/or manner. Also, please understand that sometimes the story that gets home is not always complete or accurate. Children sometimes tend to explain an incident in a manner that will not implicate them or cast blame their way. In addition, staff members, though well trained and experienced, are human, so please call the Club if you have any questions at all concerning disciplinary measures or any other Club activity. Your support and involvement as the parent/guardian is vital to our success as youth development professionals.
Yellow Cards and Red Cards
When a child's behavior consistently disrupts the programs of the Boys & Girls Club or take up a considerate amount of staff time, it can negatively impact the Club experience for all our members. In an effort to better work with parents to address chronic misbehavior, we have developed a discipline procedure that relies on cards to communicate with parents.
How it works:
· You receive no card: Your child had a great day at the Club. They might have received a timeout or verbal counseling, but he was able to complete the rest of the day with no problems.
· You receive a yellow card (or warning card): Your child struggled through the afternoon and ignored staff instructions resulting in multiple timeouts. On the card, you will find a description of your child's behavior. When a staff gives you the card, they will also inform you of any consequences your child has earned (suspension, loss of privileges, etc.)
· You receive a red card (or stop card): Your child has previously received two warning cards or has created such a difficult situation that our standard discipline tools are inadequate to address the problem. Anyone can have a bad day, but collecting three cards within the course of a year shows a pattern of poor behavior that must be addressed. Parents or guardians must meet with our Director before the child can return to the Boys & Girls Club. These meetings are scheduled subject to her availability. Depending on Club attendance and the current waiting list, if your child receives a red card, he or she may not be able to return to the Club until the next semester. Any child on red card status will not be able to participate in any field trips, parties, or other Club activities until they are cleared.
Phone Calls
Our phones are for Club business only. Members should not plan to use our phones. If you must make an inquiry, you can call and speak to a Club staff but please do not expect to call the Club and speak to your child. Our lines need to remain open in the event of an emergency. Please make any necessary arrangements before your child comes to the Club so that you do not have to call the Club and your child does not have to call you.
Personal Belongings
All personal belongings brought into the Club by a youth are the responsibility of that youth. The Boys & Girls Club is NOT responsible for lost, damaged or stolen items. Please discourage your child from bringing anything to the Club that is not completely necessary, especially money. Necessary items, such as backpacks and jackets should be clearly marked with the member's name. Items that are not collected from our lost-and-found within two weeks will be donated to a local charity.
Medication
The Boys & Girls Club is NOT allowed, by policy, to dispense, store and/or oversee medication of any kind, including all non-prescription medications. If medication is needed, it is the parents' responsibility to administer it at the proper times. The only exception is rescue medication (i.e. Epi pens, asthma inhalers) and staff can only administer those with a note from the physician.
Accidents
The Boys & Girls Club strives to maintain a safe and secure environment. There is an assumed risk in many of our core programs, including, but not limited to sports. Please feel safe in knowing that our trained staff is attentive to providing the safest environment possible. The completed membership application authorizes the Club staff to seek medical treatment for a member, if necessary, and that any associated costs for such care are the responsibility of the parent or guardian. The Boys & Girls Club does NOT provide medical insurance for members. In the event of a serious injury, the staff will call 911 immediately and then call the parents/guardians or alternative emergency contacts. Updated contact information is your responsibility and is crucial to your child's well-being. Failing to update your contact information will result in suspension or termination of your child’s membership.
Infestation or Contagious Conditions
Any and all suspected transferable infestations or transmittable contagious conditions (including COVID) will be addressed fully in the following manner:
1. Parents will be contacted for immediate removal of the member from Club facilities. In the meantime, child will be relocated to an isolation area.
2. Proof of treatment from a health care facility with a note permitting child to return AND approval from the Unit Director is required before the child will be allowed back into the Club.
Additionally- The Boys & Girls Club has a strict "no-nits" policy. If your child is suspected of having lice, his/her head will be checked in a private location by Club staff. If nits or lice are found, he/she will be sent home and will not be allowed to return until he/she if found to be nit-free.
Food
The Boys & Girls Club understands and appreciates the need for a healthy diet among all of our members and snacks and meals will be provided regularly. It is our goal to encourage healthy eating habits that promote the well-being of our youth. The Club has a designated area and a designated time for eating. Please keep food and drinks out of the areas where such items are prohibited. If your child is on a restricted diet due to food allergies, we must have a note from your physician on file. If the restricted diet is due to religious reasons, we must have a note from the parent or guardian stating such.
“The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or if all or part of an individual's income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by the Department. (Not all prohibited bases will apply to all programs and/or employment activities.)If you wish to file a Civil Rights program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202) 690-7442 or email at program.intake@usda.gov. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339; or (800) 845-6136 (in Spanish). USDA is an equal opportunity provider and employer.”
Please note: All information is confidential and will not be released to any third party unless required by law.
I have read the membership application, reviewed the handbook, and understand the rules and regulations of the Club. I agree to follow these rules. I also understand that if I break these rules, I may be suspended from the Club. I recognize that it is my responsibility to know and follow the rules.
I have read the membership application, understand the rules of the Boys & Girls Clubs of Appalachia, and request that my child be admitted into membership. I have explained the rules to my child. I agree that the Boys and Girls Club is not responsible for any accident to my child while on the premises or while engaged in any activities that are conducted away from the Club. I understand that the Boys and Girls Club is not a daycare operation and staff members, under normal circumstances, are not allowed to prohibit a member from leaving the facility per the regulations of the state of Kentucky exempting the Club from licensure as a child care. I further agree that it is my responsibility to keep the information on this application current.
I hereby authorize and consent to the Boys and Girls Club recording my child's picture and voice on photographs, films, audio-video tapes to use for the purpose of publicity, advertising, and sales promotion without any compensation whatsoever. I further release the Boys and Girls Club from any and all claims for damages, libel, slander, and invasion of privacy arising out of the use of the foregoing material.
As a parent or guardian of a Club member, I hereby authorize the Boys and Girls Club, in the event of a medical emergency to seek transportation to a hospital. I authorize medical treatment from a licensed physician if, in the opinion of the licensed physician, the medical emergency may endanger the Club member's life, cause disfigurement, physical impairment, or undo discomfort if treatment is delayed. This authority is granted only after a reasonable effort has been made to contact me or authorized persons with the phone numbers identified on this application.
I give permission to the Boys and Girls Club to survey and interview my child to find out what his/her behavior, skills, and attitudes are in regards to issues such as health risks and habits, positive self- esteem, respect to diversity, education and educational resources, positives relationships, career choices, and connection to community, as well as his/her experience at the Club. I understand that this information will remain private, and that only my child's Club director and program aides will be able to look at his/her responses.
I understand that my child's responses will be automatically grouped together with the responses of other Boys and Girls Club members for any public presentation of the finding, and that my child will never be individually linked to his/her responses. In addition, I understand that I can take back my permission at any time by giving written notice to the Club director of the Boys and Girls Club. Finally, I understand that I can receive a copy of the signed consent forms and that, upon request, I may arrange a meeting with the Club director to discuss questions or concerns.
By typing my name below I agree and consent to all items as outlined in this Membership Handbook.
