Youth Ladder Registration Form 2021-24

Please fill out this form and click submit.
Main

 
 
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Primary Household

 
 
 
 
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Secondary Household

 
 
 
 
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Emergency Contact (Non-Parent)

 
 
 
Medical Info

Should a medical emergency happen to your child while at The Ladder, could we provide the medical responders with your child’s medical history?  If "Yes" please provide the info below.
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Parent Consent Form

I the parent/guardian of the named youth on this form, hereby consent to and give my permission for the following.


(TLCC office will print to get your official signature in person at The Ladder.)
Parent/Guardian’s Signature:
Date: 


  • To participate as a member of The Ladder Community Center (TLCC).

  • To participate in all TLCC activities and programs, which may also include, activities held at other locations.



  • On behalf of the member and myself, I acknowledge that the member will be participating at his/her own risk and I on his/her and my own behalf, release indemnify and hold harmless TLCC, its directors, officers, employees, volunteers, agents, and affiliates from liability for injury to person or damage to property of myself and member arising out of participation in, and transportation associated with TLCC.

  • If I am not personally at TLCC activities in which the member is participating, so as to be consulted in case of necessity, you are authorized on my behalf and at my account to take such measures to arrange for such medical and hospital treatment as you may deem advisable for the health and wellbeing of the member.

  • I understand that TLCC assumes no responsibility for transportation to or from TLCC, and that TLCC is not responsible for youth before they arrive at TLCC or after they leave. I understand that my child must be picked up on time when TLCC closes. Our volunteer staff will not leave until all students have left the premises. (If you are concerned about who is able to pick up your youth, please ask for a Youth Release Agreement Form.)

  • In permitting the member to participate, I am specifically granting permission to TLCC to use the likeness, voice and words of the member in television, radio, films, newspaper, magazines and other media, and in any form not heretofore described, for the purpose of advertising or communicating the purpose and activities of TLCC and appealing for funds to support such activities.  No _____


  • The Youth Program begins at 3:00 pm and ends at 5:00 pm. Because the safety and well-being of your child is important to us, we will call you if your child arrives after 3:30 pm or leaves before 4:45. If there is a day that you know your child will be arriving late, after 3:30 pm or leaving early, before 4:45, please stop at The Ladder, call The Ladder (231-259-0211), or send a note with your child.



***TLCC does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or services. 

Youth Expectations
Training Policy:
Proverbs 22:6 “Train up a child in the way he should go, even when he is old he will not depart from it.”  Please impress upon your child the importance of positive behavior. Our goal is to praise and reward positive behavior. Even though it is always our goal to praise good behavior, consequences will be given to members who need more encouragement.

General Rules

1.     A person may attend at TLCC when they have completed an intake form.


2.     All members must sign in when they arrive at TLCC, sign out when they leave and are expected to be respectful at the Bible devotional. Name tags should be worn on the lapel area. Once the member signs out or leaves the building, the member cannot re-enter. 


3.     The staff will call the parent when a member runs out of the building because of anger. The staff may ask an upset or noncompliant member to sit in the office.


4.     TLCC phone can only be used to contact your parent/guardian.


5.     Backpacks and personal items should be hung up in the lobby area on the hooks.  Vauables, like headphones, need to be kept inside your backpack. 


6.     If you bring personal property into TLCC, please secure and care for your property. TLCC is not responsible for loss or damage to, or theft of, any member’s personal property.


7.     It is the responsibility of the parent/guardian to promptly pick up their child at the conclusion of activities.

Rules to Show RESPECT:


1.     Treat staff and peers with respect and consideration. Please refrain from swearing, putting down others, teasing, bullying and confronting others aggressively.


2.     Treat all equipment and furnishings with respect and care. Members and parents will be responsible for any damage caused at TLCC.  The booths are for sitting and talking with friends, not for lying down.  Please keep feet off cushioned benches. 


3.     The café is where members eat and drink. Please eat sitting down on a chair, not on the cushion benches.  Walk to the trash bins and drop your trash. Do not play with food or the containers.


4.     Public displays of affection are prohibited.


5.     Personal phones and devices are permitted in the lobby upon entering and exciting the building, in the café, in the game area, and in the gym.  Personal phones or devices may never be used in the bathrooms, in the gym area during group games, during Bible lessons, at the table during meals and in the lobby during youth hours. Personal phones and devices may not be used for any purposes which would go against Biblical standards. (Psalm 101:3)


6.     Be considerate and inclusive to others. 


7.     Wear modest clothing that is sensible and appropriate, acceptable according to Biblical standards. (1 Tim. 2:9)


8.     Hoods, sunglasses and spike-or chain-style jewelry are prohibited.


9.     Hats, kerchiefs or do-rags that cover the top of the head are prohibited. (verified religious exceptions are allowed).


10.  Clothing with sexual connotations, inappropriate language or demeaning remarks is prohibited.


11.  Clothing that advertises alcohol, tobacco, drugs, or promotes violence is prohibited.


12.  All tops must be long enough to be tucked in. No exposed bras, bare shoulders, or cleavage.


13.  Refrain from exposed midriffs, bare backs, or showing underwear.


14.  Skirts and shorts must be fingertip length.


15.  All students are required to wear appropriate footwear (no slippers). Shoes must be worn in large group games.


16.  Clothing and/or paraphernalia that may appear to be gang-related are prohibited.


17.  Pants or cut-offs with holes in the groin area are not allowed.


18.  Some messages on clothing have multiple meanings. If one of the meanings refers to drugs, alcohol, smoking, gambling, sex, or other illicit behaviors, the clothing is prohibited.


19.  While TLCC is not responsible for lost or stolen property, messing with someone else’s property, using others Property without permission, and/or stealing property is not permitted.


20.  Vandalism of others property at TLCC is not permitted. This includes defacing the messages on the whiteboards also.

Rules for SAFETY:


1.     For your safety, guns, knives and other items used as weapons are not allowed.


2.     Smoking, vaping, and gambling are prohibited.


3.     Members and guests must not be under the influence of, be in possession of, supply others with, or consume any drug or alcoholic beverage while on TLCC property. If TLCC has any reasonable basis to believe that this rule is being violated, the parents and/or other emergency contact of the youth, will be called to come pickup the child.  If The Ladder can not reach a contact person, the police will be called.


4.     No hanging out on TLCC property. If you leave or are asked to leave please exit the property.


5.    Outside beverages are not allowed.  Outside food must be stored in your backpack for the entire time of your visit.


6.     No hanging out in the lobby and/or the bathroom. 


7.  No running throughout the center.  Running is allowed in the gym area only.

Accountability Procedure:


The director along with another staff person will talk with the member when a minor rule is broken explaining the need to comply. After the second minor offense, parents will be informed of the situation and the consequences given will be at the discretion of the director. If the member still isn’t following the rules after their third minor offense, a suspension will be given because of the pattern of minor offenses. For major offenses, members will be suspended from the center.


Students wishing to return to The Ladder community center after a suspension will be asked to meet with the director before returning so that appropriate behavior expectations may be reviewed.


If a dress code violation occurs, the member will be loaned a large, oversized t-shirt to wear for the day.


Minor Offenses


1st Offense:  The Ladder staff will talk with the member about the issue and expect him/her to correct the behavior.


        admit their mistake


        apologize


2nd Offense: The Ladder staff will inform parents of the situation and that the next offense will result in suspension.


        admit their mistake


        apologize


        one hour of service to The Ladder


3rd Offense:  The Ladder staff will inform parents of their child’s suspension. Youth will be dismissed according to parent’s directions.


        youth writes a letter or has a conversation with a staff member that includes:


o   an admission of their mistake


o   an apology


o   a short paragraph or explanation of what you will do differently, so this doesn’t happen again


        three hours of service to The Ladder


Major Offense


Major Offense:  The Ladder staff will inform parents of their child’s suspension. Youth will be dismissed according to parent’s directions.


        youth writes a letter or has a conversation with a staff member that includes:


o   an admission of their mistake


o   an apology


o   a short paragraph or explanation of what you will do differently, so this doesn’t happen again


        three hours of service to The Ladder

(TLCC office will print to get your official signature in person at The Ladder.)
Youth Signature:
Date:
(TLCC office will print to get your official signature in person at The Ladder.)
Parent/Guardian Signature:
Date:
Network Computing/Email Policy & Contract

TLCC of Shelby is responsible for securing its network and computing system to a reasonable and economically feasible degree against unauthorized access and/or abuse, while making them accessible for authorized and legitimate users.  This responsibility includes informing users of the expected standards of conduct and the disciplinary or legal consequences for not adhering to them.  Any attempt to violate the provisions of this policy will result in disciplinary action and possible revocation of use regardless of the success or failure of the attempt.


 


Once a user is granted permission to access the electronics network facilities, the user is solely responsible for all actions while using the equipment. Therefore, the following actions are prohibited:


1.     Any deliberate action, which damages or disrupts a computing system or network, alters its normal performance or causes malfunction, regardless of location or time duration. (trying to “crash” network systems or programs)


2.     Any willful development or introduction of computer “virus”, disruptive, or destructive programs into TLCC network.  NO DOWNLOADING WITHOUT PERMISSION!


3.     Deleting, copying, or modification of any files and/or data belonging to other users without their prior consent.


4.     Transmitting and/or processing files containing obscene, indecent, lewd material or other material, which explicitly or implicitly refer to sexual conduct.


5.     Transmitting any material in violation of any United States or state regulations.  This includes, but not limited to, copyright and threatening materials.


6.     Impeding other users through mass consumption of system resources.


7.     Using facilities and/or services for unauthorized commercial purposes.


8.     Forging or attempting to forge electronic mail messages.


9.     Attempting to read, delete, copy, modify, or view without permission, another user’s email.


10.  Sending or attempting to send harassing, obscene and/or threatening email to another user.


11.  Attempting to send unsolicited junk mail, “for profit” messages, or chain letters.


12.  Any other action that is deemed inappropriate.


 


TLCC of Shelby’s electronic network facilities are to be used exclusively for education, related functions, and applications. TLCC Directors will have access to all files, including email files. Users will have no expectation of privacy regarding the said files or email.  Any attempt to break the law with the network will result in litigation against the offender by the proper authorities. If such an event should occur, TLCC of Shelby will fully comply with the authorities to provide any information necessary for the litigation process. I understand and agree to abide by the terms and conditions of TLCC of Shelby Network Computing and Email Policy. I further understand that any violations of the above regulations are unethical and may constitute a criminal offense. I understand that any violation of these terms and conditions will result in the revocation of my access rights and the imposition of TLCC discipline. In addition TLCC of Shelby will comply with the authorities to provide any information necessary for the litigation process. As the parent/guardian of this student, I have read the Terms and Conditions for access to TLCC of Shelby Network Computing and Email Policy. I understand that this access is designed for educational purposes and TLCC has taken precautions to eliminate controversial materials. However, I also recognize that it is impossible for TLCC to restrict access to all controversial materials and I indemnify and hold harmless TLCC, its directors, officers, employees, volunteers, agents, and affiliates for materials acquired on the network. Further, I understand that the inappropriate use of network by my child will result in the revocation of my child’s access rights imposition of TLCC discipline. In addition, TLCC will comply with the authorities to provide any information necessary for the litigation process. I indemnify and hold harmless TLCC, its directors, officers, employees, volunteers, agents, and affiliates for supervision when my child’s use is not in a community center setting.  Further, I indemnify and hold harmless TLCC, its directors, officers, employees, volunteers, agents, and affiliates for any damages or injuries caused by my child’s use of the network, either in TLCC or outside of TLCC, in a manner which violates the Terms and Conditions set forth in this agreement. With this understanding, I hereby give permission to issue electronic access for my child and certify that the information on this form is correct. 

(TLCC office will print to get your official signature in person at The Ladder.)
Youth Signature:
Date:
(TLCC office will print to get your official signature in person at The Ladder.)
Parent/Guardian Signature:
Date

Description

Please fill out this form and click submit.