FRC Registration

FRC Registration

FRC Registration 2020-07-14
  • FRC Registration

  • Adult Information

  • Date Format: MM slash DD slash YYYY
  • Medical & Dental Information

  • Race and Ethnicity

  • Emergency Contact

  • Child's Information

    • *Parents/Guardians list ALL children who will be attending playgroup.
    • *ECE Providers list ALL children under your care during programming.
  • Date Format: MM slash DD slash YYYY


  • Date Format: MM slash DD slash YYYY


  • Date Format: MM slash DD slash YYYY
  • Medical & Dental Information

  • Photo Release

  • Family Assessment

  • Child Assessment, select Yes or No

  • Family Experiences and Stressors, select Yes or No

  • Family Assessment, select Yes or No

  • Rights & Responsibilities

  • Children and families receiving services are entitled to certain rights and have certain responsibilities

    Rights

    Families participating in the Child & Family Resource Center Program have the right to; ongoing participation in the program which includes the development of an individualized plan; periodic review and assessment of needs; and appropriate revisions of the plan. Refuse or end services at any time. Referral to other provider services at any time, including upon ending the PAT program. Obtain, upon request, one's own record. Confidentiality of records, both electronic and hard copy. Records will be made available only to those individuals who monitor the program such as funders and credentialing organizations, and of course, to the individual whom the record is about, if so requesting. The review of records by funders and credentialing organizations will only be used to determine the program's compliance to work plans and critical elements. Report any dissatisfaction with the program content or actions of program staff to the program manager. All complaints and/or grievances will be handled according to agency policy.

    Responsibilities

    Families participating in the Child & Family Resource Center Program have the following responsibilities;

    • Punctuality: It is very important that families make every effort to arrive to playgroup, field trips, and any other CFA sponsored events on time. This is to minimize disruption to the ongoing program and to ensure all families are receiving quality services. Families may be asked to leave the playgroup or activity if they are late. Chronic lateness may also be addressed and may be cause for dismissal from the program.
    • Conduct: Parents/Guardians/Caregivers are expected to demonstrate appropriate behavior towards all staff, family members, and other clients. Rude or obscene language, evidence of intoxication or substance abuse, and/or verbal/physical threats towards all staff, family members, or other clients will not be tolerated and may result in immediate termination of services. Further, threats or actions against one's self or others are not protected by confidentiality and may be reported to the appropriate authority.
    • Personal Visit Component: Families have access to free playgroups and group socialization opportunities, field trips, resource and referral services, and education services from trained Parents as Teacher educators. Staff will develop individualized plans for program participants.

  • Date Format: MM slash DD slash YYYY