Stop & Go Depot / Recreation Station (2021-2022)
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Page 1 of 6
Stop & Go Depot / Recreation Station
(2021-2022)
COVID-19 Parent Supplement
1. READ entire packet (pages 1-7)
2. Sign ALL three required Forms
a. Stop and Go/Recreation Station Registration Form (on pg 2)
b. Ridgefield P&R COVID-19 Waiver (on pg 3)
c. COVID-19 Parent Supplement Agreement (on pg 7)
3. Return ALL Forms to the Rec Center upon In-Person Registration
Updated 1.4.2021Page 2 of 6
Stop & Go Depot Registration Form
Parents/Guardian: ____________________________________________________________________
Child’s Name:___________________________________________D/O/B: ____/____/____ M/F_____
Primary Contact Number:( )______________ Secondary Contact Number:( )_______________
E-Mail Address:_______________________________________________________________
Emergency Name:______________________________ Emergency Number:( )__________________
Address:___________________________________City: _______________ State: ____
Zip:_____________
Emergency Name:______________________________Emergency Number:( )_________________
Address:___________________________________City: _______________ State: ____
Zip:_____________
School (circle one): Barlow Veterans Park Branchville Farmingville Ridgebury Scotland
Programs Day (CIRCLE) Time (WRITE IN)
1_____________________________________ M T W TR F _________________________________
2_____________________________________ M T W TR F _________________________________
3_____________________________________ M T W TR F _________________________________
4_____________________________________ M T W TR F _________________________________
5_____________________________________ M T W TR F _________________________________
6_____________________________________ M T W TR F _________________________________
7 ____________________________________ M T W TR F __________________________________
*Anyone with special needs should contact Jim Rafferty at 431-2755* **STAFF USE ONLY**
Is child in good physical condition? YES NO Date:_____________ Bus #:______
If not, explain briefly:
__________________________________________________________ Complete Forms: Y
__________________________________________________________ Staff Initials:___
Any Allergies? YES NO
If yes, explain briefly:
__________________________________________________________
______________________________________________________________________
_______
Any changes to your child’s schedule needs our attention. You must notify us at stopandgo@ridgefieldct.org
Any
or special
in an info. staff
emergency callshould know?
Front Desk.
______________________________________________
REFUNDS: Refunds will not be honored if an individual cancels a class within 1 week prior to the start of the session. Any refund request made
prior to this time will be surcharged of $25.00 administrative fee per person. Refunds (medical only) for the remainder of the session only when
verified by a physician’s note. Prorated refunds for individual classes missed will not be honored, even with a doctor’s note. Although we make
every effort to reschedule classes, there are no weather related refunds.
LATE PICK-UP POLICY: Pick-up is 6:00 pm. For the first five minutes after dismissal time, parents will not be charged a late fee. After the first five minutes,
there will be a charge of $25.00 for each 15 minute interval you are late. This fee must be paid within 24 hours of late pick up.
WAIVER OF TOWN LIABILITY: I recognize that by the nature of this activity that an injury might occur. In the event of an injury to my family
member or myself, I give permission to the attending physician to render such treatment and agree to pay for the treatment. I release Parks &
Recreation, its employees and instructors, of all liability. I understand that this release applies to any present or future injuries. I agree that all photos
taken during activities may be used for local advertising purposes at the discretion of the Ridgefield Recreation Center. I understand that Ridgefield
Parks & Recreation can contact me via email with any updates and news. I have read this and sign it voluntarily.
Form Updated: JULY 2019
Signed: _____________________________________________________ Date: ___________________________Page 3 of 6
Stop & Go Depot / Recreation Station
(2021-2022)
COVID-19 Parent Supplement Agreement
.
Please sign below, indicating that you have read and reviewed all policies, protocols, and procedures that
the Recreation Station Program will take throughout this year to provide a safe and enjoyable experience for all
participants. All action taken within these protocols has been guided by the CDC. Signature of this document
also verifies that you will follow any guidelines and requirements set forth by the Ridgefield Parks &
Recreation Center.
Signature:____________________________________ Date:____________________Page 4 of 6
Required Forms - needed BEFORE start date:
● Stop and Go(Bus Service) / Rec Station(Program) Registration Form (signature needed))
● Signed Ridgefield P&R COVID-19 Waiver
● Signed Stop&Go/Rec Station COVID-19 Parent Supplement Agreement (see prior page of this document)
Recreation Station Program-
● Runs daily from Monday through Friday from 4pm to 6pm.
● Children will engage in socially distant activities such as art, games, and sports.
● Time will be allotted for homework when requested
● Parents will be assigned a staggered dismissal time of either 5:30 or 5:45 for each session.
● Any urgent changes must be approved by the Rec Station Coordinator, please contact with your needs.
Groups-
● We are accepting children entering grades K-5.
● Children will be in groups of up to 14 with two counselors.
● Children in Stop&Go ONLY (bus) will be grouped separately for their later classes (See below).
● Siblings will be kept in the same group.
● Striving to limit interaction with anyone outside of participant’s group while at Rec Station.
● Groups will be assigned to separate rooms to create a cohort.
● Participants will be assigned personal space and will participate in socially distant activities led by their
counselors.
● Each cohort will have supplies for games and art located in their group rooms.
What to Bring Each Day -
● Snack (Nut free AND Spoon free)
● Water bottle
● Everything must be appropriately labeled with the participant’s name on it.
Arrival -
● There will be curb-side arrival every day.
● Parents will be asked to complete a daily COVID-19 Questionnaire via email & when in person..
● Participants will arrive to the Rec Center via the school bus between 3:15 and 4:00 PM.
● Parents bringing child to Recreation Station are asked to stay in their car at all times.
● Parent drop off for arrivals is at 3:45pm (be prepared to show ID & answer questionnaire at this point).
● Participants will be received by the Rec Station Coordinator along with their counselor.
● Participants will have their temperatures taken upon arrival.
● A temperature of 100°F or above means the child needs to be isolated and parent will be called to pick up or if
present, take home.
● Counselor will bring children through exterior doors directly into their group room.Page 5 of 6
Dismissal -
● There will be curb-side dismissal every day.
● Staggered dismissal times (5:30 or 5:45 PM) will be assigned.
● Rec Station Coordinator will greet and ID parents in the Founders Hall parking lot and direct parent to allocated
room when child is ready to leave.
● Parents are asked to stay in the car at all times during dismissal.
● Children will be dismissed from exterior doors of their group’s room.
● Early dismissals: Participants may be dismissed early. Parent must e-mail: stopandgo@ridgefieldct.org before
2PM. For any immediate change, you can telephone the Front Desk and ask for the Rec Station Coordinator.
Upon parent arrival for pick up, parent must pull up to the curb and call (203) 431-2755 and ask for the Rec
Station Coordinator to help check the child out. Your child will be brought out to your car.
Safety -
● The initial COVID-19 waiver must be signed and on file the Thursday BEFORE the first day.
● All staff and children are required to wear face coverings at all times.
● Staff and children may have a mask break when properly social distanced
● All staff and children will have their temperature taken daily
● Staff and participants’ parents will fill out daily questionnaires regarding tracking and exposure to ensure safety.
Bathroom -
● Designated bathrooms will be assigned to each group.
● Counselors will disinfect stalls and sinks between uses.
● These bathrooms are for our use only and are not open to the public during our program.
Snack-
● Children will eat snack in their room and socially distant from one another.
● If a child forgets their snack, one cannot be provided.
● Snacks are expected to be nut-free and spoon-free at all times.
● Hand washing/sanitizing will occur before and after eating.
● Children are asked to bring their own water bottle for Rec Station Time.
Activities -
● All activities will take place in groups specific rooms.
● Supplies will be individualized as often as possible.
● Group games and supplies will be disinfected after every use
● Participants will also have the opportunity to work on homework or enjoy quiet time if they would like.
● Children will wash hands or sanitize before and after all activities, such as throwing a football around or playing
catch with a Frisbee
● Most activities will be modified to enforce social distancingPage 6 of 6
Stop&Go Depot Classes/Programs -
● Participants who are enrolled in a program other than Recreation Station (art, dance, karate, tumbling, etc.) will be
brought to that class but MUST be picked up at program end time (i.e.; 5:30, 5:45, 6:00) by the Parent/Guardian.
* NOTE: Please see our website description for Stop & Go/Rec Station
Standard Sick Protocol-
● If a child is starting to show symptoms of feeling sick, child will be separated from group and we will provide a
separate area for sick child until parent pick-up.
● If a child is picked up early for sickness reasons, so must their siblings.
● Child’s counselors will bring their belongings to the office.
● When a child or staff member exhibits a fever or symptoms of illness, they must be fever and symptom free for 24
hours and must provide a note from a doctor confirming a negative COVID-19 test result, before returning.
COVID-19 Sick Protocol-
Out of an abundance of caution, we will proceed as such:
● Please notify the Rec Station Coordinator immediately, via stopandgo email, if your child receives a positive
COVID-19 test result.
● If a child or staff member exhibits symptoms of illness or a fever on a particular day, he/she will be required to be
symptom- or fever-free for 24 hours and provide a note from a doctor confirming a negative COVID test result,
before returning.
● If a child or staff member tests positive for COVID-19, we will notify all families in their cohort, without naming
the individual. The affected cohort must then quarantine for 14 days.
● If a child or staff member was tested positive for COVID-19, he/she must quarantine for 14 days and will be
required to show proof of a negative COVID-19 test result before returning to the room.
● In the event a person diagnosed with COVID-19 is determined to have been in the room or the building and poses
risk to the community, the Rec Center may close for 1-3 days for cleaning and disinfecting.
● Parents can help participants understand these new safety protocols and procedures.
If you have READ all of the above…..we Thank YOU!!!! Now write, “Here We Go!” under your signature on
the agreement page, so we can give you a socially distanced hug when we see you on Day 1.
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