Sorry you are not eligible for this program.

If you are interested in other services funded by The Children’s Trust, please call 211 or visit www.thechildrenstrust.org. For special needs resources for your child, visit http://www.advocacynetwork.org/ or https://www.thechildrenstrust.org/content/children-disabilities. 

I give my permission for this information to be submitted to The Children's Trust for program quality and evaluation purposes.  The Children’s Trust provides funding for the program.

I,

the parent or guardian of:

hereby authorize and give consent to the staff of The Children’s Trust of Miami-Dade County and/or its funded service provider, the City of Miami Beach, and Miami Beach All Stars’ partners/subcontractors as follows:

the staff of The Children’s Trust of Miami-Dade County and/or its funded service providers and partners to take/use still photographs, digital photographs, motion pictures, television transmissions and/or videotaped recordings (hereinafter “Recordings”) of me, my children or my wards for educational, research, documentary and public relations purposes. Any such Recordings may reveal your identity through the image itself without any compensation to you, your children or wards.Any and all Recordings taken of you, your children or wards shall be the sole property of The Children’s Trust or its funded service providers.    With regard to the use of any Recordings taken of you, your children or wards, you hereby waive any and all present and future claims you may have against the City of Miami Beach, MDCPS-Nautilus Middle School, The Children’s Trust of Miami-Dade County, and their staff, funded service providers, employees, agents, affiliates and board members

The purpose of this form is to enable the Miami Beach All Stars Program staff to better serve your child in case of an emergency.
Please note, City of Miami Beach employees perform basic first aid for MINOR injuries; we will call Fire Rescue for all major injuries. Miami Beach Staff cannot administer any type of oral or injectable medications, such as antibiotics, aspirin, insulin, EpiPens, etc.

In case of an emergency, I authorize the following people to be contacted in the event that I cannot be reached:

In an event of an emergency and parent/guardian cannot be contacted, The Miami Beach All Stars Program staff will contact emergency services (911) to provide stabilization.

City Policy
It has been a long-standing City policy to provide equal services and opportunities to all its citizens and employees in accordance with federal, state, and county guidelines with regards to race, religion, national origin, age, sex, or disability. The City of Miami Beach is proud to have passed the State of Florida's first human rights ordinance prohibiting discrimination -- including discrimination on the basis of sexual orientation -- and providing for penalties upon conviction of the ordinance.

The City of Miami Beach and The Children’s Trust are dedicated to maintaining the privacy of your child’s personal information as part of providing professional service. If the City of Miami Beach, The Children’s Trust or you want to use or disclose (send, share, release) your information for any other purposes, we will discuss this with you and ask you to sign an Authorization form to allow this. We will safeguard your information but there times when the law requires us to use or share it in order to access needed services. Your child’s information is stored in a file folder in a secured file cabinet in a secured City of Miami Beach office.

I hereby provide consent for my child to participate in the All Stars Summer Program provided by the City of Miami Beach Office of Housing & Community Services, and funded by The Children’s Trust.

By providing consent, I agree to the following:

1. My child’s participation in all summer program activities at Nautilus Middle School and adjacent open spaces beginning June 10 – August 9, 2024 (June 19 and July 4 - No programming), Monday – Friday.

2. Drop off is 8:30 a.m. – 9 a.m. and pick up is 4:30 p.m. – 5:00 p.m.

3. The following person/persons are authorized to pick up my child. Any changes must be made in writing at least 24 hours in advance.

4. Junior, Pre-Teens and Teens will be permitted to walk home only if they have signed permission from their parent/legal guardian (below).

5. All participants must be picked up no later than program closing time (parent/legal guardian is responsible to check program hours of operation).

*I understand that there will be NO adult supervision provided by the City of Miami Beach All Stars Program before 8:30 a.m. and after 5 p.m. The safety of your child is of the utmost importance. Your cooperation in abiding by the above procedure/policy is required. Please note: I do hereby release the City of Miami Beach from all liability for any accident or injury that might be sustained through my child’s participation in this activity.

I reserve the right to terminate my child’s participation at any time via written notification to the City of Miami Beach All Stars Program at the Office of Housing and Community Services. This parental consent and information is valid for one year.

Program guidelines and expectations are intended to maintain a safe, respectful, and productive environment.

I. Safety
a) Always stay in authorized areas.
It is important to ask for permission and inform program staff in order to leave program area.
b) Engage in safe and positive behaviors. Aggressive, violent, and unsafe behaviors will not be allowed.
This includes no fighting, kicking, hitting, shoving/pushing, throwing objects, etc.
c) Preserve a safe and positive environment.
Program participants are not allowed to bring unsafe objects/ items to program. This includes firearms, BB guns, knives, pocketknives, matches, lighters, brass knuckles, nun chucks, throwing stars, or any other object that endangers the safety of self/others. Please note that all drugs are prohibited unless accompanied by a medical note and only in the dosing amount prescribed for the period in the program.

II. Respect
a) Respect property and belongings.
Respect program supplies/equipment/space, phones, tablets, others personal belongings, such as backpacks, purses, wallets, etc.
b) Use respectful language.
Utilize positive words vs. negative words that include profanity, teasing, name-calling, talking-back, cursing, etc.
c) Listen while others are speaking.
Be respectful of people’s time in the program.
d) Protect the confidentiality of other program participants.
Personal and sensitive information discussed in the session should not be discussed or disclosed outside of the session.

III. Productivity
a) Participants are asked to actively engage in program sessions, discussions, and activities by asking questions and having conversations with program staff and peers as appropriate.
b) Participants are asked to complete program tasks and activities, including assignments and worksheets .

IV. Attendance
a) Program attendance is important in order to benefit from and meet the program goals and objectives.
b) Absences should be kept to a minimum. Only three (3) unexcused absences will be permitted. Students with more than three (3) unexcused absences will be dismissed from the program.
c) If an absence is foreseen, the CAMPER PLANNED ABSENCE FORM should be filled out and submitted a week prior to the absence. Once the form has been processed, you will receive a confirmation email.

The role of the All Stars Program Staff is to keep all participants safe and protected. Rules will be consistent based on understanding individual needs and development and will promote self-discipline and acceptable behavior. When a participant is having difficulty in the program or displays unacceptable behaviors, the All Stars Program Staff, participant, and parent/guardian will work together to identify what is preventing the participant from having an optimum experience and will work together to seek solutions. Suspension of any participant from the program will only occur after every reasonable effort has been made to resolve the problem and the parent/guardian has been notified.

I acknowledge that I have read and understand the program guidelines and expectations by signing below.

I. Conduct
Good conduct ensures that everyone gets to enjoy camp in an open and respectful environment. Students are expected to:
a. Listen while others are speaking.
b. Ask for permission to leave designated activity areas (ex: using the restroom).
c. Give undivided attention during daily activities. This means that electronic devices be put away.
d. Keep their hands and feet to themselves.
e. Be respectful to all students and staff.

II. Disciplinary Actions
In order to maintain a fun and safe environment, a 3-strike rule will be employed. After each infraction, a student will be given a strike.
a. Strike 1: When the student has their first behavioral incident, student will receive a call home.
b. Strike 2: After the student has their second behavioral incident, the student will be banned from attending the next field trip.
c. Strike 3: After the student has their third behavioral incident, he or she will be dismissed from the program.
d. A parent will be notified each time a student gets a strike.

III. Attire
a. Outside of field trip days, the camp has no daily uniform. Students are free to dress comfortably and express themselves through appropriate clothing. Appropriate clothing:
i. Does not depict nudity, foul language, or prejudiced views
ii. Does not overexpose the student’s midriff (crop- tops), chest (deep V-necks, tubed tops, or spaghetti strap tops), or buttocks (short-shorts)
b. Students are advised to wear sneakers on all camp days.
c. If a student is dressed inappropriately, he or she will not be permitted on the bus or on-site.

IV. Field Trips
a. Each Wednesday, students will have the opportunity to go on a fun and exciting field trip. As such, field trip forms will be given out every Thursday prior to the trip. You must return the signed field trip form no later than Tuesday. Forms will not be accepted on the day of a field trip.
b. Students must wear their issued All-Stars field trip shirts on the day of the trip. Shirts serve as an added safety measure to track students when we are off-site visually.
c. All guidelines regarding conduct and disciplinary actions will apply while off-site on field trips.
d. Students may bring money to purchase items on field trips. However, all cash or items of monetary value are the responsibility of the student. If any items are lost, it is not the responsibility of any All-Star Staff to locate it.

I acknowledge that I have read and understand the program guidelines and expectations by signing below. We strongly advise that both parent and student review this contract together before signing.