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2024-2025 BOOST PARENT/GUARDIAN CONTRACT
I acknowledge, understand and agree to the following regarding my child’s participation in BOOST
as set forth in this Parent/Guardian Contract:
1. I understand that BOOST programs are voluntary activities organized and conducted by BOOST for the benefit of
the parents and students attending Brownsburg Community School Corporation.
2. I will take whatever action necessary to ensure my child understands and adheres to all rules, policies, and
procedures as outlined by BOOST including, but not limited to those contained in this Parent/Guardian Handbook,
other official BOOST publications, and any and all subsequent updates. Failure to follow any of the rules, policies,
and procedures set forth by BOOST may result in the loss of any paid fees, the expulsion or prohibition of my child
from current and future programs, as well as any other consequences deemed appropriate by BOOST.
3. I will accurately complete all required registration information requested by BOOST, prior to my child attending BOOST,
and I have disclosed all sufficient information about my student in order to be successful in the BOOST program. I
understand that BOOST will run reporting with BCSC Special Education Department to verify all student information is
correct and entered accurately.
4. I acknowledge that under Indiana law, all sta members of BOOST are mandated reporters and are required to
report suspected child abuse or neglect to the Department of Child Services (DCS) immediately. If a report to DCS
triggers an investigation, BOOST will cooperate fully with DCS and authorities.
5. I or a designated adult will escort my child into the program each day and check in with the procare pin pan provided. I
will make and handle any and all arrangements for transportation to/from the BOOST program. I will pick up my child
within the established operating hours of the program. Late fees of $3 per minute will be charged to my household
account beginning one minute past closing time.
6. I understand that if my child is showing or developing symptoms such as fever, rash, diarrhea, or vomiting, I will not
send my child to the program. I will not send my child if he/she currently has or has had a temperature above 100 F
degrees or above in the past 24-hour period prior to attendance. If any of the above symptoms develop during the
program, I will be contacted and I will make necessary arrangements to pick up my child immediately.
7. If my child needs to take any medication during the day, I will complete a Medication Dispensing Authorization Form
and supply the prescribed medication in its original container during drop o. I understand that sta members are not
allowed to give the first dosage of any medication. If my child refuses medication, it will be documented and I will
receive a phone call to discuss the incident.
8. I will be responsible for any medical care, transportation expenses, or additional expenses incurred on my child’s behalf
during his/her participation in the program.
9. I will meet immediately with BOOST sta members upon request.
10. I will pay all court costs and attorney’s fees associated with the collection of delinquent fees.
11. I understand that any cancellations or refund requests made after the program has started will not be eligible for a
refund of any amount owed or already paid. Any program openings filled after the program has started will be
subject to payment in full requirement and will not be eligible for any refunds.
12. I agree to INDEMNIFY, HOLD HARMLESS, AND DEFEND BOOST and BCSC, their employees, agents, elected and
appointed officials, and directors in any action or proceeding against all claims, lawsuits, losses, damages, actions,
suits, proceedings, claims and expenses, including attorney’s fees and costs arising from or relating in any respect to
either me or my minor child’s participation in the program or my assistance at the program or my breach of this
contract, regardless of whether the act or omission complained of was caused in whole or in part by the negligence in
any form of the BOOST or BCSC.
13. This is a full release and waiver of any and all liability that may now or forever be attributed to BOOST or BCSC
resulting from the program and/or my child’s participation in the program. This Contract cannot be changed except by
written amendment approved by BOOST which specifically refers to this Contract. I have read and fully understand
this Contract and agree to be bound by its terms. I understand that by signing this document I may be waiving certain
legal rights, including the right to sue the BOOST program or the Brownsburg Community School Corporation or any of
its employees, agents, officials, and directors. I have read this document and sign this document freely and willingly.
Parent/Guardian Name (printed) ______________________________________________________
Parent/Guardian (signature) ______________________________________________________
Child Name(s) (printed) ______________________________________________________
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