medical_information_needs
(
nullable: true, editable: true, defaultValue: N/A, length: 1000, alias: Check any that apply to your child. With awareness of your child's needs, staff may be able to modify activities and techniques for inclusivity., type: esriFieldTypeString
)
list_triggers_signs_or_symptoms
(
nullable: true, editable: true, defaultValue: N/A, length: 255, alias: List triggers, signs or symptoms for these conditions, type: esriFieldTypeString
)
recommended_techniques
(
nullable: true, editable: true, defaultValue: N/A, length: 1000, alias: What techniques do you recommend in managing your child's behavior?, type: esriFieldTypeString
)
list_activities_from_which_the
(
nullable: true, editable: true, defaultValue: N/A, length: 255, alias: List activities from which the participant should be exempted for health reasons or require special accommodations., type: esriFieldTypeString
)
medication_dispensed
(
nullable: true, editable: true, defaultValue: N/A, length: 255, alias: Will your child need medication DURING the program?, type: esriFieldTypeString
, Coded Values:
[Yes: Yes]
, [No: No]
)
inhaler_epipen_permission
(
nullable: true, editable: true, defaultValue: N/A, length: 1000, alias: My child has permission to carry and knows how to properly use their own inhaler or EpiPen and has been instructed not to show or share with others., type: esriFieldTypeString
)
past_medical_treatment
(
nullable: true, editable: true, defaultValue: N/A, length: 1000, alias: Past Medical Treatment, type: esriFieldTypeString
)
notification_when_do_you_want_t
(
nullable: true, editable: true, defaultValue: N/A, length: 255, alias: Notification: When do you want to be notified for minor injuries (e.g. scape, non-allergic bee sting, bloody nose, sliver) that do not limit participation?, type: esriFieldTypeString
, Coded Values:
[Immediately: Immediately]
, [At pick up: At pick up]
)
printed_name_of_parentguardian
(
nullable: true, editable: true, defaultValue: N/A, length: 255, alias: Printed Name of Parent/Guardian, type: esriFieldTypeString
)
transportationwaiverinfo
(
nullable: true, editable: true, defaultValue: N/A, length: 255, alias: Please read this form carefully and be aware that in consideration for the Lake County Forest Preserve District providing transportation services for the Science First in Lake County program, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of said services, including but not limited to, vehicle operations and boarding and exiting the vehicle.I recognize and acknowledge that the Lake County Forest Preserve District is neither a common carrier nor in the business of providing transportation services to the public. I further recognize and acknowledge that there are certain risks of physical injury to vehicle passengers, and I voluntarily agree to assume the full risk of any injuries, damages or loss, regardless of severity that my minor child/ward or I may sustain as a result of participating in any and all activities connected with or associated with receiving transportation services, including, but not limited to, injuries, damages and loss arising out of negligent operation or supervision of the vehicle. I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward) against the Lake County Forest Preserve District, including its respective officials, agents, volunteers and employees (hereinafter collectively referred as "Parties").I do hereby fully release and forever discharge the Parties from any and all claims for injuries, damages or loss that my minor child/ward or I may have or which may accrue to me or my minor child/ward and arising out of, connected with, or in any way associated with said transportation services.I further agree that this agreement shall be governed by the laws of the State of Illinois.I have read and fully understand the above wavier and release of all claims. If registering on-line, my on-line signature shall substitute for and have the same legal effect as an original form signature., type: esriFieldTypeString
)