EXTRAORDINARY SKIES. UNCOMMON GROUND.
2020-21
KIDS W.O.R.L.D.
Available to children in grades K - 6
Program begins when school ends and lasts until
5:30 
$45 per week
Program sites are Bella Vista Elementary, Huachuca
Mountain Elementary, Town & Country Elementary
Completed registration forms should be emailed to
KidsWORLD@SierraVistaAZ.gov. Sta will contact you for
payment. Program begins September 14.
Carmichael and Village Meadows
students will be bused to Bella Vista
Pueblo Del Sol students will be
bused to Town & Country
Registration forms are available
online, just searchKW Registration
Form
For more information:
OSCAR YRUN COMMUNITY
CENTER (OYCC)
3020 E Tacoma St
(520) 458-7922
Monday - Friday 8:00AM - 5:00PM
For more information:
KidsWORLD@SierraVistaAZ.gov
EXTRAORDINARY SKIES. UNCOMMON GROUND.
2020-21 KID’S W.O.R.L.D. REGISTRATION FORM
Kid’s W.O.R.L.D. Parent Information Sheet
NOTICE: The conditions surrounding the COVID-19 pandemic are continually evolving, and Kid’s W.O.R.L.D.’s
plan and safety protocols will be constantly evaluated to adapt to the continuing trends of the COVID-19
virus, guided by local, state, and national authorities
SCREENING – All children will be screened upon arrival to the program. They CANNOT attend the
program if they have a fever above 99.9 and/or a dry cough. Children MUST be fever free (without
medication) for AT LEAST 24 hours.
MASK POLICY - Masks are mandatory for all children, parents/guardians, and staff while at the Kids
W.O.R.L.D. program.
EXPOSURE ACKNOWLEDGEMENT - The risk to have direct or indirect contact with individuals who have
been exposed to and/or diagnosed with one or more communicable diseases, including but not limited
to COVID-19 or other medical conditions, diseases, or maladies, and/or any mutation or variation thereof
does exist and it is impossible to eliminate the risk that your child could become infected through contact
with or close proximity to an individual with a communicable disease.
PICKUP DUE TO ILLNESS – Immediate pick up is required for children with a fever above 99.9, a dry
cough, or any other illness for safety concerns. Children MUST be fever free (without medication) for AT
LEAST 24 hours to return to the program.
FEE PAYMENT – Weekly participation fees are due by 1:00 P.M. the first day of attendance that week.
When payment is not received by 1:00 p.m., a $10 late fee will apply. Payments are not accepted at the
program site. No exceptions. I understand weekly attendance fees can be paid online, via credit card or
over the phone at the OYCC during business hours.
REFUNDS/CREDITS - The weekly fee applies to any number of days attended Monday-Friday. To receive
a credit or refund for participation fees paid in advance (for the current week or beyond), notification
must be sent in writing to KidsWORLD@SierraVistaAZ.gov no later than 1:00
pm Monday of that week. No
refunds or credits will be given for absences, sickness, or days otherwise missed during the current week
of participation (including suspensions). A 15% administrative fee will be charged on any refunds.
COVID-19 REFUND POLICY - Household credits will be issued in the event of program closure due to
direct exposure.
LATE PICK UP FEES – The program ends at 5:30
pm late pick ups will be charged $10/child for every 10
minutes (5:31 -5:40 pm = $10, 5:41 -5:50 pm = $20, etc.) Multiple late pick ups may result in a suspension or
removal from the program. If a Before School Program is offered, no drop offs will be allowed prior to
6:40
am.
SIGN IN/OUT - Daily attendance is tracked for program purposes. Children will be signed in/out daily.
Pickup will be contactless. Participants must be picked up by someone on the registration form. An ID is
required when signing out a child. We cannot physically / otherwise restrain participants who choose to
leave the program of their own volition.
BEHAVIOR MANAGEMENT – We promote a “hands off” approach, so participants MUST be able to
respond to verbal direction from staff. Emphasis is placed on each child taking responsibility for their
own actions. Participants do not have the right to endanger or interrupt the activity of other children.
If your child is having trouble with another participant or needs assistance, they should notify a staff
member. Behavioral problems will be approached as deemed appropriate:
Verbal Warning/Redirection
Time Out/Loss of Privileges Short/Long-Term Suspension
Extreme behaviors that put a child, or those around them in danger or harms way, may accelerate
this process. These include, but are not limited to:
Leaving the Program Inappropriately
Throwing Objects Physical Attacks
Inappropriate Language Disrespect to Staff
EXTRAORDINARY SKIES. UNCOMMON GROUND.
2020-21 KID’S W.O.R.L.D. REGISTRATION FORM
Kid’s W.O.R.L.D. Parent Information Sheet (continued)
EMERGENCY CARE - In the event I cannot be reached in an emergency, I hereby give my permission to
employees of Sierra Vista Leisure Services to secure medical care for my child as deemed necessary. I
understand 9-1-1 can be used for urgent medical care.
PHOTOS - The City of Sierra may take photos of participants enrolled in our programs or activities. These
photos are for department use /promotion or may be used in future promotional materials. As a public
program, participants may also be exposed to outside sources/media.
LIABILITY WAIVER - As a participant in the above activity, I recognize that there are certain risks of
physical injury and I agree to assume the full risk of any injuries, including death, damages or loss which
my child may sustain as a result of participating in any and all activities connected with or associated
with such programs. I agree to waive and relinquish all claims I may have as a result of participating in
the program against the U.S. Government or City of Sierra Vista, their officers, agents, servants, and
employees. I do hereby release and discharge the U.S. Government, City of Sierra Vista and their officers,
agents, servants, and employees from any and all claims from injuries, including death, damage or loss
which I may have or which may occur to me on account of my participation in the program. I do further
agree to indemnify and hold harmless the U.S. Government, City of Sierra Vista and their officers, agents,
servants, and employees from any and all claims resulting from injuries, including death, and losses
sustained by me and arising out of, connected with, or in any way associated with the activities of the
program.
Online Payment Instructions
First Time Online Users
1. You will need to register for the Kid’s W.O.R.L.D. program before you can make online
payments.
2. Once you have registered, you will get your Household ID. It is located in the top right
corner of your receipt. The default password is your zip code. Once you have your login
information, follow the instructions for “Registered Users” below.
After logging in for the first time, you may change your login information.
Registered Users
1. Go to the citys website (www.SierraVistaAZ.gov).
2. Click on the top bar where it says “I want to:”
3. Click “Pay Online” then the pop out will give you the option to choose your child’s school/
site.
4. Scroll to “Activity Search Results” and “add to cart” the program site and activity dates by
clicking on the shopping cart.
5. You’ll be prompted to login using your ID/user name and password (see below).
6. Select the family member you wish to register and click the “add to cart” icon.
7. Repeat for additional weeks/family members, then proceed to check out.
8. An email with your receipt will be sent to you.
IMPORTANT: If you do not receive an email with your receipt, then the payment has not
been processed. Please give us a call if you do not receive a receipt.
My household ID #/User Name is
My password is
EXTRAORDINARY SKIES. UNCOMMON GROUND.
2020-21 KID’S W.O.R.L.D. REGISTRATION FORM
Kid’s W.O.R.L.D. is a group-recreation focused program. All participants must be able to feed & toilet themselves,
follow verbal directions, and interact appropriately in a group environment. If a child has a disability that requires
an ADA accommodation, please contact the OYCC to receive a Request for Accommodation packet and submit
prior to enrollment. If a request has already been granted for KW 2020-21, another one is not necessary.
This packet must be filled out completely and turned in prior to enrollment & attending the program.
CHILD:
Grade: School: Birth date: Sex(M/F):
Address: City: Zip Code:
FATHER/GUARDIAN E-mail:
Employer: Wk. Ph#: Cell /Hm. Ph#:
MOTHER/GUARDIAN: E-mail:
Employer: Wk. Ph#: Cell/Hm. Ph#:
HEALTH INFORMATION (Please initial all below):
YES: I understand my child must be able to toilet them self (includes identify need, proper use, dress self, no
pull-ups, etc)
NO / YES: Are there any health issues (food allergies, etc) affecting your child?
If so, please provide details:
NO / YES: Does your child have an ADA disability requiring an accommodation? If so, attach completed
Request for Accomodation packet.
NO / YES: Is your child on any medication? If so, please list:
MEDICATIONS - Meds are not allowed on site, except for Rescue Inhalers & EPI-pens. These must be left with
staff in the prescription box.
EMERGENCY CONTACTSList (2) or more LOCAL individuals BESIDES Parents/Guardians listed above.
We attempt to contact the parent(s) first. The following may also be contacted (or) remove my child from the
program.
NAME – As it appears on ID
(Do not re-list parent/guardian above)
RELATIONSHIP HOME PHONE/
CELL
WORK PHONE
The following person, or persons, may not remove my child from the program: (Copy of custody or court papers
MUST be provided for any name given for us to enforce):
EXTRAORDINARY SKIES. UNCOMMON GROUND.
2020-21 KID’S W.O.R.L.D. REGISTRATION FORM
Kid’s W.O.R.L.D. Terms & Conditions
NOTICE: The conditions surrounding the COVID-19 pandemic are continually evolving, and Kid’s W.O.R.L.D.’s
plan and safety protocols will be constantly evaluated to adapt to the continuing trends of the COVID-19
virus, guided by local, state, and national authorities
Initial ALL Below:
: SCREENING* – All children will be screened upon arrival to the program. They CANNOT attend
the program if they have a fever above 99.9 and/or a dry cough. Children MUST be fever free (without
medication) for AT LEAST 24 hours.*Pickup will be contactless.
: MASK POLICY - Masks are mandatory for all children, parents/guardians, and staff while at the
Kid’s W.O.R.L.D. program.
: EXPOSURE ACKNOWLEDGEMENT - The risk to have direct or indirect contact with individuals
who have been exposed to and/or diagnosed with one or more communicable diseases, including but not
limited to COVID-19 or other medical conditions, diseases, or maladies, and/or any mutation or variation
thereof does exist, and it is impossible to eliminate the risk that your child could become infected through
contact with or close proximity to an individual with a communicable disease.
: PICKUP DUE TO ILLNESS – Immediate pick up is required for children with a fever above 99.9, a
dry cough, or any other illness for safety concerns. Children MUST be fever free (without medication) for
AT LEAST 24 hours to return to the program.
: FEE PAYMENT – Weekly participation fees are due by 1:00 P.M. the first day of attendance that
week. When payment is not received by 1:00 p.m., a $10 late fee will apply. Payments are not accepted at
the program site. No exceptions. I understand weekly attendance fees can be paid online, via credit card
or over the phone at the OYCC during business hours.
: REFUNDS/CREDITS - The weekly fee applies to any number of days attended Monday-Friday.
To receive a credit or refund for participation fees paid in advance (for the current week or beyond),
notification must be sent in writing to KidsWORLD@SierraVistaAZ.gov no later than 1:00
pm Monday of
that week. No refunds or credits will be given for absences, sickness, or days otherwise missed during
the current week of participation (including suspensions). A 15% administrative fee will be charged on any
refunds.
: COVID-19 REFUND POLICY - Household credits will be issued in the event of program closure due
to direct exposure.
: LATE PICK UP FEES – The program ends at 5:30 pm late pick ups will be charged $10/child for
every 10 minutes (5:31 -5:40 pm = $10, 5:41 -5:50 pm = $20, etc.) Multiple late pick ups may result in a
suspension or removal from the program. If a Before School Program is offered, no drop offs will be
allowed prior to 6:40
am.
: SIGN IN/OUT - Daily attendance is tracked for program purposes. Children will be signed in/out
daily. Pickup will be contactless. Participants must be picked up by someone on the registration form.
An ID is required when signing out a child. We cannot physically / otherwise restrain participants who
choose to leave the program of their own volition.
: BEHAVIOR MANAGEMENT – We promote a “hands off” approach, so participants MUST be able
to respond to verbal direction from staff. Emphasis is placed on each child taking responsibility for their
own actions. Participants do not have the right to endanger or interrupt the activity of other children.
If your child is having trouble with another participant or needs assistance, they should notify a staff
member. Behavioral problems will be approached as deemed appropriate:
Verbal Warning/Redirection
Time Out/Loss of Privileges Short/Long-Term Suspension
Extreme behaviors that put a child, or those around them in danger or harms way, may accelerate this
process. These include, but are not limited to:
Leaving the Program Inappropriately
Throwing Objects Physical Attacks
Inappropriate Language Disrespect to Staff
EXTRAORDINARY SKIES. UNCOMMON GROUND.
2020-21 KID’S W.O.R.L.D. REGISTRATION FORM
Kid’s W.O.R.L.D. Terms & Conditions (continued)
: EMERGENCY CARE - In the event I cannot be reached in an emergency, I hereby give my
permission to employees of Sierra Vista Leisure Services to secure medical care for my child as deemed
necessary. I understand 9-1-1 can be used for urgent medical care.
: PHOTOS - The City of Sierra may take photos of participants enrolled in our programs or
activities. These photos are for department use /promotion or may be used in future promotional
materials. As a public program, participants may also be exposed to outside sources/media.
: LIABILITY WAIVER - As a participant in the above activity, I recognize that there are certain risks
of physical injury and I agree to assume the full risk of any injuries, including death, damages or loss which
my child may sustain as a result of participating in any and all activities connected with or associated
with such programs. I agree to waive and relinquish all claims I may have as a result of participating in
the program against the U.S. Government or City of Sierra Vista, their officers, agents, servants, and
employees. I do hereby release and discharge the U.S. Government, City of Sierra Vista and their officers,
agents, servants, and employees from any and all claims from injuries, including death, damage or loss
which I may have or which may occur to me on account of my participation in the program. I do further
agree to indemnify and hold harmless the U.S. Government, City of Sierra Vista and their officers, agents,
servants, and employees from any and all claims resulting from injuries, including death, and losses
sustained by me and arising out of, connected with, or in any way associated with the activities of the
program.
Only one form will be required from August 2020 until the end of July 2021 for all Kid’s W.O.R.L.D.
programs. The use of any additional Kid’s W.O.R.L.D. programs will not require another
registration form. Please select which program(s) your child will be attending this school year
(You can change this selection anytime):
After school at Bella Vista Elementary (BV, VM, and Carmichael students)
After school at Huachuca Mountain Elementary (HM students)
After school at Town & Country Elementary (T&C and PDS students)
Please list the first day your child will be attending the Kid’s W.O.R.L.D. program
I agree to the program terms and conditions. I certify the information provided is true, and accept
full responsibility for payment of all registration, usage, and miscellaneous fees required for my
child to attend this program.
Parent (PRINT): Signature: Date:
click to sign
signature
click to edit