Easton Community Center (ECC) Membership Application

Family (Household) Name:

Address:

Phone # (H)

Phone # (W)

Phone # (C)

List family members living at the above address (commencing with Primary Card Holder):

Name (Primary 1)

Gender

D.O.B

Name (Primary 2)

Gender

D.O.B

Name

Gender

D.O.B

Name

Gender

D.O.B

Name

Gender

D.O.B

Name

Gender

D.O.B

Email Address

Emergency Phone

Consent

When enrolled in an ECC program, I authorize emergency medical treatment of all family members listed under this household, as deemed necessary by the ECC staff, and I agree to assume the costs of any such treatment.

In consideration of accepting the membership and permitting the voluntary participation of the above named family members in ECC programs, rentals or events, I/We hereby waive, release, discharge, indemnify and agree to hold harmless [ECC] its board, employees, volunteers, officials, sponsors and other representatives from any and all claims, demands, costs, expenses, and compensation arising out of or in any way related to any injury or other damage that may result to said participant while attending and/or participating in any [ECC] sponsored event, including any physical or other injury caused by negligence of any such person while performing his/her duties at any time.

_________________________________ ______________

Parent/Guardian signature Date

Pledge

I have read and understand the ECC’s Code of Conduct governing membership and we pledge to adhere to the same.

_________________________________ ___________________

Parent/Guardian signature Date

Membership Rates – 12 Months from joining

Easton Resident Family Membership = $250.00 per family Non Resident = $300.00 per family

Resident ‘Empty Nesters’ Membership = $150.00 (1-2 adults) Non Resident = $225.00 (1-2 adults)

Membership Payments

Please check membership option o Family Membership o Empty Nester Membership / o Resident o Non Resident

I am not interested in becoming a member at this time, however, in support of the ECC, please accept my tax deductible donation of $____________

I enclose a check payable to ECC for $_________ or, please charge my oVISA o MasterCard for $ _______

Card Number:

Name on Card:	Exp. Date:
3 Digit Security Code __________

ECC – Family Code of Conduct

The ECC is a place where patrons can socialize in a comfortable environment that is drug, alcohol and tobacco free. The Code of Conduct reflects this.

Eligibility

ü All residents of Easton are eligible to become members of the ECC through the purchase of a family membership.

ü Family Membership encompasses all family members residing at the same primary address (household) in Easton. Family members eligible for free teen center membership are encouraged to join as teen members.

ü The Facility Director or his/her appointed staff member may revoke eligibility at any time.

Rules

• Children, Grade 5 and younger must be accompanied by an adult while visiting the ECC unless enrolled in an ECC program.
• Use, possession, sales or distribution of drugs, or drug related paraphernalia is prohibited in the ECC.
• Alcohol may only be consumed in the ECC at a function sanctioned by management and in accordance with the ECC’s Alcohol Policy.
• Smoking is prohibited inside the ECC facility.
• Inappropriate behavior, including but not limited to violence, threatening, weapon possession, explosive possession, dangerous actions, lewdness, stealing, vandalism, gambling are prohibited.
• The ECC is not responsible for the loss or damage of personal property.
• The ECC is not responsible for personal injury that results from reckless or irresponsible behavior.
• The onsite director or designated staff member in his or her absence has absolute authority to interpret the rules.
• Noise and loitering: Loitering and excessive noise outside of the ECC building and adjoining property is prohibited. Please consider our neighbors.

Procedures

• Members or their guests who are suspected of being under the influence of drugs and/or alcohol will be asked to leave the facility.

• If the situation warrants medical intervention, at the sole discretion of the ECC staff, the Easton EMS and Easton Police will be notified.

• Members or guests found in possession of drugs, explosives and/or weapons, or those that engage in other illegal activity, will be referred to police.

Suspension of Privileges

• Members or guests found to be in violation of the drug, alcohol or inappropriate behavior rules will be removed from the ECC with up to a six-week suspension of privileges at the sole discretion of the Director.

• Repeated violations may result in a suspension of privileges or revocation. The length of such suspensions will be at the discretion of the Facility Director or designated staff member.

• A suspension or revocation may be appealed. Such an appeal will be review by a panel made up of the Facility Director and two members from the Board of Directors. The decision of the panel will be final.

• Members or guests found in violations of the weapons and explosives rules will be removed immediately from the ECC facility and will have their membership suspended indefinitely. Reinstatement may occur pending an appeal, a review by the above stated review panel and the consensus of the Board of Directors.

Access

• All eligible persons, wishing to become members, must complete the ‘Membership Application’ form and sign a pledge to adhere to the ECC ‘Code of Conduct’.

· All members will be issued a bar coded ‘Member ID Card’ (MIC). Upon entering the ECC, each member is required to present and swipe the card through a reader. It is requested that they do the same on departure.

ECC Teen Center Membership Application
Student Name		Date of Birth
Address
School Name		Grade 2004/05
E-Mail Address		Age
Name Parent Guardian 1	Name Parent Guardian 2
Address 1	Address 2
Phone # (H)	Phone # (H)
Phone # (W)	Phone # (W)
Phone # (C)	Phone # (C)
Emergency Contact Name	Emergency Contact Telephone
Consent: I authorize emergency medical treatment of my child, as deemed necessary by the ECC staff, and I agree to assume the costs of any such treatment. In consideration of accepting the membership and permitting the voluntary participation of the above named participant in its teen center and/or programs, I/We hereby waive, release, discharge, indemnify and agree to hold harmless [ECC] its board, employees, volunteers, officials, sponsors and other representatives from any and all claims, demands, costs, expenses, and compensation arising out of or in any way related to any injury or other damage that may result to said participant while attending the teen center and/or participating in any [ECC] sponsored event, including any physical or other injury caused by negligence of any such person while performing his/her duties at any time. ___________________________________________ ______________________ Parent/Guardian Signature Date
Pledge My child (member applicant) and I have read and understand the ECC’s Code of Conduct governing membership and we pledge to adhere to the same. ___________________________ _________________ _____________________________ ________________ Teen Member signature Date Parent/Guardian signature Date

ECC Teen Center - Code of Conduct

The ECC Teen Center is a place where teenagers can socialize in a comfortable environment that is drug, alcohol and tobacco free. The Code of Conduct reflects this.

Eligibility

· All residents of Easton attending Middle or High School, regardless of the school location, are eligible to become members of the ECC Teen Center free of charge. Eligible children of Non Resident Family Members, may also join the Teen Center.

· The Facility Director or his/her appointed staff member may revoke eligibility at any time.

· Special event eligibility may differ and will be posted with event announcements. For example, Grade 7 & 8 Dance night would render other grades ineligible to attend.

· Upon entering, members and their guests agree to allow reasonable inspection of bags and clothing, by the Director or appointed staff, to ensure that contraband is not brought into the ECC.

Rules

· Use, possession, sales or distribution of drugs, alcohol, tobacco or related paraphernalia is prohibited in the ECC.

· Inappropriate behavior, including but not limited to violence, threatening, weapon possession, explosive possession, dangerous actions, lewdness, stealing, vandalism, gambling are prohibited

· The ECC is not responsible for the loss or damage of personal property.

· The ECC is not responsible for personal injury that results from reckless or irresponsible behavior.

· The onsite director or designated staff member in his or her absence has absolute authority to interpret the rules.

· Noise and loitering: Loitering outside of the ECC building and adjacent property is prohibited as is excessive noise such as honking car horns, yelling and playing car stereos loudly. Please consider our neighbors.

· Phone calls Outgoing: A dedicated line for necessary outgoing local calls will be available to members and their guests at no charge. Call duration must be kept to a minimum.

· Phone calls Incoming: With the exception of a family emergency, incoming calls to members and their guests or calls to relay messages will be discouraged

Procedures

· Members or their guests who are suspected of being under the influence of drugs and/or alcohol will be asked to wait in a secured area while parents are called. In the event that parents cannot be contacted, Easton police will be called to escort the child home safely.

· If the situation warrants medical intervention, at the sole discretion of the ECC staff, the Easton Ambulance Corps and Easton Police will be notified immediately followed by the parents/guardian.

· All reasonable attempts will be made to ensure no teen suspected of drug and/or alcohol use will be allowed to leave the premises without adult supervision. The ECC and its staff cannot be held responsible if the teen/s choose to leave without adult supervision.

· Members or guests found in possession of drugs, alcohol, explosives and/or weapons, or those that engage in other illegal activity, will be referred to police.

Suspension of Privileges

· Members or guests found to be in violation of the drug, alcohol or inappropriate behavior rules will be removed from the ECC with up to a six-week suspension of privileges at the sole discretion of the Director.

· Repeated violations may result in a suspension of privileges for up to three (3) months. The length of such suspensions will be at the discretion of the Facility Director or designated staff member.

· A suspension or revocation may be appealed. Such an appeal will be review by a panel made up of the Teen Center Program Director, Facility Director and a member from the Board of Directors. The decision of the panel will be final.

· Members or guests found in violations of the weapons and explosives rules will be removed immediately from the ECC facility and will have their membership suspended indefinitely. Reinstatement may occur pending an appeal, a review by the above stated review panel and the consensus of the Board of Directors.

Access

· All eligible children of ECC Family Members, wishing to become teen members, must complete the ‘Membership Application’ form and sign a pledge to adhere to the ECC Teen Center ‘Code of Conduct’.

· All members will be issued a bar coded ‘Member ID Card’ (MIC). Upon entering the ECC Teen Center, each member is required to present and swipe the card through a reader. It is requested that they do the same on departure.

· All guests must be accompanied by a member of the ECC Teen Center. Upon entering each guest must complete the required information and sign the visitors book. The member will then place their ‘Member ID Card’ number in the appropriate space provided adjacent their guest/s entry/entries. Guests must leave the facility when their sponsoring member departs.

· During regular hours of operation, members and their guests will be permitted to come and go at will. The exception will be for some special events where a ‘closed door’ policy may be adopted. A ‘closed door’ policy does not allow for departure and re-entry after initial admission.