Non-Member Teacher Details

We are excited to have you join us this next semester. Below are the details that we have to finalize before you can teach a class this semester. After all of these forms and payments are submitted for your background check, we will send you an email with links to submit your background check.

Forms To Fill Out

All forms must be completed and submitted. Please click the arrow next to each name for the form to appear.

Child Safety Training
Purpose: To promote a safe, respectful, and protective environment for all children participating in our homeschool cooperative. Please read each of the sections carefully and check that you agree to uphold these statements while working with children at The Purposeful Servants Cooperative. This is mandatory to participate in our cooperative.
Supervision
Supervision Statements:
– Children will be supervised at all times by an assigned adult.
– No adult will be alone in a private space with a child who is not their own unless another adult is present.
Physical Contact
Physical Contact Statements:
– Physical contact will be respectful and appropriate at all times.
– Tickling, wrestling, or physical discipline is not permitted.
Boundaries
Boundaries Statements:
– Adults will respect children’s physical and emotional boundaries.
– No inappropriate jokes, suggestive language, or personal questions about bodies or families.
Bathroom Use
Bathroom Use Statements:
– Adults will not accompany children into bathrooms unless assisting their own child.
– Children requiring assistance will be supported by their own parent unless a prior agreement is made or there are two adults in the bathroom and the child is under the age of 5.
Reporting
Reporting Statements:
– Any concern about a child’s safety, well-being, or behavior must be reported to the Co-op Director or Board Member immediately.
– We will take all concerns seriously and involve parents or authorities when appropriate.
Conduct
Conduct Statements:
– All adults agree to model respectful, kind, and inclusive behavior.
– Bullying, yelling, or shaming children is not acceptable.
Training
Training Statements:
All participating parents are encouraged to watch the linked training video to become more aware of child safety and reporting basics.
Name
By typing your first and last name in this field you agree to follow the above safety standards while participating in co-op activities.
Media Release Form
Parent/Guardian Full Name
Include child’s first & last name and Date of Birth. Input an “enter” or “return” in between each child’s information. Type “N/A” if you are a non-member teacher.
Release of Media
Please check ONE of the options above.
I am releasing The Purposeful Servants Cooperative from any claims or liability arising from the use of the media as specified in the chosen option above.
I have read and understand the terms of this Media Release Form.
This release is valid from the date signed until revoked in writing by me.
By typing your first and last name in this field you acknowledge that you have read and understood this liability release and agree to its terms.
Liability Waiver & Release
Parent/Guardian Information: Full Name
Include house number, street name, city, state, and zip code.
Include first & last name of each additional adult (anyone over 18+) living in the household or that is getting a background check to be at co-op regularly. Press “enter” or “return” in between each child information. Type N/A if there are no additional adults in your household.
Include first & last name of each child. Press “enter” or “return” in between each child information.
Acknowledgement *Required to Participate in our Cooperative*
As the parent or legal guardian of the above-named child(ren) and for the adults listed above, I acknowledge that participation in The Purposeful Servants Cooperative events, classes, and activities involves certain inherent risks. These may include, but are not limited to, physical activity, field trips, outdoor play, and interaction with others. I voluntarily assume all such risks on behalf of myself and my child(ren), and I hereby release, discharge, and hold harmless The Purposeful Servants Cooperative, its board, volunteers, members, teachers, coordinators, and associated facilities from any and all claims, liabilities, demands, or causes of action that may arise from injury, illness, or loss during participation in any co-op activities. This release includes claims based on the negligence, action, or inaction of the co-op or its representatives, except for those resulting from gross negligence or willful misconduct.
Emergency Authorization *Required to Participate in our Cooperative*
In the event of a medical emergency, I authorize the representatives of The Purposeful Servants Cooperative to seek emergency medical treatment for my child(ren) or adults, and I agree to be responsible for any expenses incurred. I understand that every reasonable effort will be made to contact me before such action is taken.
Understanding *Required to Participate in our Cooperative*
I acknowledge that I have read and understood this liability release and agree to its terms.
By typing your first and last name in this field you acknowledge that you have read and understood this liability release and agree to its terms. This is signing for all persons identified on this form.
By typing your first and last name in this field you acknowledge that you have read and understood this liability release and agree to its terms. This is signing for all children identified on this form.

Background Check Payment

Background Check (Per Person)

$5.00

This is to cover your background check of $5. Add one per adult (18+) who lives in your household.

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