Boones Mill Baptist Day School 

10 Whispering Creek Rd 

Boones Mill VA 24065




Handbook Policy Agreement/Disclosure Statements

Section 63.2-1716 of code of Virginia exempts from licensure any Child Day Centers operated or conducted under the auspices of a religious institution.

Boones Mill Baptist Day School is religiously exempt from state licensure through the Code of Virginia but is regulated by the Virginia Dept. of Social Services (VDSS) to be in compliance with all requirements set by the Code.


 1. General Staff qualifications and job description are on file in the school office.

 2. Each staff member is required to be certified by a practicing physician to be free from any disability, which would prevent them from                  caring for the children.

 3. The school director and lead teachers are CPR and First Aid Certified.

 4. Criminal background checks are completed on all staff and volunteers and are on file in the school or church office.

 5. Our student/teacher ratios are in compliance with VDSS regulations.

 6. Snacks/Lunches will be provided by the parents/guardians of each child.

 7. Our school maintains a Liability Insurance Policy as recommended by the Code of Virginia

 8. Our physical facilities are located on the upper and lower floor of Boones Mill Baptist Church. Each room is vented and includes                      heating and air conditioning. All rooms are free from apparent danger and are in compliance with all building and fire inspection                codes.

 9. Our school capacity is 99 students.

10. Boones Mill Baptist Day School has made the decision NOT to administer prescription medications. We will administer Epi Pen or                           Benadryl in case of an allergic reaction. First-aid will be administered when necessary.


I hereby acknowledge that I have read, understand and agree to all policies and procedures set forth in the Parent Handbook of Boones Mill Baptist Day School.


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Parent/Guardian Signature                                                                          Date



I hereby acknowledge that I have read and understand Disclosure Statements of Boones Mill Baptist Day School.


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Parent/Guardian Signature                                                                          Date


CHILD’S NAME__________________________________________________


Staff Initials: ________________
To be kept on file








Religiously Exempt Child Day Center

Program Decision to Not Administer Prescription Medications

My program has made the following decision regarding the administration of medications to a child in my program: (mark one)

_____I (or my staff) WILL NOT administer any medications-prescription or non-prescription Medication.

__X__I (or my staff) will administer ONLY non-prescription medications (non-prescription medications include, but are not limited to; Tylenol, cough syrup, diaper ointment, sunscreen, and topical insect repellants).

Provider and the parent of each enrolled child must sign below. The provider must maintain a copy of this form in each child’s individual record.



_______________________________________________                                                    BOONES MILL BAPTIST DAY SCHOOL

Provider/Director Name (print)                                                                                                         Facility Name


____________________________________________________________________________________________________________

Provider/Director Signature                                                                            Date


____________________________________________________________________________________________________________

Parent/Guardian Signature                                                                               Date



Confidentiality Statement

Information about any child in my program is confidential and will not be given to anyone except VDSS’ designees or other persons authorized by law unless the child’s parent/guardian gives written permission. Information about a child in my program will be given to the local department of social services if the child received a day care subsidy or if the child has been named in a report of suspected child abuse or maltreatment or as otherwise allowed by law.

Rehabilitation Act of 1973

I understand that if my program receives any federal funding (such as child care subsidy from a local department of social services), I am subject to Section 504 of the Rehabilitation Act of 1973 which is similar to the provisions of the Americans with Disabilities Act. If a child enrolled in my program now or in the future is identified as having a disability covered under the Rehabilitation Act. I will assess the ability of the program to meet the needs of the child. For further information on the Rehabilitation Act seek legal counsel and/or go to the following website: http://www.dol.gov/oasam/reg/statutes/sec504.htm

Provider Statement

I understand that it is my responsibility to follow my Program’s Decision Regarding Medication plan and all health, infection control, and medication administration regulations applicable to my child day program. The Program Decision Regarding Medication plan will be made available to parents at enrollment, whenever changes are made and upon request.



Boones Mill Baptist Day School Release Form 



I declare that Boones Mill Baptist Church will not be held responsible for any accident that might occur to my child while in attendance at Boones Mill Baptist Day School.

I declare that I release Boones Mill Baptist Day School Advisory Committee and employees from any claim or cause of action out of the operation of the school.


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Parent Signature                                                                                     Date


I give my permission for Boones Mill Baptist to put my child’s picture and/or name in the Franklin News Post, Roanoke Times, Face Book and/or Church publications.


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Parent Signature                                                                                    Date



OFFICE USE ONLY:

____ Health/Immunization Form/Waiver                                               ____Registration Fee/CK #

____ Release Form                                                                                 ____ 1st Month Tuition./CK #

____ Birth Certificate



Forms/Payments received by: _____________________________________________________________________


_____________________________________________________________________ ________________________
Directors Signature                                                                                                              Date