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CONSENT AND RELEASE OF LIABILITY FORM FOR SAFE HAVEN SUMMER BREAK PROGRAM 2015 DESCRIPTION OF PROGRAM: SAFE HAVEN SITES AND SERVICES SUMMER BREAK PROGRAM 2015 TIME PERIOD: JULY 6, 2014 THROUGH AUGUST.

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How to fill out the Safe Haven CPS Intake Form online

Filling out the Safe Haven CPS Intake Form is essential for enrolling your child in this program. This guide will walk you through each section of the form to ensure that all necessary information is provided accurately and efficiently.

Follow the steps to complete the Safe Haven CPS Intake Form online.

  1. Click ‘Get Form’ button to access the Safe Haven CPS Intake Form and open it in your preferred editor.
  2. In the first section, you will see a prompt to print the name of the participating student. Ensure that you clearly write their full name in the provided space.
  3. Next, indicate the student's grade level by selecting or writing it in the designated field.
  4. You will also need to specify the student's school. Write the full name of the school in the designated area.
  5. In the parent or guardian section, provide your signature where indicated. This confirms your consent for your child’s participation.
  6. Below your signature, include the date this form is being completed. This is important for record-keeping purposes.
  7. Lastly, fill in your phone number and print your full name in the respective fields to ensure you can be contacted if necessary. You will also need to provide an emergency contact’s name and phone number.
  8. After completing all the required fields, review the entire form for accuracy. Save your changes, and then choose to download, print, or share the form as needed.

Complete the Safe Haven CPS Intake Form online today to secure your child's spot in the program.

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An abused or neglected child is one whose parent or custodian creates, inflicts, allows, or threatens physical or mental injury (other than by accidental means).

1-800-4-A-CHILD (National Child Abuse Hotline)

Because of confidentiality laws, the name of the reporter will not be released unless there is a court order or during court testimony. What Happens After A Report Is Made? CPS will respond to valid child abuse or neglect reports by conducting a family assessment response or an investigation response.

You are not required to give your name when you make the report, but if you do identify yourself, the local department of social services will be able to contact you for further information if needed and will be able to inform you of actions that were taken.

Many people wonder, “What does CPS look for in a home visit?” The major factors are making sure the home is a safe place for the child. For example, they look at the quality of the sleeping conditions, how much food is available, and if the child has enough clothing to determine if there's any sign of neglect.

The CPS worker will observe the child/children for injuries or signs of abuse or neglect. Under Section 63.2-1520 of the Code of Virginia, the CPS worker is permitted to take photographs and make the necessary arrangements to X-ray the child as part of a medical evaluation.

Pursuant to § 63.2-1509 D of the Code of Virginia, a mandated reporter's failure to report as soon as possible, but no longer than 24 hours after having reason to suspect a reportable offense of child abuse or neglect, shall result in a fine.

Neglect is when a parent or guardian does not provide for the basic needs of a child, though capable of doing so. Neglect can include not meeting physical, medical, educational or emotional needs.

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