Secondary Emergency Contacts:
Persons who act for parents when parents cannot be reached. These persons should be able to provide transportation. TWO CONTACT NAMES MUST BE PROVIDED:
School Information (to be completed by school personnel):
Student’s English Proficiency
(If English Learner, need year enrolled, if Proficient, need year re-classified):
Select from dropdown boxes below to provide medical information if needed
If there is any change in your child’s health which affects her/his ability to participate in physical education, or if she/he is given regular medication (Ed. Codes 49423, 51241), it is the parents’ responsibility. All forms can be obtained from the School Health Office.
* These conditions require a Health Care Plan. Note: Any of the above conditions may require a Health Care Plan. This information is kept in the student’s health record. I give permission for the nurse to share this information with school staff if necessary.
State law requires that parents or guardians be notified of their rights and responsibilities pertaining to their child’s education. The Parent Notice of Rights and Responsibilities document is posted on the Knights Ferry Elementary School website, (available in hard copy by request). Signing this form acknowledges that you have read and understood the Parent or Guardian Rights and Responsibilities notification. Also, please indicate below whether your child is on a continuing medication program and select the appropriate response regarding personal information.
If you do not choose to provide permission to allow your child’s personal information to be released, which may include their photo, name, age, or birthdate, please select the appropriate box. *Note that this will prohibit the District from providing this information to any newspapers reporting on Knights Ferry School events, interested schools, Parent-Teacher Club events or Facebook page, interested employers, and similar parties. If you choose not to allow the District to release this information but would like to make an exception for the school yearbook, you may do so by selecting the box stating this exception.
I hereby acknowledge receipt of information regarding my rights, responsibilities, and protections.
The California Education Code requires schools to determine the language(s) spoken at home by each student. This information is essential inorder for schools to provide meaningful instruction for all students.Your cooperation in helping us meet this important requirement is requested. Please answer the following questions and have yourson/daughter return this form to his/her teacher. Thank you for your help.
El código de educación de California requiere que las escuelas para determinar el idioma o idiomas hablados en el hogar por cadaestudiante. Esta información es esencial para que las escuelas a proporcionar instrucción significativa para todos los estudiantes.Se solicita su colaboración en ayudarnos a cumplir con este requisito importante. Por favor contesta las siguientes preguntas y tener a suhijo/hija devolver este formulario a su maestro. Gracias por tu ayuda.
Knights Ferry School District now has access to the Internet - a collection of thousands of interconnected computer networks around the world that allows almost instantaneous sharing of information.
Students and staff will have access to college and university libraries, information and news from a variety of sources and research institutions, software of all types, electronic mail and discussion groups on a wide variety of topics, and much more.
Knights Ferry School District strongly believes in the educational value of such electronic services and recognizes the potential of such to support our curriculum and student learning in our district. Our goal in providing this service is to promote educationalexcellence by facilitating resource sharing, innovation, and communication. We also want to take every precaution to protect students and staff from any misuses or abuses of this world-wide service. With access to computers and people all over the world also comes the potential availability of material that may not be considered tobe of educational value in the context of the school setting. There may be some material or individual communications which are not suitable for school-age children.
In that agreement, the student and his/her parent/guardian shall agree not to hold the district or any district staff responsible for thefailure of any technology protection measures, violations of copyright restrictions, or user mistakes or negligence. They shall alsoagree to indemnify and hold harmless the district and district personnel for any damages or costs incurred.
Students must agree to responsible use of the system under the rules for use listed below
Harmful matter includes matter, taken as a whole, which to the average person, applying contemporary statewide standards,appeals to the prurient interest and is matter which depicts or describes, in a patently offensive way, sexual conduct and which lacks serious literary, artistic, political, or scientific value for minors.
A Student MUST BE PREPARED to be held accountable for his/her actions and for the loss of privileges if the rules listed on the reverse side of this form are violated.
The district reserves the right to monitor use of the district’s systems for improper use without advance notice or consent. Students shall be informed that computer files and electronic communications, including email, are not private and may be accessed by the district for the purpose of ensuring proper use.
Whenever a student is found to have violated Board policy, administrative regulation, or the district’s Acceptable Use Agreement, the Superintendent/Principal or designee may cancel or limit a student’s user privileges or increase supervision of the student’s use of the district’s technological resources, as appropriate. Inappropriate use also may result in disciplinary action and/or legal action in accordance with law and Board policy.
Use of the District’s computer system is a privilege, not a right. Network administrators may review communications to maintainsystem integrity and insure that students are using the system responsibly. Anyone can read what you write. Consequences forviolating the behavior standards outlined above include:
Staff shall provide age-appropriate instruction regarding safe and appropriate behavior on social networking sites, chat rooms, and other Internet services. Such instruction shall include, but not limited to, the dangers of posting personal information online, misrepresentation by online predators, how to report inappropriate or offensive content or threats, behaviors that constitutecyberbullying, and how to respond when subjected to cyberbullying.
Student use of district computers to access social networking sites is prohibited.
In order to use the Internet, students and parents must sign the agreement to indicate understanding of the conditions of responsibilityand return this form to their child’s teacher.
PARENT OR GUARDIAN
District computers with Internet access have a technology protection measure that blocks or filters Internet access to visual depictions that are obscene, child pornography, or harmful to minors and that the operation or such measures is enforced.
As the parent or guardian of this student, I have read this contract and understand that it is designated for educational purposes. Iunderstand that it is impossible for the school to restrict access to all controversial materials, and I will not hold the school responsiblefor materials acquired on the Internet. I also agree to report any misuse of the information system to the school. Misuse can come in many forms, but can be viewed as any messages sent or received that indicate or suggests pornography, unethical or illegal solicitation, racism, sexism, inappropriate language, and other issues described in this document.
I understand that my child is responsible for his or her behavior, and agree to the consequences set up by Knights Ferry School.
This form will be kept on file until the end of the school year
Each student should be helped to reach his/her highest potential for intellectual growth. To achieve this, the student, staff and parent must work together by recognizing and agreeing upon the responsibilities of each in the learning process.
As a student, I will be responsible for:
As a parent, I will be responsible for:
The Knights Ferry School Staff will be responsible for:
In order to participate in the sports program (flag football, volleyball, soccer, basketball, softball, track) your child must have insurance coverage. If your child does not have insurance coverage, please contact the school office if you need to purchase student insurance.
If you are interested in allowing your child to participate in the school sports program, please provide the information requested below. Thank you.
VERIFICATION OF DMV DRIVING RECORDAn annual DMV print-out of your driving record must be on file in the schooloffice if you anticipate transporting students on school field trips. To obtain thisinformation you may either, drop by your local DMV office or go online atwww.dmv.ca.gov. Click on the “Online Services” tab at the top of the page,choose the very first item listed, “Driver Record.” Follow the directions on thepage, the fee for this online service is $2.00. If you go into a DMV office the cost is $5.00.
I certify that the information given above is true and correct. I understand that if an accident occurs, my insurance coverage shall bear primary responsibility for any losses or claims for damages.
In granting this permission I understand & agree that:
has my permission to have in his/her possession a mobile phone. I understand that he/she may not have their phone on them. I understand that it must be turned in to the teacher each day at the beginning of the school day and that it will be given back at the conclusion of the school day. I understand that the phone must be turned off at all times during school hours. If at any time your child is found with the phone on or in his/her immediate possession during school hours it will be confiscated by school personnel and kept in the office until a parent comes to pick it up. In addition a student who violates this policy may be prohibited from possessing a mobile communication device at school and/or may be subject to further discipline.