Jasper's Corner Tutee Intake Form

Jasper's Corner Registration Form

Please submit this form to complete your student's registration for Jasper's Corner. Please limit one Registration Form for per child. There are three locations for Jasper's Corner: A. K. Smiley Public Library (high school and middle school students only), Redlands Community Center (1st-12th) and University of Redlands-Armacost Library (1st-12th). Completing this form does not guarantee placement in the program. Once a spot is available, you will be contacted by our team regarding placement of your student. Contact the Community Service-Learning Office at csl_office@redlands.edu, with any concerns.
Child Participant Information
Child Name

First NameLast Name
Date of Birth
Age
T-Shirt Size
Grade Level
Are you interested in registering your child for one of our on-campus Mentorship programs as well? (Big Buddies/CHAMPS offered Mondays 5:30-7:30PM)
Please list the subjects in which this child needs help:
School District
Current School
Languages Spoken at Home
Please indicate your preference for location of Jasper's Corner tutoring
Which days would your child be available for tutoring?
Family Information
Street Address
City
Zip Code

Family Contact Information

Please list the name, phone number, and email of the primary person we should contact with program updates, and in case of an emergency.
Guardian Name

First NameLast Name
Relationship to Child
Cell
Email
all of our communication will be email, unless an emergency occurs.
Emergency Contact Information

Please list the names and contact information of three other people who we can contact in case of an emergency.
Contact 1 Name

First NameLast Name
Contact 1 Relationship to Child
Contact 1 Cell Number
Contact 1 Email
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this person allowed to pick up/drop off your child at the program location?
Contact 2 Name

First NameLast Name
Contact 2 Relationship to Child
Contact 2 Cell Number
Contact 2 Email
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this person allowed to pick up/drop off your child at the program location?
Contact 3 Name

First NameLast Name
Contact 3 Relationship to Child
Contact 3 Cell Number
Contact 3 Email
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this person allowed to pick up/drop off your child at the program location?

Please list any physical, mental, or medical conditions your child has, including any allergies that could impact their participation in the program.
Does your child have any food allergies? If so, please explain.
Will program staff need to administer any medications to your child? If yes, please list medication & instructions.
Is your child allowed to administer any of their own medications (provided by a parent or legal guardian)? If yes, please list medication and instructions.
Does your child wear contact lenses?

Waivers and Release Forms

Please review our parent/guardian handout to review our program rules and policies.
My signature below indicates my understanding of the policies and procedures outlined above for this upcoming year. Should my child have more than two unexcused absences I understand they risk being dismissed from the program.
I, blanks*, hereby understand that the attendance policy will be enforced, and failure of (child's name) blank* to come to scheduled program sessions could lead removal from the program.
Date
Signature
Mandated Reporting
All University of Redlands students working for Jasper's Corner are mandated reporters. A mandated reporter is required by law to report known or suspected abuse or neglect relating to children. Please sign to indicate your understanding that program staff are mandated reporters.
Date
Signature
I do not give consent for the use and reproduction, in print or electronic format by the University of Redlands ("University") or anyone authorized by the University, of any and all audio, video, or photographic images, which have been taken from any publicity purpose, without compensation
University of Redlands Children's Program Agreement
Please Review the following and check each box and sign the agreement indicating the mutual support, commitment, and understanding of the program. Thank you!
I, the parent or guardian of blanks* (child's name) have read and will abide by the agreement above and endeavor to support this program.
Date
Name

First NameLast Name
Signature
If your student is in high school and is under the age of 16, do you give them permission to sign themselves in and out of program? (All participants in middle and elementary school must be signed in and out of program by an authorized adult)
Please Review our Updated Policies and Procedures 2026-2027:

Jasper’s Corner Tutees/Families Policies 2026-2027 Academic Year

1. Responsible Attendance & Absence Policy
Purpose:
Jasper’s Corner is a free tutoring program designed to provide consistent academic support to students in our community. Because space in the program is limited and there may be a waitlist, regular attendance is important.

Our attendance policy is intended to be fair, reasonable, and supportive while ensuring that available tutoring spaces are provided to families who can participate consistently.

Attendance Expectations:
Students and families are expected to:

·       Attend all scheduled tutoring sessions whenever possible.

·       Arrive on time and remain for the duration of their scheduled session.

·       Notify Jasper’s Corner Student Directors as soon as possible if the student will be absent or late.

·       Communicate with program staff when circumstances make regular attendance difficult.

Absences:
We understand that absences sometimes happen. Students will not be penalized for occasional absences due to illness, family emergencies, school activities, transportation problems, or other circumstances deemed reasonable.

When possible, families should notify the program before the scheduled session through the designated communication method.

Unexcused or Repeated Absences:
Because tutoring spaces are limited and the program may have a waitlist, repeated absences or failure to communicate about absences may result in a review of the student's enrollment.

As a general guideline:

·       1–2 absences: No action will normally be taken, although families may receive a reminder about attendance expectations.

·       3 consecutive absences without communication: Program staff may contact the family to check in and determine whether the student is still able to participate.

·       Repeated absences or a pattern of missed sessions: Staff may meet with the family to discuss whether the current schedule continues to work for the student.

·       Continued non-attendance: The student enrollment may be reviewed, and their spot may be offered to another student on the waitlist.

Alternative Tutoring Options:
If a student is unable to regularly participate in scheduled in-person tutoring sessions, the Jasper’s Corner team may encourage the family to utilize an asynchronous tutoring option, when available and appropriate. This may allow the student to continue receiving academic support without requiring them to attend every scheduled in-person session.

Late Arrivals and Early Departures:
Families should make every effort to arrive on time. Frequent late arrivals or early departures can reduce the amount of tutoring time available and may disrupt tutors who have planned their sessions around the student's scheduled time.

If a student is significantly late, families should notify program staff whenever possible.

Fair Access:

Jasper’s Corner is a free program with limited capacity. When there is a waitlist, maintaining a tutoring spot while consistently missing scheduled sessions can prevent another student from accessing services.

Our attendance policy helps ensure that available spaces are used by students who are able to participate regularly.

We will work with families when possible, to determine whether a different schedule, asynchronous tutoring, or another arrangement may better meet their needs.

Enrollment & Program Discretion:
*Enrollment in Jasper’s Corner is ultimately at the discretion of the Jasper’s Corner program team. Meeting the program's initial eligibility or enrollment requirements does not guarantee continued enrollment.

The program team may review or adjust a student's enrollment based on attendance, communication, program capacity, waitlist needs, the student's ability to participate meaningfully during their scheduled session, and other circumstances affecting the student's participation.

When enrollment is reviewed, the team will consider the circumstances surrounding the student attendance and will make reasonable efforts to communicate with the family before making a change.

If a student is unable to participate consistently in the format in which they are enrolled, the team may recommend an asynchronous tutoring option or determine that another student would be better served by the available enrollment space.

Our Commitment
We recognize that every family's circumstances are different. If attendance becomes difficult, please communicate with us. We would much rather work together to find a solution than have a family feel that they cannot ask for help.

Jasper’s Corner is committed to creating an accessible, supportive, and equitable tutoring environment for all students and families.

2.   Academic Support Policy
CSL’s Children’s Programs are designed to offer homework help and subject-based tutoring, not formal classroom instruction.

Our tutors are qualified and trained to assist students with their school-assigned work, clarify concepts, and provide academic support within their area of knowledge.

Tutors do not teach new curriculum or provide structured lessons outside of what students are already learning in school.

Practice worksheets may be used to reinforce learning or provide light enrichment; however, these are not part of an established educational curriculum.

Parents and guardians are responsible for ensuring that their child brings current homework or study materials to each session.

Jasper’s Corner tutors are not authorized to use extensive measures to check to confirm a child has already completed their assignments. If a child arrives to program and states they have no assignments, we will encourage worksheets, but cannot physically search for a homework assignment in their bag, etc.

(If a parent or guardian is seeking formal curriculum instruction, structured homeschooling support, or instruction beyond the scope of Jasper’s Corner, they may request a meeting with the program team to discuss whether other academic support options or resources may be available.

The Jasper’s Corner team reserves the right to determine whether a student’s academic needs fall within the scope of the program.)

3.     Health and Wellness Policy
The health and safety of all participants, volunteers, and staff are our top priorities.
To prevent the spread of illness, children showing any cold or flu-like symptoms are not permitted to attend the program.
If a child appears to arrive sick or develops any symptoms during a session, parents or guardians will be contacted immediately and asked to pick up their child.

This policy helps us maintain a safe, healthy, and positive environment for all participants.

4.   Drop Off/Pick Up Policy:

Please notify the program via phone or email if you are running late for either pick-up or drop-off.

Please respect the program schedules and University student commitments by ensuring your child is picked up and dropped off on time.

Parents, legal guardians, or other approved individuals must sign children in and out at the beginning and end of each session.

The legal guardian on file is the only one who can verify for another person to pick up and drop off their child from their session. This confirmation will need to be verbally noted to our staff or in writing notifying us who will be picking up the child and their relation to the child.

Children may only sign themselves in or out if they are at least 16 years old and have parent/guardian permission on file.

5.   Cell Phone Policy
To minimize distractions, child participants should keep their cell phones put away during program and tutoring sessions.

If parents need to contact their child during program hours, please reach out to the appropriate team:

Program Contact Information

·       Jasper’s Corner Tutoring Program:

o      A.K. Smiley Library – jaspers_smiley@redlands.edu | (909) 704-4137

o      Redlands Community Center – jaspers_rcc@redlands.edu | (909) 704-4138

o      Armacost Library (U of R) – jaspers_a3@redlands.edu | (909) 335-5116

·       Graduate Assistant for Children’s Programs: makenna_ternes@redlands.edu

·       Director of Children’s Programs / Associate Director of CSL:
Ellie Dreslough | ellie_dreslough@redlands.edu (909) 748-8292

·       Urgent matters and Emergencies Only, Please contact: (860) 942-4985

6.   Policy Enforcement:
We strive to create a positive, supportive environment for all participants. Program Advisors, Student Directors, and University Volunteers are trained to handle disciplinary situations in a way that fosters learning and growth.

7. Zero-Tolerance Statement
Jasper’s Corner maintains a zero-tolerance policy for violence, threats, bullying, harassment, discrimination, sexual misconduct, weapons, theft, and other serious behaviors that compromise the safety or wellbeing of our students, tutors, staff, or community members. Any such behavior may result in immediate removal from the program. Enrollment and continued participation in Jasper’s Corner are ultimately at the discretion of the program team.

8.   Tutee Behavioral Management Policy:

·       If a child acts inappropriately, they will first receive a verbal warning from a University Volunteer or Student Director.

·       If the behavior continues, Student Directors will call home to notify parents/guardians

·       *If a tutee’s behavior becomes disruptive, prevents their tutor from providing effective support, or significantly interferes with the learning environment, Student Directors ultimately reserve the right to end the student’s tutoring session and send the student home early. (Repeated behavioral disruptions may result in a review of the student’s continued enrollment in Jasper’s Corner)

All decisions regarding program enrollment or policy enforcement will align with the Office of Community Service Learning’s Guiding Principles: Be Faithful, Be Just, Be Purposeful, Respect Autonomy, and Do No Harm

With questions or concerns regarding any of the listed Jasper’s Corner policies, or if you do not agree with a policy enforcement made, please contact Ellie Dreslough, Director of Children’s Programs
I signify that I have read the above Jasper's Corner Homework Club Policies and Procedures and will abide by the endeavor above to support this program:
Should be Empty:

Jasper's Corner Registration Form

Child Participant Information

Family Information

Family Contact Information

Emergency Contact Information

Child's Educational History

Waivers and Release Forms

Mandated Reporting

University of Redlands Children's Program Agreement