Edge High School 2020-2021 New Student Enrollment Packet

EMERGENCY CONTACT/MEDICAL

STUDENT PROFILE
Student's Name*

First NameLast Name
For Emergency Contact, please list at least one person other than a parent/guardian. They must be over 18.
Contact #1 Name*

First NameLast Name
Contact #1 Relationship *
Contact #1 Home Phone*
Contact #1 Cell Phone*
Contact #1 Work Phone
Contact #1 may pick up student:

YesNo
Contact #2 Name

First NameLast Name
Contact #2 Relationship
Contact #2 Home Phone
Contact #2 Cell Phone
Contact #2 Work Phone
Contact #2 may pick up student:

YesNo
List any special medical considerations:*
Allergies:*
Does the student have visual/hearing problems? (i.e.; corrective lenses, hearing aids):*
PERMISSION TO DISPENSE MEDICATION
Please list prescription medication(s) the student is currently taking.
The following prescription medication must be dispensed during school hours (I will personally provide the school with medication and a copy of the doctor’s orders.):
In addition, Edge High School staff has my permission to provide non-prescription medication such as acetaminophen (Tylenol), ibuprofen (Motrin), bismuth subsalicylate (Pepto-Bismol) to my child as may be needed at school.
Signature of Parent/Legal Guardian or student if 18+:

Clear
Date

MonthDayYear
Date
FIELD TRIP PERMISSION

Medical Release: In case of accident or serious illness, I request the trip sponsor to contact me. If I cannot be reached, I hereby authorize the trip sponsor to call the physician indicated and follow his/her instructions. If it is impossible to contact the physician, the trip sponsor may make whatever arrangements are necessary. The trip sponsor will follow special medical treatment, including any information regarding allergies or drug reactions as listed above, provided by Edge High School.
Dr. Name
Dr. Phone Number
Emergency Phone Number
Signature of Parent/Legal Guardian or student if 18+:

Clear
Date

MonthDayYear
Date
ASBESTOS HAZARD EMERGENCY RESPONSE ACT (AHERA)

To all students, parents, faculty and staff of Edge High School: Edge High School is required to comply with the Asbestos Hazard Emergency Response Act (AHERA).The asbestos management plan detailing all required activities is available for review in the Edge High School main office, located at 2555 E. First Street, and at Edge High School Northwest office, 231 W. Giaconda Way, #113.
If you have any questions concerning asbestos-containing materials at Edge High School, you are encouraged to review the management plan or contact the designated person for asbestos matters. The designated person for asbestos matters is Anne Ortiz (Business Associate), at Edge High School, 2555 E. First Street, Tucson, AZ 85716. Phone (520) 881-1389
I have read the above information regarding AHERA:*

Clear
Signature of Parent/Legal Guardian or student if 18+
Date*

MonthDayYear
Date

Arizona Department of Education

Office of English Language Acquisition Services
Home Language Survey

The responses to this Home Language Survey (HLS) are used by the school to provide the most appropriate instructional programs and services for the student. The answers below will determine if a student will take the Arizona English Language Learner Assessment (AZELLA). Please respond to each of the three questions as accurately as possible. If you need to correct any of your responses, this must be done before the student takes the AZELLA Placement Test.
1. What language do people speak in the home most of the time?*
2. What language does the student speak most of the time?*
3. What language did the student first speak or understand?*
Student Full Name*
Date of Birth*

MonthDayYear
Date
SSID - for office use only
Parent/Guardian Signature*

Clear
Date

MonthDayYear
Date
District or Charter: The Edge School Inc.*

Edge High School Himmel ParkEdge High School Northwest

PERMISSION

GIFTED TESTING
One time per semester, Edge offers gifted testing to interested students. As a parent/guardian, please indicate if you Give or Do Not give permission, for your student to take the gifted tests.
Check one box:

Yes, I give permission for my child to take the gifted tests.No, I do not give permission for my child to take the gifted tests..
Signature of Parent/Legal Guardian or student if 18+*

Clear
Date:*

MonthDayYear
Date
Permission to take part in Life Skills Workshops

Dear Parent or Guardian: Edge provides students with a Life Skills component in addition to our academic skills programs. Our Life Skills component covers topics such as Goal Setting, Decision Making,Taking Responsibility, Healthy Relationships, and Harm Reduction Strategies. In addition to class activities, we also invite speakers from the community to come in and address issues facing our teens today. Some speakers discuss family planning, pregnancy prevention, and how to avoid sexually transmitted diseases. Speakers from non-profit organizations such as the Southern Arizona AIDS Foundation and Arizona Youth Partnerships may bring in condoms and make them accessible to students. If workshops of this nature are NOT something you want your child to participate in, please CHECK THE APPROPRIATE BOX BELOW and we will make sure that s/he is not included in these activities.
Edge requires students to take responsibility for themselves, but also encourages parental involvement. If you ever have any questions or concerns, please feel free to contact the Principal at your child’s site. For the Himmel Park site, you may contact me, at 881-1389. For the Northwest site, you may contact Dave Thatcher, at 877-9179.
Sincerely, Rob Pecharich - Edge High School Principal
Check one box:

My son/daughter MAY take part in all programsMy son/daughter MAY NOT take part in the programs underlined above.
LIABILITY RELEASE

"I understand that Physical Education (PE) and/or Student Service Learning (SSL) activities may take place at a variety of sites in the community as well as on the school campus. Students are responsible for their own transportation and liability in commuting to and from activities. The school will provide public bus passes as needed. I agree to indemnify and save Edge School, Inc., and its staff and volunteers should any accident happen to my child/me while involved in these activities. Should an accident occur, I give permission for my child/me to be transported to the nearest medical facility.”
Signature of Parent/Legal Guardian or student if 18+*

Clear
Date:*

MonthDayYear
Date

Student Full Name*
Student Signature*

Clear
Phone Number
Email
example@example.com
Date

MonthDayYear
Date
Print name of Parent/Legal Guardian (Required if student is under 18):*
Signature of Parent/Legal Guardian (Required if student is under 18):

Clear
Phone Number
Email
example@example.com
Date

MonthDayYear
Date
Community Partner Signature: ________________________________ Date: _________________ Edge Staff Signature: _________________________________________ Date: _________________

I have read and understand the COMPACT AND CONTRACT.

An Edge High School Student Handbook is available for the current school year, on our school website (www.edgehighschool.org), or upon request in the administrative office.

I understand that it is my responsibility to read the handbook and become familiar with the policies, procedures, and attendance policy, stated in the Edge Handbook.

The student named below agrees to abide by them while attending Edge High School.

I understand that if the student does not follow the policies and procedures, it may be grounds for dismissal from the school.
Student Full Name
Student Signature (required)*

Clear
Phone Number
Email
example@example.com
Date

MonthDayYear
Date
Print name of Parent/Legal Guardian (Required if student is under 18):
Signature of Parent/Legal Guardian (Required if student is under 18):

Clear
Phone Number
Email
example@example.com
Date

MonthDayYear
Date
Edge Staff Signature: _____________________________ Date: ____________
Should be Empty:

Success for every student, every day

Need help? Call us or come in!
520-881-1389
Be You. With Us. At Edge!

STUDENT MILITARY IDENTIFIER

RACE AND ETHNICITY DATA COLLECTION

HOME LANGUAGE SURVEY

MCKINNEY-VENTO ELIGIBILITY

EMERGENCY CONTACT/MEDICAL

PERMISSION TO DISPENSE MEDICATION

FIELD TRIP PERMISSION

ASBESTOS HAZARD EMERGENCY RESPONSE ACT (AHERA)

Education

LIST PREVIOUS SCHOOLS ATTENDED PRIOR TO EDGE. START WITH MOST RECENT SCHOOL.

Arizona Department of Education

State of Arizona

DO NOT

Arizona Department of Education

Home Language Survey

PERMISSION

Permission to take part in Life Skills Workshops

LIABILITY RELEASE

Guidelines to Determine Eligible Students

	Child's Name	School	Grade
1
2
3
4

	Nombre Del Estudiante	Grado Escolar	Edad
1
2
3
4

Success for every student, every day

Need help? Call us or come in! 520-881-1389 Be You. With Us. At Edge!

STUDENT MILITARY IDENTIFIER

RACE AND ETHNICITY DATA COLLECTION

HOME LANGUAGE SURVEY

MCKINNEY-VENTO ELIGIBILITY

EMERGENCY CONTACT/MEDICAL

PERMISSION TO DISPENSE MEDICATION

FIELD TRIP PERMISSION

ASBESTOS HAZARD EMERGENCY RESPONSE ACT (AHERA)

Education

LIST PREVIOUS SCHOOLS ATTENDED PRIOR TO EDGE. START WITH MOST RECENT SCHOOL.

Arizona Department of Education

State of Arizona

DO NOT

Arizona Department of Education

Home Language Survey

PERMISSION

Permission to take part in Life Skills Workshops

LIABILITY RELEASE

Guidelines to Determine Eligible Students

Need help? Call us or come in!
520-881-1389
Be You. With Us. At Edge!