2024-2025 Annual Forms Packet

Evergreen Community Charter School - Annual Forms Packet

For the 2024-2025 school year
Please fill out each of the following forms in this packet. One packet per student is required; if you have multiple children enrolled at Evergreen, you will need to fill out this packet for each child.

Please note, if your child is entering 2nd grade, or is new to Evergreen in any grade older than 2nd grade, your student will need to sign the Network Acceptable Use Policy page on this Forms Packet.
Student's Name*

First NameLast Name
Today's Date

MonthDayYear
Date
Duplicate check

{studentName}'s Grade for 2024-2025*
Will 2024-2025 be {studentName}'s first year at Evergreen?

YesNo
Has {studentName} ever been enrolled in a North Carolina Public School?*

YesNo
Name of Parent or Guardian filling out this form*

First NameLast Name
Parent or Guardian email*

Confirmation EmailYou'll get a confirmation at this address, as well as link to edit your responses.
2nd or older
needs AUP
needs lower lot, etc

Agreements and Authorizations

The following agreements and authorizations are required conditions of enrollment. If you have concerns about any of them, contact Kelly Stephenson in the student services office.
Emergency Medical Authorization

Should any injury occur, I grant permission for {studentName} to receive emergency medical treatment from an appropriate health care provider to be selected by the adult supervisor of the activity, when, in such supervisor's opinion, the need for such treatment is immediate, and when efforts to contact me are unsuccessful. I also agree to pay and be responsible for all medical, hospital or other expenses which Evergreen Community Charter School and/or adult supervisors may incur as a result of securing such treatment.
I agree to the terms of the Emergency Medical Authorization
Hold Harmless Agreement

I, {nameOf}, agree and hereby do release and hold harmless Evergreen Community Charter School and/or any all adult supervisors for the activity from and for all liability which may arise from damages, loss or injuries, either to person or property, which {studentName} may sustain while engaged in activities conducted on or off campus including, but not limited to, any damages, loss or injuries that may be sustained through transportation to or from the activity.
I agree to the terms of the Hold Harmless Agreement
Annual Field Trip Release for {studentName}.

Classes participate in field work both within Buncombe County and outside of Buncombe County. This permission slip is for all field trips throughout the year inside and outside of Buncombe County for the current 2024-2025 school year. You will be notified of all field trips. Field work is planned, organized, and supervised with the students' welfare first and foremost. All field trips are supervised by Evergreen Community Charter School staff.

I hereby certify my approval for my child (as named above) to attend field trips for the 2024-2025 school year. I understand that my child will be transported by another parent in a private vehicle, on a school bus, or by city bus. All students will be required to wear seat belts in a private passenger vehicle.
I agree to the terms of the Annual Field Trip Release
Confidentiality Agreement

While volunteering at Evergreen Community Charter School, you will at times be exposed to confidential information regarding students and/or staff. This information can come to you in a variety of forms, such as verbal or written information or an incident that you observe. It is imperative that such information be kept confidential for all parties involved. By signing below, you agree that you will keep confidential any such information you witness while volunteering at Evergreen Community Charter School.
I agree to the terms of the Confidentiality Agreement

Community Commitment and Handbook Preference

As we enter another school year striving to cut cost and making every effort to reduce our paper usage, we are asking parents to choose one of two options. The first option indicates that you will access the Community Handbook online, so all you need to do after reading the information is sign the signature form on Orientation Day. The second option lets us know to print a hard copy of the handbook and send it home with you on Orientation Day. You can access the following information at www.evergreenccs.org on or after July 31.

The Community Handbook provides information on the following:
· General Information (History, Staff List, Board...)
· Partnership Agreement
· Governance, Daily Operations and Problem Solving
· Arrival, Departure, and Transportation
· Attendance Policy
· Health and Safety
· Community Norms and Expectations for Student Behavior
· School Technology
· Other Important Information
· Homework, Make-up Work, and Late Work
· Assessment and Communicating Progress to Parents
· Promotion and Graduation Requirements
· Retentions
· Middle School Overnight Adventure Trip Policy
· Protocol for Respectful, Cooperative, Community Behavior
· Middle School Guidance Counseling
· Contact Information
Handbook Preference*

I will review the Community Handbook online on or after July 31, 2024.Please print a copy of the handbook for me to get at orientation.
I agree to review the Community Handbook, either in print form or online on the school website, and I understand that it may be updated on or before July 31st, 2024.
I have read, or will read, the Partnership Agreement that has been provided to me for review. It is also located in the Community Handbook. I agree to fulfill my responsibilities as described.
I will review Appendix C of the Community Handbook which outlines my rights as a parent according to state and federal law.

Parental Permission for Release of Student Likeness or Work Products

Staff at Evergreen often record student work and activities. The recording may be video, audio, or simply a scan of student work. Evergreen is also frequently in the media (newspaper and local news TV station). This documentation may be used for school publications including the web site, events, or publicity. In order to protect student rights to privacy, parents/guardians are requested to sign the following permission form.

I hereby authorize and grant staff of Evergreen Community Charter School the right to use {studentName}'s name, image, and/or work to be used in school publications and the school web site and other school-affiliated social networking sites. I also agree to allow {studentName} to be interviewed and/or photographed by representatives of external news media in relation to any coverage of Evergreen activities. I understand that by signing this I waive all compensation rights to the use of the above stated materials.
Do you agree to the terms of the likeness and work products release?*

YesNo
Okay, if we have any questions, we will contact you at {parentOr} before school starts to discuss your concerns.

Family Educational Rights and Privacy Act

The Family Educational Rights and Privacy Act (FERPA), a Federal law, requires that Evergreen Community Charter School, with certain exceptions, obtain your written consent prior to the disclosure of personally identifiable information from your child’s education records. However, Evergreen Community Charter School may disclose appropriately designated “directory information” without written consent, unless you have advised the District to the contrary in accordance with District procedures. The primary purpose of directory information is to allow Evergreen Community Charter School to include this type of information from your child’s education records in certain school publications. Examples include:

• A playbill, showing your student’s role in a drama production;

• The annual yearbook;

• Honor roll or other recognition lists;

• Graduation programs; and

• Sports activity sheets, such as for wrestling, showing weight and height of team members.

If you do not want Evergreen Community Charter School to disclose directory information from your child’s education records without your prior written consent, you must notify the District in writing before October 1, 2024.
Do you agree to allow Evergreen to disclose appropriately designated "directory information" without prior written consent?*

YesNo

Network Acceptable Use Policy and Agreement

Evergreen's Acceptable Use Policy must be agreed to by all students 2nd grade and older, and their parents.

You will need {studentName} to sign on this page!
Student Agreement (to be filled out by individual requesting network access)

I understand and will abide by Evergreen's Network Acceptable Use Policy located in the Community Handbook. I further understand that any violation of the policies in the referenced document may result in my loss of Network access privileges. I understand that Evergreen may pursue other courses of action including, but not limited to, disciplinary actions and legal recourse for any damages or expenses I may cause by my actions. This agreement is effective as long as I am enrolled at Evergreen.
{studentName}, by signing below, you agree to abide by Evergreen's Network Acceptable Use Policy:

Clear
Date

MonthDayYear
Date
Parent or Guardian Agreement (to be filled out by parent or guardian)

I have read the Network Acceptable Use Policy located in the Community Handbook and have ensured that my child understands it. I also understand that it is impossible to restrict access to only appropriate materials and deem Evergreen to be without liability and to be considered blameless for any Network content viewed by my charge whether it is considered harmful or otherwise. Furthermore, I accept full responsibility and accept any liabilities due to {studentName}'s actions with regard for his or her failure to abide by the Network Acceptable Use Policy and by my signature give permission for my charge to access Network content and resources when required as part of the school curriculum. This agreement is effective as long as {studentName} is enrolled at Evergreen. Notice that policy may change with or without notice. You can view the updated policy on our website. Please check the policy for changes at the beginning of the new school year.

(You will sign on the last page of this forms packet).

Lower lot, public transportation, and walking home permissions

Walk to the lower lot at dismissal time.

I acknowledge that this is a privilege for {studentName} and I will be responsible for any misconduct that occurs once student is off school property. If there is thunder/lightning, we will not release students. We will try to send a robo-call/text if time allows. Parents should pick-up students no later than 1:55 on Mondays and 3:35 on other days. Repeated failure to pick-up in a timely manner may mean loss of the privilege. Do not stop on Bell Road to pick up students. When walking to the lower lot after school, please remind your children of the following safety guidelines:

●         Stay in the grassy area between the swim club parking lot and the ball field parking lot.

●         Quietly socialize until they are picked up.

●         Self-monitor the behavior of the group and confront each other if their behavior is unruly or unsafe. (For example: running, going to the road, swinging on the gate or climbing on the swim club columns.)

●         Stay out of and away from the creek.

Walk home from Evergreen Community Charter School.

I acknowledge that {studentName} may be walking home in inclement weather or alone. If there is thunder/lightning, we will not release students. We will try to send a robo-call/text if time allows. When walking home from school, please remind your children of the following safety guidelines:

●         Try walking with a partner or group. Go directly from school to your home.

●         Always walk home from school using the same route.

●         Walk home using the sidewalk or walking path.

●         Check in with a parent or older sibling once you arrive home.

●         Cross at designated crosswalks. Obey all traffic signs and signals.
I grant {studentName} the following permissions, as described above:*

Walk to and pick up from the Lower LotWalk homeNone of the above

Guardian and Pick Up Permissions
Who CAN pick up your student from school?*
Who CANNOT pick up your student from school? (If this is a parent or legal guardian the school MUST have a court document on file.)
If there is no restriction, please leave this field blank!
If possible, please provide at lease one recent photograph of anyone who CANNOT pick your student up from school.

Browse Files

Cancelof
Is there any additional information we need to know about pick-up or transportation?

Community Services Survey

Please answer the following questions to help us determine if you might qualify for support through migrant education services. Thank you for providing us with this information!
Have you or any family member worked in agriculture during the last 3 years? (Examples: picking apples, tomatoes, or tobacco, working in a nursery, etc.)*

YesNo
What type of work did you do?*
Have you moved to Buncombe County within the last three years?*

YesNo
When did you move to Buncombe County?*
Within the last three years, have you moved in search of a new job or for housing reasons?*

YesNo

School Fees and Finance

Our anticipated school fees for the 2024-2025 school year are as follows:

Annual, for all students, due in August:
- Classroom supply fee - $50/student
- Insurance - $6/student
There will also be field work fees for trips taken during the school year and for end of year trips. The specific costs will be communicated by classroom teachers later this summer. Some grade levels charge a flat field work fee for trips taken during the school year and those range from $30-$40/student; others charge for each trip as they come along. Fees for end-of-year trips for students 3rd grade and older can range from $100-$500.

Additionally, the anticipated fees for before school care and the EverAfter program are as follows:

Before school - Drop Off between 7:30 and 7:55 - $5/day per child

EverAfter Registration - $45/single child, $75 multiple children (annual)

EverAfter Daily Fee (covers dismissal until 6PM) - $16.50/day day per child
Based on the anticipated amounts, do you think your family will need financial assistance to pay any of these fees in 2024-2025?*

YesNo
If you checked yes, our business manager, Beth Rankin, will contact you over the summer with information and forms. If you have questions before then you can reach her at beth.rankin@evergreenccs.org.

Ingles Tools for Schools - If you are willing, please enter your Ingles Advantage Card number. We will link it to our school and get a portion of the sale each time you shop!
I certify that all of my responses on the preceding pages of this form are made in good faith and that the information I have provided is true to best of my knowledge.
Your Name*

First NameLast Name
Date*
Name
Your signature

Clear
Should be Empty:

Evergreen Community Charter School - Annual Forms Packet