BPS Enrollment Registration Form

By completing the registration forms you are accepting the scholars offer of enrollment. These registration questions will help us design your Scholar's education so that he or she will get the most out of school. Your Scholar may qualify for additional services and support. It should take 15-20 minutes to complete these questions and if you need help, you can contact the Office of Student Enrollment (contact information at the bottom of each page).

 

Field Trip Permission Form

These permission forms will be in effect for student's entire academic career at Breakthrough Schools, or if the parent revokes agreement in writing.

I hereby state that I am the parent or legal guardian of a Scholar enrolling (hereafter "my child"), and that in consideration of the agreement by the school to permit my child to participate in any and all school-sponsored field trips, do state that:

I am aware of the nature of field trips and understand there are risks/dangers attendant to my child's participation in such trips; I understand that participation by my child in field trips is voluntary and is an entirely optional school activity; I permit my child to participate in any and all such field trips unless I advise the school in writing beforehand that I revoke my permission for a particular trip or trips; I warrant that there is accident and health insurance coverage for my child that will cover him or her while participating in field trips.

I agree to release, indemnify, protect and hold harmless Breakthrough Schools its teachers, administrators, directors, supervisors, agents, employees, and all private persons or organizations, volunteering services without charge to supervise or chaperone my child while on field trips, from any claim or liability whatsoever, including but not limited to personal injury or loss of any kind and/or property damage, court cost, attorney fees and interest, as a result of my child's participation in the field trips. I do not, however, agree to such release in the case of gross negligence or intentional inappropriate actions or actions intended to do harm.

I agree that Breakthrough Schools, its teachers, administrators, agents, and/or employees may terminate my child's participation in the field trips for my child's failure to behave and act in accordance with the school's rules and/or regulations on conduct, failure to follow the instructions and directions of supervisors and/or chaperones or conduct deemed to be detrimental to or incompatible with the interest, comfort or welfare of those participating in the field trips.

Media Release Form

These permission forms will be in effect for the student's entire academic career at Breakthrough Schools or until the parent revokes the agreement in writing.

From time to time, Breakthrough Schools would like to utilize photographs or videos of school activities that include students to publicize and describe our school. This may include publishing on the school website or other educational websites.

I consent that photographs or video clips of my child, be taken for use in school publications or publicity materials. I am aware that the pictures or videos may be published or reproduced and shared with outside media (including newspapers) and organizations (including private foundations) to document and publicize life at Breakthrough Schools.

Scholar Future Records Release

We follow the progress of our Scholars from now until graduation and through high school, to improve our educational programs and to stay in contact about opportunities such as mentors and scholarships. Please authorize the sharing of records from your Scholar's future high school.

I authorize my Scholar's future high school to release academic and behavior information, including student attendance history, class standing, enrolled credits, semester and cumulative grade point average, to Breakthrough Schools. This release of information is confidential and will continue to be effective unless and until I void this permit in writing.

Home Language Survey

A completed language usage survey is required for all students upon enrollment in Ohio schools. This information will help school staff to determine if your student would benefit from additional support with language development. Answers to these question ensure your child receives the free and integrated education services necessary to succeed in school. The information is NOT used to identify immigration status.

Special Education Services

An IEP is an 'Individualized Education Program.' If your Scholar has an IEP, we want to make sure that he or she continues to receive services. If your scholar has an IEP please upload your Scholar's most recent IEP. Your Scholar cannot receive special services until the school has the IEP.

A 504 plan is put in place for students who do NOT need the support of special education with individualized instruction, but do need support with very specific issues that impact their school performance. An ETR ("Evaluation Team Report" or psychological testing) would have shown that the student did not require special education, but a 504 Plan might be developed to address medical concerns listed in the ETR.

Homeless Services

The McKinney-Vento Homeless Children and Youth Program aims to ensure that all children and youth, including preschoolers, have equal access to the same free and appropriate public education as non-homeless children and youth.