2024-2025 Family Consent Form

Family Consent Form

2024 / 2025
Parent/Guardian #1's Last Name*
Parent/Guardian #1's First Name*
Parent/Guardian #1's Relationship to the student(s)*
Parent/Guardian #2's Last Name
Parent/Guardian #2's First Name
Parent/Guardian #2's Relationship to the student(s)

Student #6 Last Name
Student #6 First Name
Student #6 Grade
Student #6 Race

American Indian/Native AlaskaAsianBlack/African/AmericanNative Hawaiian/Pac. IslanderMiddle Eastern/North AfricaHispanic/LatinoWhiteTwo or More RacesUnknown
If Parent(s)/Guardian(s) are different from the listed above, please specify their name(s) and relationship(s) to Student #6

Parent/Student Handbook

ASCS Parent/Student Handbook (found on the allsaintskenosha.org website: https://www.allsaintskenosha.org/ascs-hub/policies-procedures/#toc_Handbooks
I acknowledge that I am aware of the online copy of the All Saints Catholic School Handbook. I understand that it is my responsibility to read it with my child(ren) and to follow the rules and regulations it contains:*

YES

Hot Lunch

All families need to be informed of the changes to hot lunch for the 2024-2025 school year. The hot lunch information can be found on our website https://www.allsaintskenosha.org/ascs-hub/2024-2025-school-year/#toc_Hot_Lunch
I understand that it is my responsibility to read about the changes in the hot lunch program for the 2024-2025 school year and follow the rules and regulations:*

YES

PG Movie Permission

Parental permission is required to show PG rated movies. Teachers will notify parents beforehand the title of the movie.
Movies and videos shown during the school day will have an educational value and genuinely fit into the lesson plan. Teachers will be aware of the ratings established by the Motion Picture industry, and only show G or PG rated movies. Teachers will notify parents before any showing of PG movies. As parent/guardian I give consent for my child(ren) to watch PG movies.*

YES

Calendar

ASCS Calendar - found on our website, click the following link: https://www.allsaintskenosha.org/calendar/
I acknowledge that the calendar can be viewed on the ASCS website and calendar updates will be announced regularly in the weekly newsletters. If you don't receive weekly newsletter contact our school office.*

YES

School Directory
We will share parent names, phone numbers, emails, student names, and grade levels with ASCS families in a form of School Directory. If you wish to opt out, please send out a written signed letter to our school office. *

I acknowledge that I'll be added to the Directory. To opt out, I need to contact school office.

Student Acceptable Use Policy - Computer and Internet

I acknowledge that I am aware of the Archdiocese of Milwaukee Student Acceptable Use Policy. I understand that it is my responsibility to read it with my child(ren) and to follow the rules and regulations it contains:
Copies of this form can be found on the Archdiocese of Milwaukee website https://www.archmil.org/Resources-2.0/6161.2-a-Student-Acceptable-Use-Policy-Form-2022-12-14T085610997.htm
Acknowledgement from the students named at the beginning of this form.*

YES. I have read the rules for acceptable online behavior, understand the rules, and agree to comply with the above stated rules. Should I violate the rules, I understand that I may lose privileges at the school.
As the parent or legal guardian of the above named student(s) at the beginning of this form, I grant permission for her/him/them to use the school technology and to access the network or computer services such as e-mail, files, cloud storage, websites, and other Internet resources used for educational purposes. I understand that all students use a filtered connection to the Internet that is designed to protect them from inappropriate materials. I understand that no filter can catch 100% of these sites, but the school makes a good faith attempt in this area. I understand there could be disciplinary action if the above named student(s) do(es) not follow the guideline set for acceptable use of the school technology.*

Yes.
Read by Parent/Guardian*

YES. Clicking yes on this form indicates my intent to adopt the content of this form and communicate such information and consent electronically to my school.

Parent/Student Equipment Agreement

Student(s) in all grades use ASCS chromebooks, tablets, desktop computers and other devices for learning activities in school. The student must handle these equipment properly and respectfully. The parent/guardian will be responsible for the cost of the repair or the full replacement of damaged equipment caused by the student(s) misuse, neglect or intentional damage of this equipment.
I accept full responsibility for the payment of fees imposed by ASCS for the cost of the repair or the full replacement of the damaged equipment caused by the student(s) misuse, neglect or intentional damage of this equipment. *

Yes

Home & School Information Consent
I give my consent to share my name & email address to my child(ren)'s room parent.*

Yes

Volunteer Procedure

All our school volunteers must meet the requirements listed on the allsaintskenosha.org website. Click the following link: https://www.allsaintskenosha.org/ascs-hub/policies-procedures/#toc_Volunteering
I am aware that all volunteers must meet the requirements listed on the allsaintskenosha.org website listed above.*

Yes

Family Income Survey ESEA

This information is confidential. Some of our families may qualify for participation in Federal Elementary and Secondary Education Act (ESEA) programs designed to support academic achievement. Below are a few areas supported and our school has benefited from in the past:

 Academic interventions and assistance (Mrs. Kok - Title I)
 Professional development activities for our staff members
 Purchase of instructional materials (Chromebooks and carts; Teacher computers)
 Support for English language learners
 Safe and Drug Free Schools Programs
 Family Engagement
 During Covid - Materials to sanitize, desinfect, purify, etc

Our school facilitates participation in ESEA programs for our students in partnership with Kenosha Unified School District. In order to qualify for full funding under ESEA, we need to collect family income data. Students from a family whose income falls below U. S. Department of Agriculture (USDA) guidelines for free and reduced price meals are counted for each participating school. Both the numbers and the concentrations of students from economically disadvantaged families help to determine allocation amounts.

Collection of income data from our families will greatly facilitate our ability to respond accurately and promptly when ESEA Participation Surveys are sent each year. While such data has a profound effect on both our access to and our level of ESEA funding, it has nothing to do with the placement of individual students in ESEA programs. While we need to keep income verification statements on file in our school office, such statements will be kept confidential and used only to enable us to accurately count students from families who fall below the income guidelines found below.
Family Name (Family's Last Name(s))*
Number of members in your household*
Our household income is:*

Household of 2 members - equal or less than Monthly $3,152 or Annual $37,814Household of 3 members - equal or less than Monthly $3,912 or Annual $47,767Household of 4 members - equal or less than Monthly $4,810 or Annual $57,720Household of 5 members- equal or less than Monthly $5,640 or Annual $67,673Household of 6 members - equal or less than Monthly $6,469 or Annual $77,626Household of 7 members- equal or less than Monthly $7,299 or Annual $87,579Household of 8 members - equal or less than Monthly $8,128 or Annual $97,532Household of more than 8 members - equal or less than (add Monthly $830 or Annual $9,953 per each additional household member)Our household income is greater than the income specified in the option above for our number of members in our household

Electronic Signature of Consent Forms

You are about to submit your response. This will complete your responsibility for filling out your Parent/Student Handbook, PG Movie Permission, Calendar Notice, School Directory, Student Acceptable Computer Use Policy, Parent-Student School Equipment Agreement, Home & School Information Consent, Volunteer Procedure, and Family Income Survey ESEA. By entering my name and last name below, I attest that this constitutes my legal electronic signature on this form.

After submitting this form you will receive an email with a copy of your responses.
Enter your Last Name*
Your First Name*
Your Email*
Relationship to student(s)*
Should be Empty:

Family Consent Form

Parent/Student Handbook

Hot Lunch

PG Movie Permission

Calendar

School Directory

Student Acceptable Use Policy - Computer and Internet

Parent/Student Equipment Agreement

Home & School Information Consent

Volunteer Procedure

Family Income Survey ESEA

Electronic Signature of Consent Forms