Kids Care Elementary

Kids Care Elementary
Enrolling K - 6th!
25-26 Enrollment Application & Registration
Kids Care Elementary School is a community school established under Chapter 3314. of the Revised Code. The school is a public school and students enrolled in and attending the school are required to take proficiency tests and other examinations prescribed by law. In addition, there may be other requirements for students at the school that are prescribed by law. Students who are exempt from the compulsory attendance law for the purpose of home education pursuant to section 3321.042 of the Revised Code shall no longer be exempt for that purpose upon their enrollment in a community school. For more information about this matter contact the school administration or the Ohio Department of Education and Workforce." Last updated August 21, 2023 at 2:09 PM

Ready to enroll at Kids Care Elementary (KCE)? Please complete the form below to begin your application process.

We are excited about your interest in enrolling at KCE! You can contact the KCE Office regarding enrollment by calling (614) 498-0220 or fill out the enrollment form below.

New Student Enrollment Application
In order to complete your scholar’s enrollment at Kids Care Elementary, please provide all necessary information. In addition, in order to secure your scholar’s seat we also require that you submit all of the following enrollment paperwork to our main office:
- Birth Certification
- Proof of Residency (i.e. current utility bill, official agency or government mail, copy of lease)
- Residence Status Form
- Release of Records Form
- Current immunization records
- Individual Education Plan (IEP) or 504 Plan (if applicable)
- Copy of Parent/Guardian License or state issued ID
- Child Custody Documentation (if applicable)
- Emergency Contact Information Form - This form must be completed for each child, regardless of
  how many students you have applying to Kids Care Elementary.
- Student Evaluation Form - This form must be completed separately for each child you have applying to Kids Care Elementary.
- Emergency Medical Authorization Form
- Health Examination Record – Medical History
- Household Survey Form
- Field Trip / Activities Notice & Authorization
- Field Trip Permission Slip
- School Transportation Means
Note: Incomplete information could delay the processing of your child’s application. Please inform us if there is a specific reason that you are unable to provide any of the required documents.

Enrollment Process:
Step 1 - Parent completes enrollment application and returns it to Kids Care Elementary, or submits the application online.
Step 2 – Application is processed by Kids Care.
Step 3 – Parent is notified of registration of scholar to Kids Care.

A member of our team will reach out to you upon receipt of the application and provide you with information regarding the next steps.

Un miembro de nuestro equipo se comunicará con usted al recibir la solicitud y le brindará información sobre los próximos pasos.

*Completing this application does not guarantee your scholar a spot in our upcoming cohort. You will receive notification from one of our staff members when your child has been assigned.

If unable to upload your student's documentation please feel free to fax or drop off the documentation to the school.

Fax: 614.498.0221
Phone: 614.498.0220
Email: iramos@administration.kidscareelementary.org
Address: 3400 Kohr Blvd (Door 9)
Columbus, OH 43224
For Questions, please contact Student Enrollment Coordinator Iris Ramos at 614.216.3761 iramos@administration.kidscareelementary.org

Kids Care Elementary is a tuition free, public community (charter) school. We provide education to students in grades K−5th. Proof of Residency is required at enrollment for all students. The proof of residency submitted will confirm your students' District of Residency. Please note: Our district does random monthly residence verifications throughout the school year.

Admission to Kids Care Elementary is open to any individual ages 5−22 entitled to attend school pursuant to 3313.64 or 3313.65 of the ORC in a school district in the state.

Admission to Kids Care Elementary is limited to students in the grade levels of Kindergarten − Fifth Grade. Enrollment is available to students who reside in the Columbus City Schools district as well as surrounding districts in Central Ohio.

There will be no discrimination in the admission of students on the basis of race, creed, color, disability, or sex. Upon admission of any student with a disability, Kids Care Elementary will comply with all federal and state laws regarding the education of students with disabilities. Kids Care Elementary will not limit admission to students on the basis of intellectual ability, measures of achievement or aptitude, or athletic ability, except as outlined herein.

New entrants at all grade levels are required to present at the time of enrollment a birth certificate or other document as evidence of birth, a certified copy of any child custody order or decree, proof of having received or being in the process of receiving required immunizations and copies of those records pertaining to him/her which are maintained by the school most recently attended.

Grade Levels for student's will be determined by proof of the successful completion of the prior grade level via the students last report card or verification from the prior school directly.

Early Admission
Each child who is five years of age on or before September 30 shall be eligible to enroll in kindergarten. Each child who has successfully completed kindergarten shall be eligible to enroll in the first grade. If a child who does not meet the minimum age requirements, but who will be age 5 , by October 15th in the school year for which admission is requested, they may be admitted after the following:

-A parent or guardian, an educator employed by Kids Care Elementary, a preschool educator who knows the child, or a
pediatrician or child school psychologist that knows the child has referred the child for early admittance to Main Prep.
-Main Preparatory Academy will evaluate the child for early admittance using diagnostic assessments. After the child has been
evaluated, the Kids Care Elementary administrative team will make a decision to accept the child for early admission.

Assessment Information
Kids Care Elementary will collect student performance data by using Formative assessments, NWEA −MAP. Students will be assessed in reading and math three times a year. The Ohio state reading tests for 3rd grade will be offered twice a year. Grades 3 −5 will be assessed in math once a year. Classroom Tools including: exit slips, brief quizzes, and class projects are other ways we will gather information on students' academic status. Data from observations can also lead to adjusting pacing for the whole class or scaffolding for those students who are still struggling. Summative assessments, such as literary analysis essays or end−of−unit science exams, allow us to measure the growth of individual and whole−group learning.

Parents Obligation to see that Child Receives Instruction
Every child of compulsory school age shall attend a school or participate in a special education program that conforms to the minimum standards prescribed by the state board of education until the child:
1. Receives a diploma granted by the board of education or other governing authority, successfully completes the curriculum of any high school, or successfully completes the individualized education program developed for the student by any high school pursuant to Chapter 3323. of the Revised Code;
2. Receives an age and schooling certificate as provided in section 3331.01 of the Revised Code; or
3. Is excused from school under standards adopted by the state board of education pursuant to section 3321.04 of the Revised Code, or if in need of special education, the child is excused from such programs pursuant to section 3321.04 of the Revised Code.
Attendance
All students are expected to be on time, and in attendance daily. A student's absence will be considered excused for the following reasons: Student Illness, Family Illness, Doctor's Appointment, Dental Appointment, Death in the Family, Prior Approved Family Vacation. Please send in documentation with your student for all absences.
SCHOLAR INFORMATION
Name*

First NameMiddle NameLast Name
MaleFemale
Date of birth*

MonthDayYear
Scholar Enrollment Grade
Previous School
YesNo
This form is to be filled out by the student's parents or guardians, and both questions MUST be answered. Part A asks about the student's ethnicity and Part B asks about the student's race.

Part A - Ethnicity
Is the student Hispanic / Latino?required
A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

Part B - Race
- IAmerican Indian or Alaskan Native: A person having origins in any of the original peoples of North and South America including Central America, and who maintains a tribal affiliation or a community attachment.
- Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.
- Black or African American: A person having origins in any of the black racial groups in Africa.
- Native Hawaiian or other Pacific Islander: A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands.
- White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
Please select Race*
YesNo
YesNo
Home Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Home Language
SPECIAL EDUCATION

If your child receives special education services, documentation of the current plan is required prior to enrollment.
YesNo
YesNo
IEPSpeech/LanguageSocial WorkNA
MILITARY FAMILIES
YesNo
MIGRANT STUDENTS
YesNo
STUDENT NIGHT TIME RESIDENCE
Temporarily sharing a house with friends or family due to the loss of housing, economic hardship, or similar reason.In a motel, hotel, or campground due to a lack of alternative accommodations.In an emergency or transitional shelter or hospital.In Foster Care.Unaccompanied youth and/or runaway.In a living arrangement not described above that is not fixed, regular and adequate.None of the above
HOME LANGUAGE SURVEY

Jalen Rose Leadership Academy is collecting information regarding the language background of each of its students. This information will be used by the district to determine the number of children who should be provided bilingual instruction according to Sections 380.1151 – 380.1158 of the School Code of 1976, Michigan’s Bilingual Education Law. Would you please help by providing the following information?
YesNo
YesNo
YesNo
PARENT/GUARDIAN Information
YesNo
Preferred language*
Your Relationship to Scholar
Highest Level of Education
EMERGENCY CONTACT
Title
Emergency Contact First Name*
Emergency Contact Last Name*
Emergency Contact Suffix
MaleFemale
YesNo
YesNo
YesNo
YesNo
PARENT CONTACT 1
Mobile Phone*
Please enter a valid phone number.Format: (000) 000-0000.
YesNo
Enrolling Parent email*
example@example.com
PARENT CONTACT 2
Parent Contact 2 First Name
Parent Contact 2 Last Name
Parent Contact 2 Mobile
Please enter a valid phone number.Format: (000) 000-0000.
YesNo
Parent Contact 2 Email
example@example.com
SIBLINGS
YesNo
Sibling First and Last Name
Sibling Grade
Sibling School Attending
Sibling Date of Birth

MonthDayYear
Date
YesNo
HOUSEHOLD INFORMATION
Benefits Recieved

You will be asked to provide the name and case number for the person who receives benefits. Bridge Card Numbers and Medicaid Numbers are NOT ACCEPTABLE case numbers.
YesNo
Name of person who receives the benefits
Case Number
Size of Family
Enter the total number of individuals living in your household, including all adults and children.*
STUDENT'S MEDICAL INFORMATION
Physician Name*
Physician's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Dentist Name*
Dentist Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Insurance
YesNo
If yes, please provide Insurance Company Name
If yes, please provide insurance Policy Number
Health History
YesNo
YesNo
Food Allergy Form
Please list all allergies:
YesNo
Please list all other medical conditions:
Medication
YesNo
YesNo
Medication Administration Form

Special Circumstances/Personal Emergencies
YesNo
Please list any special circumstances:
AGREEMENTS
Media Release

There may be times during the school year when media or others wish to photograph or videotape your son/daughter at Kids Care Academy. I hereby permit Kids Care Academy to release items concerning school activities of my son/daughter to the media. I also give my permission for my child's name, portrait, picture, or voice to be used for display or in promotion material for the school or its management company, and/or in local media coverage of school events.
YES, I do give permission to use my child's photo or likeness as described.NO, I do not give permission to use my child's photo or likeness as described.
DOCUMENTS
If unable to upload your student's documentation please feel free to fax or drop off the documentation to the school.

Fax: 614-498-0221
Phone: 614-498-0220
Email: iramos@administration.kidscareelementary.org
Address: 3400 Kohr Blvd (Door 9)
Columbus, OH 43224
For Questions, please contact Student Enrollment Coordinator Iris Ramos at iramos@administration.kidscareelementary.org
Parent/Guardian's Driver License
How would you like to submit a Copy of Parent/Guardian's Driver's License?*

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Scholar's Birth Certificate
How would you like to submit your Scholar's Birth Certificate?*

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Scholar's Immunization records
Upload Scholar's Immunization records*

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Scholar's Last Report Card or Final Transcript
Upload Scholar's Last Report Card*

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Food Allergy Form
Yes (If yes, please upload the food allergy form below)No
How would you like to submit your Scholar's Food Allergy Form?

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Administration of Medication by School Personnel
Yes (If yes, please uplaod your student's medication administration form)No
How would you like to submit your Scholar's Administration of Medication by School Personnel Form?

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Special Education Documents
Yes (If yes, please upload your student's special education form below)No
IEP/504

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Behavioral Report
Yes (if yes, please upload below)No
Please upload the behavioral report(s) from previous school.
Behavioral Report Upload

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Eligibility Determination Form for Students Experiencing Housing Instability

This form is designed to help a district homeless liaison determine whether a student is homeless as defined by the federal McKinney-Vento Act. Answers may be used to help determine if the student meets eligibility requirements for services. The district liaison may use this as an interview form and give a copy of it to the family after completing the form. Liaisons may want to keep this form as an ongoing tool to keep notes on throughout the duration of a student’s homelessness.

Eligibility Determination Form for Students Experiencing Housing Instability
Eligibility Determination Form for Students Experiencing Housing Instability

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Household Information Survey

Household Information Survey
Household Income Survey Form

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ELECTRONIC SIGNATURE
The electronic signature, and all of its related fields, replaces a handwritten signature on paper and is legally binding.

I affirm that the information provided is true, correct and complete, to the best of my knowledge and belief. This electronic signature below and its related fields are treated like a handwritten signature on a paper form.
YesNo
Electronic Signature (type name of parent/guardian)*
Electronic Signature *
Today's Date*

MonthDayYear
Date
Should be Empty:

SCHOLAR INFORMATION

SPECIAL EDUCATION

MILITARY FAMILIES

MIGRANT STUDENTS

STUDENT NIGHT TIME RESIDENCE

HOME LANGUAGE SURVEY

PARENT/GUARDIAN Information

EMERGENCY CONTACT

PARENT CONTACT 1

PARENT CONTACT 2

SIBLINGS

HOUSEHOLD INFORMATION

STUDENT'S MEDICAL INFORMATION

AGREEMENTS

DOCUMENTS

ELECTRONIC SIGNATURE