• Atlas Academy Re-Enrollment Packet

  • By requesting enrollment at Atlas Academy you are agreeing to the following commitments.

    Atlas Academy commits to: 

    • Treating students and families with dignity and respect at all times striving to provide the highest level of support.
    • Frequently communicating with families through newsletters, daily behavior summaries, phone calls, calendar invites, and posts on Quickschools. 
    • Setting individualized student goals for both behaviors and academics and making progress towards those goals.
    • Providing high quality education to all students in a safe environment.

    Atlas Families commit to:

    • Treating school staff and students with respect and value at all times
    • Participate in person for monthly family training with the school to grow our culture and ability to support each other. 
    • Attend quarterly progress monitoring meetings with the school to review student’s academic and behavioral goals and progress. 
    • Ensure our child attends school at least 85% of the scheduled school days in the year due to the fact that inconsistent attendance is related to reduced math and reading achievement outcomes, reduced educational engagement, and reduced social engagement.
  • Atlas Academy Documents Listing

  • A list of documents that is needed for enrollment:

    • Scholarship Information.
    • Updated Shot Record is required for 7th graders prior to first day of school.
    • Updated School Entry Exam (School Physical) is required for all students prior to the first day of school.

    Please upload these items below.

     

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  • Atlas Academy Emergency Information Form

  • Date of Birth*
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • It is the guardian’s responsibility to notify the school of any special custody arrangements (in writing), and any changes to the information contained on this form. Custody paperwork must be on file with the school.

    Persons other than a guardian who may check student out of school or who will care for the student in case guardians cannot be reached. ONLY guardians and these individuals may check student out of school.

  • Date*
     - -
  • Atlas Academy Request for Services

  • If you answered yes to the above question please identify what services you are interested in:
  • Date*
     - -
  • Atlas Academy Physical Restraint Information Form

  • In order for your student to attend Atlas Academy, your permission for the use of physical restraints is required. Positive Crisis Management (PCM) has provided training to all our staff to ensure the safe use of approved physical restraints in case of emergency. If your student is a danger to themselves or others while engaging in maladaptive behaviors, physical restraints may be used when less restrictive methods prove to be ineffective. Three staff members will implement the use of restraint at all times to ensure safe implementation. If your student elopes from the building, authorities will be contacted. Your signature validates that the benefits and potential risks have been explained to and discussed with you.

    The following is a brief description of the restraints that may be used if necessary:

    • Physical Restraint- Direct physical contact that prevents or significantly restricts a student’s freedom of movement. Physical restraint does not include: brief physical contact to promote student safety, providing physical guidance or prompting when teaching a skill, redirecting attention, providing comfort, or a physical escort. Physical restraint is allowed as an emergency procedure of last resort.
    • Prone restraint- shall mean a physical restraint in which a student is placed face down on the floor or another surface, and physical pressure is applied to the student’s body to keep the student in the facedown position. Prone restraint shall be prohibited in public education programs except on an individual student basis, and only under the following circumstances:
    • The student has a documented history of repeatedly causing serious self-injuries and/or injuries to other students or staff;
    • All other forms of physical restraints have failed to ensure the safety of the student and/or the safety of others;
    • There are no medical contraindications as documented by a licensed physician;
    • There is psychological or behavioral justification for the use of prone restraint and there are no psychological or behavioral contraindications, as documented by a licensed mental health professional
    • Physical escort - a temporary touching or holding, without the use of force, of the hand, wrist, arm, shoulder, or back for the purpose of inducing a student who is agitated to walk to a safe location. This is not considered a restraint. However, if the escort is performed against the active resistance of the student to go with the staff person, consider the procedure a restraint and document its occurrence as such.
    • Time-out- a behavioral support strategy in which a student temporarily separates from the learning activity or the classroom, either by choice or by direction from staff, for the purpose of calming his or herself.
    • Seclusion- the involuntary confinement of a student alone in a room or area from which the student is physically prevented from leaving. Seclusion does not include a time-out.

     The associated benefits with the use of physical restraints include the following:

    •      Prevention of injury to self
    •      Prevention of injury to others

     The associated potential risks with performing physical restraints may include the following:

    • Accidental injury or death resulting from physical restraints (<1% of occurrences)
    • Temporary loss of balance
    • Temporary loss of mobility
    • Increased agitation
  • STATEMENT OF CONSENT

    I do consent to the use of physical restraints approved by PCM following the review of benefits and risks as well as criteria for the use of restraint. The appropriate behavior management professionals have assessed the need for restraints based on the criteria above. I agree with the use of physical restraints and holds if my student meets the above criteria

  • ACKNOWLEDGEMENT

    I have been informed of the risks and benefits of restraint use (as listed above) and hereby assume full liability for any adverse outcomes related to my decision. I have been given the opportunity to ask and receive answers to my questions.

    I understand that I may revoke permission to use restraints and as a result  my student will be withdrawn from Atas Academy.

  • Date*
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  • Atlas Academy Authorization to Administer

    NON-PRESCRIPTION MEDICATION TO STUDENTS BY SCHOOL PERSONNEL
  • Only authorized school personnel can administer non-prescription medication at school for a limited time with the parent’s written consent.

    GUARDIAN’S AUTHORIZATION:

  •  

    Over-the-counter medication can be administered by Atlas Academy staff. Parents/guardians must bring a new, unopened bottle of the medication to the clinic and complete and sign a consent form. No expired medication will be accepted.

    Prescription medication will be administered by Atlas Academy staff at designated times. All prescribed medication must be brought to school by a parent/guardian and be accompanied by the proper documentation from the prescribing physician and the parent/guardian. All prescription medications must be in the original container and labeled with the student’s name, medication name, dose and instruction, and expiration date. All paperwork for medications will need to be updated once a year. All medications are to be picked up by the parent/guardian on the final day of the school year. Any remaining medication will be destroyed following approved procedures.


    COVID-19 INFORMATION

    Atlas Academy promotes a safe, supportive learning environment based on the educational, social, mental health, and well-being of our students.

    If your student has a fever, virus, or any other contagious disease such as conjunctivitis, influenza, gastrointestinal infections, etc, we ask that you keep them home. Staying home can lower the risk of spreading infectious diseases.

     

    This CDC guidance (Updated Aug. 11, 2022) is meant to supplement—not replace—any federal, state, local, territorial, or tribal health and safety laws, rules, and regulations.

     

    If you have COVID-19, you can spread the virus to others. There are precautions you can take to prevent spreading it to others: isolation, masking, and avoiding contact with people who are at high risk of getting very sick. Isolation is used to separate people with confirmed or suspected COVID-19 from those without COVID-19.

     

    If you test positive for COVID-19, stay home for at least 5 days. You may end isolation after day 5 if you never had symptoms. If you did have symptoms, you may end isolation after day 5 if: you are fever-free for 24 hours (without the use of fever-reducing medication) and your symptoms are improving.

     

    When you have COVID-19, isolation is counted in days, as follows: if you had symptoms, day 1 is the first full day after the day your symptoms started OR if you had no symptoms, day 1 is the first full day following the day you were tested.

  • I have requested the following to be administered as needed by manufacturers. Check here for each medicine approved:
  • PARENT / GUARDIAN PERMISSION

    I hereby request that my child be given the above medication while in school and away from school for school activities. I understand that law provides that there shall be no liability for civil damages as a result of the administration of such medication where the person administering such medication acts as an ordinary reasonable prudent person should have acted under the same or similar circumstances.

  • ILLNESS AND INJURY

    Families are called under any of the following conditions:

     

    ➢     Fever Over 100.4 Degrees

    ➢     Vomiting

    ➢     Diarrhea

    ➢     Loss of Consciousness (Fainting, Head Injury)

    ➢     Possible Communicable Diseases

    ➢     Any Undiagnosed Skin Rash

    ➢     Major Injury

     

    All students who become ill at school with the above symptoms will be sent home . Students should be picked up within 60 minutes of receiving a call from Atlas Academy.

     

    Any student being sent home with a fever of 100.4 or above or vomiting will be required to remain out of school for 24 hours.

     

    Any student sent home with lice/nits cannot return to school until checked and cleared by Atlas Academy staff.


    MEDICATION

    Students are prohibited from carrying any medication to school, from school, or during school. This policy includes cough drops, eye drops, lozenges, and non-prescription and prescription medications. If a student needs to have medication during school hours, a parent/guardian will need to bring the medication to the school and complete the appropriate paperwork. Medication brought to school by a student cannot be returned to the student to take home. Unauthorized medication will be taken and either disposed of or need to be picked up by the parent/guardian. Each medication must be in its original container and must match the doctor’s order exactly.

     

    Epi-Pens, prescription inhalers, diabetic medications and supplies, and pancreatic enzymes may be carried by the student with a written authorization by the parent and physician. The parent/guardian must complete appropriate paperwork with the school in advance of the student carrying these items.

     

    Any changes in medication must be made in writing and delivered to the school. This includes any over-the-counter medications such as Tylenol, cough drops, antacids, etc. All medications are to be picked up by the parent/guardian on the final day of the school year. Any remaining medication will be destroyed following approved procedures.


    FIRST AID

    Atlas Academy is able to provide minimal first aid treatment with your permission. No student will be given any medication without a physician's order.

     

    The following non-prescription first aid treatments have been approved for use with guardian permission:

     

    ●       Minor wound care (cuts, scrapes, and abrasions)

    ○       vaseline, alcohol, triple antibiotic ointment, bacitracin

    ●       Minor eye irritation

    ○       sterile eye wash

    ●       Minor bites and stings

    ○       sting relief pad, calamine lotion, 1% hydrocortisone cream

    ●       Minor upset stomach and indigestion

    ○       water or ginger ale

     

     

  • Date*
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  • Atlas Academy School Photos and Videos Permission

  • It is a goal of ours to photograph and/or video some of our weekly activities for sharing and uploading.  This will allow families to see inside our school and classrooms to learn about our progress through the year.  This also allows our students to go beyond the walls of the classroom for learning and fun!

  • Atlas Academy Movie Permissions

  • Throughout the year, we may see fit to show a movie for either entertainment or educational purposes. This permission slip waives any objections you may have to your student watching G, PG, or PG-13 related material. If you choose not to sign this permission slip and would like to approve the movies on a case-by-case basis, please let us know.

  • Atlas Academy Lunch and Snacks Policy

  • Parents are responsible for providing meals (breakfast, lunch, and snack) for the student. They will be permitted to eat the breakfast provided from home between 8:30am - 9:00am, up to two snacks, and lunch. In the event that snacks, treats, or lunches are provided, please be sure to list all food allergies on the Emergency Contact Form.

  • With my signature I:*
  • Date*
     - -
  • Atlas Academy Student Technology Acceptable Use Agreement

  • Atlas Academy authorizes students to use technology owned or otherwise provided by the school as necessary for instructional purposes. The use of technology is a privilege and is subject to the conditions and restrictions set forth in this Acceptable Use Agreement. Atlas Academy reserves the right to suspend access at any time, without notice, for any reason. Atlas Academy expects all students to use technology responsibly in order to avoid potential problems and liability. Atlas Academy may place reasonable restrictions on the sites, material, and/or information that students may access through the system. Each student who is authorized to use Atlas technology and his/her parent/guardian shall sign this Acceptable Use Agreement as an indication that they have read and understand the agreement.

     

    Students are expected to use Atlas Academy technology safely, responsibly, and for educational purposes only. The student in whose name technology is issued is responsible for its proper use at all times. Students shall not share their assigned online services account information, passwords, or other information used for identification and authorization purposes, and shall use the system only under the account to which they have been assigned.

     

    When using Atlas Academy technology I agree to:

     

    1. I understand that district technology is to be used for educational purposes only. 

    2. I will treat all technology (computers, iPods, Chromebooks, etc.) with care and make sure they do not become damaged. 

    3.I will not change or tamper with any of the school equipment or systems. This can include settings, software, downloads, hardware, etc. 

    4. I will only represent myself in the digital world, and I will only use my account. 

    5. I will only work on the programs and websites that are appropriate and beneficial for the school setting. 

    6. I will keep passwords private only to myself, my parents, and teachers. 

    7. I will use my online accounts (i.e., Google, Edgenuity, etc.) and all other Atlas Academy equipment for schoolwork only. Atlas can and may review any material developed, viewed, or shared. 

    8. I will be respectful to my teacher(s) and peers by making eye-contact and putting the device down/away when being requested. 

    9.. I will regularly use the digital communication tools that my teacher(s) specify. 

    10. I will use respectful language in my communications in all areas: verbal, blogs, online documents, websites, videos, emails, etc

    11. I will keep myself and my family and friends safe by only publishing non-identifiable information about myself or others and not posting items such as full names, phone numbers, pictures, addresses, itineraries, events, etc.

    12. I will only send, store, or access appropriate and legal materials.

    13. I will write essays, reports, etc. with my original thoughts and I will properly cite any information I receive from other sources including images, videos, and other multimedia as per Fair Use and Copyright laws. 

    14.I will report any misuse of technology to an adult. 

    15.I will treat all others with respect in the online and digital environment. 

    16.I will ask for help immediately when needed or something goes wrong with technology. 

    1.I will follow my classroom’s technology procedures.

     

    Repair and Replacement

    ●       For each incident, student may also receive disciplinary action

    ●       1st incident – warning

    ●        2nd incident - $25

    ●       3rd+ incident - $50

     

    Student Acknowledgment 

    I have received, read, understand, and agree to abide by this Acceptable Use Agreement and other applicable policies and regulations governing the use of Atlas Academy technology. I understand that there is no expectation of privacy when using Atlas Academy technology. I further understand that any violation may result in loss of user privileges and/or disciplinary action.

  • Date*
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