• EMERGENCY INFORMATION CARD

  • Student Information

  • Ethnicity: Is the student of Hispanic, Latino or Spanish origin?*
  • Race (Check appropriate race(s).*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Parent/Guardian Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Parent/Guardian Information

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Additional individuals who will care for child in case a parent/guardian cannot be reached: These individuals may sign my child out (Photo ID required)

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • It is the Parent/Guardian’s responsibility to keep the school updated with new information and contact numbers.

  • Parent Bill of Rights
    Athenian Academy of Technology and the Arts provides various health services screenings. This means that your child will receive vision, hearing, scoliosis, and blood pressure screening at certain grade levels. In addition, there is a health unit in 6th, 7th, and 8th grade science on health issues such as abstinence, substance abuse prevention, dating and relationship issues, birth control, and sexually transmitted diseases at certain grade levels. If you object to any of these health screenings or programs, you must notify the school in writing by completing the opt-out form on our website. Please refer to our Parent Bill of Rights form on our website for additional information about services and opting out: https://www.aaota.org/wp-content/uploads/2023/05/Parents-Bill-of-Rights.pdf.

    In case of an accident or serious illness, you will be contacted by the school. If the school is unable to reach you, you authorize the school to contact the physician or dentist indicated below and to follow his/her instructions. If it is impossible to contact this physician or dentist, the school will take whatever actions are necessary to provide care and treatment for your child, and exchange medical information with the provider as necessary to support the continuity of care for your child. You agree to pay all expenses incurred by handling any emergency care. In case of an accident or illness where immediate treatment of your child is not indicated, but where he/she is unable to remain at school, you request that one of the person(s) listed above be contacted and requested to care for my child until you can be reached.

  • Does your child’s health problem(s) impact his/her learning ability?

  • If my child is covered by Medicaid and receives health services under IEP/TIEP, I consent for the school to bill Medicaid for those services.

  • Current Medicaid Card?

  • Parent/Guardian (Signature)

  • Date*
     / /

  • Family Handbook Agreement

  • I acknowledge that I have read the Athenian Academy of Technology and the Arts Family Handbook, which is located on the school’s website at www.aaota.org and agree to comply with the policies set forth in this handbook.

  • Family Service Hours Agreement

  • I acknowledge that by enrolling my child at Athenian Academy of Technology and the Arts, I am required to complete a minimum of twenty (20) service hours per year. I understand that failure to complete the required service hours will forfeit my child’s placement at Athenian Academy of Technology and the Arts for the following school year.

  • Attendance Policy Agreement

  •  

    I acknowledge that by enrolling my child at Athenian Academy of Technology and the Arts, my child may not have 18 or more unexcused absences during the school year. I understand that failure to comply with the attendance policy will forfeit my child’s placement at Athenian Academy of Technology and the Arts for the following school year.

  • Technology Policy Agreement

  • I acknowledge that by enrolling my child at Athenian Academy of Technology and the Arts, my child must comply with Athenian Academy’s Family Handbook Policies addressing the use of the school's network and chromebooks, student discipline, harassment/bullying, and acceptable use of electronic network/technology and their associated administrative procedures and regulations. A violation of any of these policies could result in loss of network privileges, loss of right to utilize the device, and/or appropriate discipline, up to and including suspension and expulsion. In addition, I understand that if my child damages his/her Chromebook, our family is responsible for the cost of repairing or replacing the device.

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