Hillcrest Elementary School Back to School Packet

School Wide Expectations

Uniform Policy

2026-2027 School Parent Compact (Agreement)
Signature
Date

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Code of Student Conduct Acknowledgement Form
Student Name

Last NameFirst NameMiddle Initial
Date of Birth

MonthDayYear
Date
School Name
Grade
Student ID Number
Parent Name

First NameLast Name
Signature
Date

MonthDayYear
Date

LAKE WALES CHARTER SCHOOLS, INC.

PHYSICAL EDUCATION PARTICIPATION/RESTRICTION FORM
Name

Last NameFirst NameMiddle Name
The following information is required regarding any physical education restrictions of your child. This will enable us to plan for the most appropriate physical activities for your child.
Physical Condition of the Student:It is recomended that a student be given a physical examination each year by his/her physician.
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____________________________________________________________________

In the event that your child is not able to take part in the regular physical education program, a form will be provided to you that must be completed by your physician.

Once the form is completed by your physican and returned to the school, your student's teacher will place it in the cumulative folder as part of his/her health record.

Student Image Form
Name

First NameLast Name
Teacher Name
Grade
PLEASE READ CAREFULLY

**Student Images will be released unless this Image Opt-Out Form is Submitted by the Parent/Guardian.**
Please place a check(s) in the boxes provided for any of the following items of which you do NOT want your child's photo/video image to be released and sign at the end of this document.
Signature

POLK COUNTY SCHOOL NUTRITION

DIET MODIFICATION FORM - 2026/2027 School Year
Please supply a Diet Modification Form to be completed by a state licensed health care professional and returned to the school.

2026-2027 Technology Agreement
***SEE THE STUDENT CODE OF CONDUCT FOR PENALTIES***

My parents and I have discussed the policy and I agree to the following:
- I will only use the computer with an adult in the room.
- I know that misuse of the computer could lead to serious consequences, including suspension or expulsion.
- I will not share any personal information such as the name, address, or phone number of my parents, classmates, teachers or anyone else over the Internet.
- I will not give my account name or password to any other student or use another student’s login.
- I understand that my parents will have to pay for anything that I break, destroy, or steal.
Parent Signature
Date

MonthDayYear
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Parent/Guardian Consent Form

At Hillcrest, your child has access to computers, the Internet and other electronic resources. It is important that you and your child read the Acceptable Computer Use rules and regulations attached. Inappropriate use will result in the loss of computer and /or Internet privileges.

As the parent/guardian of this student, I agree to accept all legal and financial obligations which may result from my son/daughter’s use of Hillcrest Elementary computers and the Internet. I also understand that I am liable for any damages incurred from theft or defacing of school property.

As the parent or guardian of this student, I have read the attached. I understand that this access is designed for educational purposes and the school has taken all available precautions to eliminate controversial materials. I will not hold the school system responsible for inappropriate materials acquired through the Internet. Further, I accept full responsibility for the actions of my child.

Please place a checkmark in the boxes below for either Yes or No
I grant permission for my child to use computers and the Internet as provided by the school.
I grant permission for my child to use an e-mail account at school for instructional purposes only.
I grant permission for the publication of my child's creative work on the Internet at the school website. No home address or telephone number will appear with such work. His/Her name may be published with the work.
I grant permission for my child's first name and photograph to be published on a School District website.
Signature
Date

MonthDayYear
Date

Required Signatures
Printed Name of Parent/Guardian

First NameLast Name
Parent/Guardian Signature
Date Signed

MonthDayYear
Date
Secondary Parent/Guardian Signature (if applicable)
Date Signed

MonthDayYear
Date
Should be Empty:

Hillcrest Elementary School Back to School Packet

Student Information

Parent/Guardian Contacts

Emergency Contacts

School Wide Expectations

Uniform Policy

2026-2027 School Parent Compact (Agreement)

Code of Student Conduct Acknowledgement Form

LAKE WALES CHARTER SCHOOLS, INC.

Student Image Form

POLK COUNTY SCHOOL NUTRITION

2026-2027 Technology Agreement

Required Signatures