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INTERNATIONAL BOARDING PRE-ARRIVAL INFORMATION 2016-2017

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Page 1: INTERNATIONAL BOARDING · 2018-01-10 · Boarding student leave. Dorms close at 4 P.M. 2016-17 School Calendar Trimester I September 7 - December 16 • Trimester II January 4 - March

INTERNATIONAL BOARDING PRE-ARRIVAL INFORMATION 2016-2017

Page 2: INTERNATIONAL BOARDING · 2018-01-10 · Boarding student leave. Dorms close at 4 P.M. 2016-17 School Calendar Trimester I September 7 - December 16 • Trimester II January 4 - March

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Dear Family, Welcome to Léman Manhattan! I would like to extend a warm welcome to all students enrolled for

the 2016-2017 school year and look forward to your arrival on campus! On behalf of our faculty and

staff we are excited to get to know your student and support your family throughout your student’s

educational journey.

Léman Manhattan is a vibrant community of active and engaged students led by incredible teachers

with proven instructional methods and innovative global experiences that prepare students to be

standouts at their top choice colleges and beyond.

Your student’s academic program will be integrated and enriched by arts, athletics, community

service and a variety of activities that will fill your days with experiences you will remember forever.

Léman Manhattan is a dynamic place where the fun and challenges of learning can be in our

school classrooms, on our stages, and our athletic fields.

Please do not hesitate to contact our residential staff or me should you have any questions as we

approach the beginning of the school year.

I am looking forward to working with you and your child in the upcoming school year and I welcome

you again to the Léman Manhattan community.

Sincerely,

Maria CastelluccioHEAD OF SCHOOL

WELCOME FROM THE HEAD OF SCHOOL

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Dear Family, Welcome to Léman Manhattan Preparatory School! We look forward to developing a collaborative

and open relationship with you as we help your child adapt to New York City and integrate into the

Léman Manhattan community. Our primary goals in the Residential Program are: 1. to ensure the safety, security, and well-being of your child,

2. to help ensure your child’s academic progress, and

3. to allow your child to have an enriching, positive, and unforgettable experience in the United States.

In order for us to achieve these goals, we ask that you review all the information in this packet and

complete all of the required forms. It is absolutely essential that we begin the school year with accurate and

complete information so that we can provide the safest and most productive experience for your child.

Important arrival times for new and returning students:As you prepare for this upcoming school year, please note the following information:

• New students must arrive at the 37 Wall Street Dormitory on August 30

from 11:00AM – 7:00PM or on August 31 from 11:00AM – 7:00PM.

Our dormitory is unable to accommodate students before August 30 so please plan your arrival accordingly.

New Student Orientation will take place on September 1-2 from 8:00AM-6:00PM on both days

and is required for all new boarding students.

Returning students must arrive at the 37 Wall Street Dormitory on September 3 from

8:00AM-8:00PM and September 4 from 8:00AM-8:00PM. With the exception of rare cases, we

will not be able to accommodate students who arrive in NYC after 9:00PM on either of these nights.

Residential Student Orientation for both new and returning students will take place on September 5

and is required for all students.

All families and family friends/guardians are invited to attend the Upper School Open House at 1

Morris Street on the morning of September 6. More details forthcoming.

School begins on September 7 at 8:00AM.

Once again, welcome to Léman Manhattan and we look forward to the wonderful and enriching journey

ahead!

Kind regards,

Joshua AnchorsDIRECTOR OF RESIDENTIAL LIFE

[email protected] • 646.427.2701

WELCOME FROM THE BOARDING TEAM

Page 4: INTERNATIONAL BOARDING · 2018-01-10 · Boarding student leave. Dorms close at 4 P.M. 2016-17 School Calendar Trimester I September 7 - December 16 • Trimester II January 4 - March

Please send the following information and the flight purchase confirmation or a copy of your boarding pass to [email protected] by August 1, 2016.

Arrival DatesNew students must arrive on either August 30 from 11:00AM – 7:00PM or on August 31 from 11:00AM – 7:00PM.

Returning students must arrive on either September 3 from 8:00AM-8:00PM and September 4 from

8:00AM-8:00PM.

Arrival Airports: JFK, EWR, LGA

Flight Information Do you need Léman Manhattan staff to arrange for airport transportation to 37 Wall St.? (Included in mandatory fees)

Please circle: YES NO

If No, students must be accompanied by a parent and provide their date/time of arrival.

Are you traveling as an “Unaccompanied Minor”? Please note there is a $150 pickup fee for the Unaccompanied Minor service.

Please circle: YES NO

Initial Flight

Connecting Flight

Final Flight

Airline: Flight Number:

Departure Airport: Departure Date: Departure Time:

Arrival Airport: Arrival Date: Arrival Time:

Airline: Flight Number:

Departure Airport: Departure Date: Departure Time:

Arrival Airport: Arrival Date: Arrival Time:

Airline: Flight Number:

FLIGHT INFORMATION

Departure Airport: Departure Date: Departure Time:

Arrival Airport: Arrival Date: Arrival Time:

4

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From the Airport (JFK, LGA, EWR): If you have provided your flight information in advance, a car service will be waiting at the

airport to drive you to 37 Wall Street. Unless you have previously made arrangements to go to 37 Wall Street without using our car

service, please do the following when you arrive at the airport:

1. At the baggage claim and outside the customs arrival door, look for a greeter holding a sign with your name

and/or the name “Léman Manhattan.”

2. If you are unable to locate the greeter, please call the My Sedan toll-free number at (855) 434-0400. You may ask an airport customer

service representative for assistance with this call. Please do not leave your pick-up location since this may delay your pick-up.

Important Notes on Arrival in NYC

ARRIVAL STUDENT INSTRUCTIONS

3. You may also call Residential Life Staff at the following numbers:

+1 646-875-9405

+1 917-330-7782

+1 646-427-1944

+1 646-427-2701

It takes 60-90 minutes to reach 37 Wall Street from the three airports around the city, so please consider this whenarranging your travel plans.Please do not book your ticket to arrive after 7:00PM. Only in rare cases can we accommodate students who arrive at the dormitory after 11:00PM.It is helpful to have a phone that will allow you to dial American numbers when you arrive at the airport in NYC.Please email [email protected] if your flight is delayed or if you have any questions.For students arriving on their own or with their families, please call one of the phone number above at least one hour before arriving at the dormitory so that staff may prepare for your arrival. You may also email [email protected] to schedule your arrival in advance.

•••

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S M T W T F SDecember

AUGUST 24-26 30-31

New Faculty OrientationNew Students arrive between 11AM-7 P.M.

SEPTEMBER3-45 6 7

Returning Students Arrive between 8AM-8 P.M. Labor Day – School ClosedOPEN HOUSE – Lower & Upper Schools Opening Day of School

OCTOBER3-4 Rosh Hashanah – School Closed 10 Columbus Day—School Closed12 Yom Kippur – School Closed

NOVEMBER11 Full Faculty In-Service – No Student Attendance23-25 Thanksgiving Break – School Closed

DECEMBER16 17

Semester Ends, Winter Break Begins @ 3:15 P.M. Dorms close at 4 P.M.

JANUARY2-3

3 16

Boarding Students Return between 11AM-7 P.M. All students must return by January 3, 9 P.M. Classes Resume Martin Luther King Day – School Closed

FEBRUARY20 Presidents Day—School Closed 21 Full Faculty In-Service - No Student Attendance

MARCH17 18

Spring Break Begins @ 3:15 P.M. Travel Day-Dorms close at 4 P.M.

APRIL2 3 11-12 14

Dorms open at 12 P.M.Classes Resume Passover – School ClosedGood Friday – School Closed

MAY29 Memorial Day – School Closed

JUNE3 4 21 21 22

Graduation DaySeniors leave by 4 P.M.Students’ Last Day of School @ 12:00 P.M.End of School Year 2016-2017 Boarding student leave. Dorms close at 4 P.M.

2016-17 School Calendar

Trimester I September 7 - December 16 • Trimester II January 4 - March 17 • Trimester III April 3 - June 21

SHADED AREAS = NO STUDENT ATTENDANCE

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BOARDING PERMISSIONS

BOARDING PERMISSIONS FORM

I. School Trip Permission:

I understand that during the student’s enrollment in the Boarding Program, the student may, from time to time, be offered

the opportunity to take field trips sponsored by Léman Manhattan and the Léman Manhattan Boarding Program. These

trips may involve overnight stays away from the school and the residential facility, including out-of-state excursions for

Thanksgiving Break and Spring Break. By execution of this Agreement, I expressly grant permission for my son/daughter

to participate in such field trips as well as permission for the school to take my son/daughter outside the residential

boundaries on such field trips. I hereby agree to assume full responsibility for the payment of all debts incurred by my son/

daughter during his/her participation in such events and to reimburse the School any damages suffered by it due to acts of

the Student during such.

Parent Signature: _______________________________________________________________________________

II. Permission to Leave the Dormitory Independently for a Specific Period of Time:

As part of the Boarding Program, I understand that my son/daughter may be granted permission from the Residential Life

Staff to leave the dormitory for a specific period of time without direct supervision. In order to be granted such permission,

I understand that my son/daughter must sign out with Residential Life Staff, he/she must carry a charged phone with a US

number, he/she must be in the company of other students, and he/she is expected to communicate clearly and honestly

with staff about his/her whereabouts. I understand that this is a unique privilege that requires a high level of personal

responsibility and trust between Residential Life Staff and my son/daughter and also full collaboration with our family.

I understand that permission to leave the dormitory may be limited or revoked by Residential Life Staff in the event that

rules put in place to ensure the safety of the Student are not followed.

Parent Signature: _______________________________________________________________________________

III. Permission to leave the dormitory under the supervision of Families of Students of Léman Manhattan:

I grant my son/daughter permission to stay overnight with families of students of Léman Manhattan

Parent Signature: _______________________________________________________________________________

I grant my son/daughter permission to leave the dormitory in vehicles driven by parents of Léman Manhattan

Parent Signature: _______________________________________________________________________________

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BOARDING PERMISSIONS

PERMISSION FOR STUDENT TO LEAVE THE DORMITORY WITH FAMILY MEMBER OR FRIEND You are giving your child permission to leave the dormitory and spend time with each of the individuals listed below. However,

before we allow your child to leave the dormitory with these family members or friends, a member of our staff will need to approve

each one of them to ensure that they understand their responsibly, act in the best interest of your child, and communicate with

our staff as necessary. Our school’s top priority is the safety, security, and health of your child, and it will be extremely important

that we trust and have good communication with the individuals who spend time with your child outside our dormitory.

IMPORTANT GUIDELINES FOR THIS PROCESS

• Students must receive permission to leave the dormitory with a family member or friend directly from their parent(s) or agent

• Parent(s) and/or agent should use the following email address to communicate any of these permissions: [email protected]

• Students may not use the same email account as their parent(s) in order to give themselves permission to leave the dormitory.

This is email fraud and will lead to severe disciplinary consequences.

• When first visiting a student, family members and friends will need to come to the dormitory to meet our staff, provide a

copy of identification, provide a plan of their time with the student, and provide contact information.

• Required Family Member or Family Friend Information (required for each individual – please do not leave any section blank)

FAMILY/FRIEND 1

Name

Relationship to the Student

Phone Number(s)

Email address

Current address

Date of Birth

I grant permission for my son/daughter to leave campus with above named family member or family frienda

Parent Signature:_____________________________________________________________________________________________________________

I grant permission for my son/daughter to leave campus in vehicles driven by above named family member or family friend

Parent Signature:_____________________________________________________________________________________________________________

I grant permission for my son/daughter to stay overnight on weekends and school holidays with above named family member or family friend

Parent Signature:_____________________________________________________________________________________________________________

IV. Permission to leave the dormitory and/or stay overnight with Approved Family Members or Approved Friends of Family:I understand that I will be required to communicate requests for specific dates and times for my son/daughter to stay overnight withapproved individuals in advance. I understand that host families and approved family member or friends of the family will also need to communicate their commitment to supervising the student for these specific dates and times in advance. I understand that permission to stay overnight may not be granted if these basic communication guidelines are not followed or if Residential Life Staff are unable to verify whether the Student will be appropriately supervised. I understand that individuals listed on the following page as Approved Family Members or Approved Friends of Family will be fully responsible for the Student during the time the Student is released to their care. I understand that the student’s Approved Family Members or Approved Friends of Family will be required to submit to a screening process, communicate fully with Residential Life Staff, and provide all necessary documentation prior to hosting the Student in their place of residence.

Parent Signature: _______________________________________________________________________________

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BOARDING PERMISSIONS

FAMILY/FRIEND 2

Name

Relationship to the Student

Phone Number(s)

Email address

Current address

Date of Birth

I grant permission for my son/daughter to leave campus with above named family member or family friend

Parent Signature:_____________________________________________________________________________________________________________

I grant permission for my son/daughter to leave campus in vehicles driven by above named family member or family friend

Parent Signature:_____________________________________________________________________________________________________________

I grant permission for my son/daughter to stay overnight on weekends and school holidays with above named family member or family friend

Parent Signature:_____________________________________________________________________________________________________________

FAMILY/FRIEND 3

Name

Relationship to the Student

Phone Number(s)

Email address

Current address

Date of Birth

PERMISSION FOR STUDENT TO LEAVE THE DORMITORY WITH FAMILY MEMBER OR FRIEND Continued

I grant permission for my son/daughter to leave campus with above named family member or family friend

Parent Signature:_____________________________________________________________________________________________________________

I grant permission for my son/daughter to leave campus in vehicles driven by above named family member or family friend

Parent Signature:_____________________________________________________________________________________________________________

I grant permission for my son/daughter to stay overnight on weekends and school holidays with above named family member or family friend

Parent Signature:_____________________________________________________________________________________________________________

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Student Last Name: __________________________________ Student First Name:__________________________________

Date of Birth:_______________________________________ Grade:_____________________________________________

1. Permission to Administer Emergency Medical Care & Attend Medical Appointments/ Waiver of Responsibility

and Permission

I hereby give permission for the School and the School’s personnel to authorize the emergency medical treatment of the

Student, including surgery, by a physician, hospital, or other provider of healthcare, in the even that I cannot be contacted

in a timely fashion in order to authorize such treatment myself. I also authorize the School’s personnel to attend medical

appointments with the Student. I understand that I shall be financially responsible for any and all medical treatment or

services administered to the Student.

Parent Signature: _______________________________________________ Date:_____________________________

2. Permission for Immunization

I hereby grant permission to immunize my son/daughter/ward in cases where immunization is necessary as part of a

treatment plan, required to attend school or live in residential facilities, or when needed for prevention of illness.

I understand that payment for all required immunizations are the responsibility of the family/student.

Parent Signature: _______________________________________________ Date:_____________________________

3. Consent for Standing Order Medications

I/We hereby give consent for the health Clinic staff or the School’s administration to assist with the administration of

standing order medications on an as needed basis for acute illnesses or injuries to my son/daughter. This will include,

but is not limited to: Acetaminophen, Ibuprofen, Antihistamines, Lozenges, Antacids, Sunblock, Oral Anesthetic, Anti-

itch cream, Artificial Tears, Other standard over the counter (OTC) medications

Prescription medications must be brought to school in the original container as dispensed by the pharmacist or physician,

with the original pharmacy label attached together with a dated, physician’s note authorizing the administration for the

medication(s). No expired, altered, or unlabeled medications will be accepted.

I DO NOT want my son or daughter to have the following medications: _______________________________________

________________________________________________________________________________________________

Parent Signature: _______________________________________________ Date:______________________________

4. Authorizations

I give permission to the school’s healthcare providers to:

1) Administer first aid to my child

2) Use their own judgment to seek medical aid for my child with the understanding that I will be notified as soon as

possible if I cannot immediately be reached.

3) Share as needed, with involved school/healthcare providers, medical information

I permit my child to be self-directed in carrying and self-administering medication, if the criteria is met to allow

the child to safely do so (ie. able to verbalize correct dose, schedule, route of administration, return demo, etc.)

Parent Signature: _______________________________________________ Date:_____________________________

MEDICAL WAIVERS

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Student Last Name: __________________________________ Student First Name:__________________________________

Date of Birth:_______________________________________ Grade:_____________________________________________

5. Person to Contact in Case of an Emergency

Name:________________________________________ Home Phone:_______________________________________

Relationship to Student:___________________________ Cell Phone:_________________________________________

Work Phone:___________________________________ Email:_____________________________________________

6. Permission to Administer Prescribed Medication

I grant designees or administration of the School permission to assist in the administration of each prescribed

medication to be provided during the school day, including when my child is away from the School attending events

sponsored by the School. In the even that my son or daughter is prescribed medication after arriving in the country,

I consent to allow the School to distribute the medication based on the wishes of the prescribing physician.

Please note: All boarding students taking prescription medication must have the authorization for medication form

completed prior to arrival.

Parent Signature: _______________________________________________ Date:_____________________________

7. Permission for Influenza (Flu) Vaccine

The Influenza (Flu) vaccine can be obtained at the office of Dr. Mark Horowitz, Léman Manhattan’s Medical Director.

The best protection agasint the Flu is to get vaccinated. The Center for Disease Control (CDC) recommends a yearly Flu

vaccine as the first and most important step in protecting against Flu viruses. The cost of the vaccine is $25.00 and not

paid for by the school.

The best protection against the Flu is to get vaccinated and the Center for Disease Control (CDC) recommends a yearly

Flu vaccine as the first and most important step in protecting against Flu viruses. This is especially important in a

dormitory environment. All LMPS boarding students will be required to get this vaccination before Winter Break

unless the family requests a special exemption in writing.

Parent Signature: ______________________________________________ Date:_____________________________

MEDICAL WAIVERS

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STUDENT HEALTH INFORMATION

Student Last Name: __________________________________ Student First Name:__________________________________

Date of Birth:_______________________________________ Grade:_____________________________________________

1. Is your child allergic to any medication? Yes No

If yes, please list:___________________________________________________________________________________

What is the reaction to the allergen?____________________________________________________________________

2. Is your child allergic to any food? Yes No

If yes, please list:___________________________________________________________________________________

What is the reaction to the allergen?____________________________________________________________________

3. Does your child have any diet restrictions? Yes No

If yes, please list:___________________________________________________________________________________

Does your child have asthma? Yes No

If yes, what are the triggers? __________________________________________________________________________

What inhaler(s) were prescribed? ______________________________________________________________________

If yes, both you and your MD need to complete the Asthma Emergency Care Plan

4. Does your child have diabetes, seizures or other medical conditions? Yes No

If yes, what condition?______________________________________________________________________________

Is medication needed during the day? Yes No

5. Has your child ever been hospitalized? Yes No

If yes, please provide the reason for hospitalization, date, and length of stay: ____________________________________

_______________________________________________________________________________________________

6. Is there any family medical history that we should be aware of?_______________________________________________

_______________________________________________________________________________________________

7. Do you have any other health concerns? ________________________________________________________________

________________________________________________________________________________________________

Parent Signature: ____________________________________________________ Date: _____________________________

MEDICAL HISTORY

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TUBERCULOSIS RISK ASSESSMENT QUESTIONNARE FOR CHILDREN AND ADOLESCENTS

1. Has your child traveled outside the United States?

lf yes and the child stayed with friends or family members in a high TB incidence area** such as Africa, Asia, Latin

America or Eastern Europe for more than one month cumulatively, a test for TB infection should be administered.

2. Has your child been exposed to anyone with TB disease?

If yes, and it has been confirmed that the child has been exposed to someone with suspected or known TB disease, a test for

TB infection should be administered, and the NYC Department of Health and Mental Hygiene should be notified.

3. Does your child have close contact with a person who bad a positive test for TB infection?

If yes, proceed as in question 3 (above).

4. Has your child consumed dairy products obtained from abroad such as raw milk or fresh cheese?

If yes, a test for TB infection should be administered.

RESIDENTIAL LIFE POLICY FOR SCREENING OF ACTIVE AND LATENT TUBERCULOSIS

For NEW Students:

Screening for latent tuberculosis (TB) is indicated for all NEW students who have lived in an at-risk country for more than

one month consecutively (countries are indicated on the “Tuberculosis Risk Assessment Questionnaire for Children and

Adolescents” provided by the New York City Department of Health and Mental Hygiene).

If a NEW student meets these criteria, they will receive a blood-based gamma interferon release test (IGRA). This blood test

costs approximately $86.00 and will be completed during your child’s physical in the first few weeks of school.

If your child has had PPD testing, a chest x-ray, or an IGRA blood test in the past year, please provide the documentation

and your child will not need further testing upon arrival.

*Adapted from The Pediatric Tuberculosis Collaborative Group:Targeted tuberculin skin testing and treatment of latent tuberculosisinfection in children and adolescents. Pediatrics, 2004: 114(4):11 75-1201**High TB incidence countries are listed in http://www.nyc.gov/htrnl/dohldownloadslpdf/tb/tb protocol.pdf

NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL HYGIENEThomas Farley, MD, MPHCommissioner

MEDICAL HISTORY

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MEDICATIONS

Student Last Name: __________________________________ Student First Name:__________________________________

Date of Birth:_______________________________________ Grade:_____________________________________________

Please have your child’s physician provide the following information if your child plans to take any medication while attending school.

This includes, but is not limited to, prescription medications, vitamins, supplements, over-the-counter (OTC) pain medication.

Name of Physician:__________________________________________________ Date:_______________________________

1. Name of Medication(s) Prescribed:_____________________________________________________________________

Diagnosis/Reason for Medication: _____________________________________________________________________

Time & Direction for Administration by School Personnel: _________________________________________________

Side Effects/Special Instructions: ______________________________________________________________________

________________________________________________________________________________________________

2. Name of Medication(s) Prescribed:_____________________________________________________________________

Diagnosis/Reason for Medication: _____________________________________________________________________

Time & Direction for Administration by School Personnel: _________________________________________________

Side Effects/Special Instructions: ______________________________________________________________________

________________________________________________________________________________________________

3. Name of Medication(s) Prescribed:_____________________________________________________________________

Diagnosis/Reason for Medication: _____________________________________________________________________

Time & Direction for Administration by School Personnel: _________________________________________________

Side Effects/Special Instructions: ______________________________________________________________________

________________________________________________________________________________________________

Physician Signature:________________________________________________ Date:______________________________

MEDICAL HISTORYINFORMATION TO BE COMPLETED BY A PHYSICAN

Please be advised that students are prohibited from storing medications in their rooms unless prescribed by a doctor and authorized

by the Residential Nurse. Upon arrival in NYC, students cannot be administered medication until they have received their NYC

physical exam. We strive to have all physical exams completed within three weeks of new student arrival.

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IMMUNIZATION HISTORY (GRADES 7-12)

Student Last Name: __________________________________ Student First Name:__________________________________

Date of Birth:_______________________________________ Grade:_____________________________________________

DTP/DTaP

Tdap (Boostrix or Adacel brand vaccine)

IPV/OPV (Polio)

MMR or

Measles

Mumps

Hepatitis B

Varicella

Meningitis

Or date of disease: MM/DD/YY:

Required for all residential boarding students at Léman.

Required Immunizations by New York State:

(3) DTP/DTap

(1) Tdap (Boostrix or Adacel brand)

(3) Polio (3)

(2) MMR OR (2) Mumps, (2) Measles, and (1) Rubella

*First MMR or measles vaccine must be administered on or after the first birthday

(3) Hepatitis B

(1) Varicella or date of disease (month/date/year) verified by a physician

(1) Meningitis (required for all residential boarding students at Léman)

Please note, all immunizations need to be up to date, with the date (month/day/year) clearly indicated, and signed by a physician,

prior to your child attending the first day of school.

Physician Signature: ____________________________________________________ Date: __________________________

Physician Stamp:

MEDICAL HISTORYINFORMATION TO BE COMPLETED BY A PHYSICAN

Rubella

Students will not be permitted to attend school without receiving the following required immunizations. When possible, we

recommend that you receive these immunizations in your home country to save time and money. Please also bring your yellow

or red immunization booklet for documentation purposes.

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Student (last, first) ______________________________________ Entering Grade _____ Sex _____ Birth Date __________ Age ______

Address _______________________________________________ Home Phone _____________________________________________

Parent 1 ______________________________________________ Parent 2 _________________________________________________

Work Phone ________________ Cell _______________________Work Phone _________________ Cell _________________________

Home Phone _______________ Email ______________________ Home Phone _______________ Email _________________________

Emergency contact ______________________________________ Phone(s) _________________________________________________

Treatment:

• Give Benadryl as follows: ____________________________________________________________________________

• Give Epi Pen (AND CALL 911) as follows: ______________________________________________________________

Notify healthcare provider onsite, notify administration and keep patient calm until EMS arrives.

ASTHMA

Physician _____________________ Phone________________ Triggers__________________________________________

Peak Flow ___________________________________________________________________________________________

Treatment:

• Stop activity immediately. Help to a comfortable seated position. Encourage pursed-lip breathing and fluids to decrease

thickness of lung secretions. Give following medications ____________________________________________________

• If no relief in 15-20 minutes, call 911, to report you have an asthma emergency. Notify healthcare provider onsite, notify

administration and keep patient calm until EMS arrives.

Provider Signature: ___________________________________ Stamp:

Phone __________________________Date _______________

Parent Signature: _____________________________________

EMERGENCY CARE PLAN FOR ALLERGIES AND/OR ASTHMA Complete this form ONLY if your child has Allergies and/or Asthma

MEDICAL HISTORYINFORMATION TO BE COMPLETED BY A PHYSICAN

SEVERE ALLERGIES Is this a life threatening allergy? Y N Physician _____________________ Phone _______________

List Allergens _______________________________________ Reaction ___________________________________________

Students who have inhalers must carry them on their person at all times and provide additional inhalers to the

School Nurse and the Residential Nurse.

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ATHLETIC DEPARTMENT PARENTAL CONSENT / ATHLETIC RELEASE FORM

Tis form must be completed, signed, and submitted to the athletic department prior to the first day of participation in any and all athletic activities.

STUDENT’S NAME: _________________________________GRADE:______________SCHOOL YEAR: ____________________

STUDENT’S DATE OF BIRTH:_____________________________________________AGE:_______________________________

PARENT #1’s NAME:__________________________________PARENT #2’s NAME:_____________________________________

PARENT #1’s PHONE:_________________________________PARENT #2’s PHONE:____________________________________

PARENT #1’s CELL PHONE:___________________________PARENT #2’s CELL PHONE:_______________________________

PARENT #1’s E-MAIL:_________________________________________________________________________________________

PARENT #2’s E-MAIL:_________________________________________________________________________________________

PARENTAL CONSENT: I hereby give my consent for my child,______________________________to participate on the____________________club/team sponsored by Léman Manhattan Prep. I understand that interscholastic and club sports are a part of a broad extra-curricular program designed to teach students certain skills and reinforce concepts of self-worth, cooperative effort, and ethical decision making. While the coaching staff and other responsible school officials will do everything within reason to protect my child against injury, including the provision for appropriate equipment, safe facilities and training designed to reduce the impact of accidents, I understand that injuries may occur and on a very rare occasion may be serious and disabling. I am also aware that athletic participation will involve travel and that alltravel involves some risk of serious injury.

My child is required to attend all team practices and attendance at practices will be reflected in playing time in games, andtournaments. I am aware that school equipment is issued to my child for participation. It is their responsibility and must be returnedpromptly upon request. Reimbursement will be expected for loss or destruction beyond ordinary wear and tear. My child has read andhas agreed to abide by the above guidelines set forth by the athletic department.

I also understand that it is necessary for my child to have an approved medical for school competition on file in the schoolbefore trying out, practicing, or competing in interscholastic and club activities. I understand that in the event my child becomessick, or receive an injury during athletic participation, all reasonable efforts will be made to contact me and obtain any requiredconsents for medical care. In situations where I cannot be contacted for specific consent to treatment, and such delay creates a riskto my child’s health or life, the school representatives will use the authority I grant to them by this form to obtain appropriatemedical care and treatment for my child. I also agree to inform the school of any change to my child’s medical or physical conditionwhich develops or is discovered at any time after the date this document is signed.

PARENT SIGNATURE: ________________________________________________________DATE: ________________________

IN AN EMERGENCY, IF PARENTS CANNOT BE CONTACTED, PLEASE NOTIFY:NAME (RELATIONSHIP): ____________________________________________________PHONE:________________________ FAMILY DOCTOR:___________________________________________________________PHONE:________________________KNOWN ALLERGIES:________________________________________________________________________________________EXISTING MEDICAL CONDITIONS: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

CURRENT MEDICATIONS:__________________________________________________ REASON:_______________________OTHER CONDITIONS TO BE AWARE OF:_____________________________________________________________________ ___________________________________________________________________________________________________________ _________________________________________________________________________________________________________# OF KNOWN HEAD INJURIES:_______________________________________________DATES:________________________

I _____________________________________________ as parent/guardian of______________________________________ herebygive permission to the coach, nurse, EMS, athletic trainer, or hospital to administer first aid to my child in case of a medical emergency at either an away or home contest in the event that I cannot be contacted. I will allow the coach, nurse, Athletic Director or an administrator of Léman Manhattan Prep to exercise their own judgment in securing medical aid and ambulance services for the care and treatment of my child in such cases.

PARENT SIGNATURE: ________________________________________________________DATE: ________________________

ATHLETIC WAIVERS

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ATHLETIC DEPARTMENT CONTRACT AND DISMISSAL PERMISSION FORM

STUDENT ATHLETE’S CONTRACT

As a participant in Léman Manhattan Prep’s Athletic Program, I promise to abide by the following rules and regulations.

• I understand that I am making a serious commitment to the Ahletic Program and that I am expected to conduct myself in aresponsible manner at all times.

• I understand that prompt attendance at all practices and all games is mandatory. If I am unable to attend, I will notify my Coach assoon as possible with a note. If you are absent from practice the day before a game you may not be permitted to play in that game.)

• I understand that if I become injured at any point during the season I will attend practices unless excused by my coach and willattend all games without excuses.

• I understand that by missing more than 2 practices or games I will jeopardize the success of the team and risk being removedfrom the team at any time.

• I will maintain good academic standing as a student. Failure to do so could result in my dismissal from the team.

• I will be a team player. I will learn and develop teamwork, discipline and sportsmanship, and practice them at all times.• I will respect all participants in the Athletic Program. This includes officials, teammates, opponents, parents, and coaches.

• I understand that smoking, narcotics and alcohol are dangerous to my health and use of them will lead to my dismissal fromthe team.

I have read and understood the above rules and regulations. In case of a rule infraction on my part, I agree to fully comply with the Coach’s and/or Athletic Director’s disciplinary ruling.

STUDENT/ATHLETE NAME:__________________________________________________ DATE: _____________________

SIGNATURE:___________________________________________________________________ DATE: ______________________

PARENT NAME:________________________________________________________________ DATE: ______________________

PARENT SIGNATURE: __________________________________________________________ DATE: ______________________

DISMISSAL PERMISSION FORM

STUDENT’S NAME: ____________________________________________________________ GRADE: ____________________

SPORT: _______________________________________________________________________ SCHOOL YEAR: _____________

This is to advise you that athletic participation may include travel in private carrier vehicles, taxi-cabs (a faculty member may notalways be present to hail or ride in the cab with the students), via public transportation or walking. No travel will be permitted otherthan in these types of vehicles, but all travel involves serious risk of injury.

I give my child permission to travel to and from games and practices by the above described means of transportation. Events notedon the schedules as “2 Way” will include return transportation to Léman Manhattan Prep.

PARENT SIGNATURE: __________________________________________________________ DATE: ______________________

I give my child permission to be dismissed directly from practices or games held at any site in Manhattan. I understand that my childmay be leaving these sites alone or with friends and unaccompanied by an adult. I understand that specific written parental permission will be required for dismissal from any site outside of Manhattan. PARENT SIGNATURE: __________________________________________________________ DATE: ______________________

I do not give my child permission to be dismissed from any sites. I will make arrangements to have my child picked up by a parent or guardian at each site. PARENT SIGNATURE: ___________________________________________________________ DATE: _____________________

ATHLETIC WAIVERS

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PAYMENT AUTHORIZATION 2016-2017

Payment Method: By selecting this Payment Method Below, you authorize Léman Manhattan Preparatory School to charge the given account for the balance due, related to charges for ancillary fees and other items charged by the student, due on the dates indicated. Please select payment method below and provide the associated U.S. Bank Account or Credit Card information and your account will be charged by the 5th of each month automatically.

Student ID: _______________ Guardian ID: _______________ Student Name: ____________________________________

Electronic Check and Credit Card Payment Terms and ConditionsBy selecting the Electronic Check or Credit Card payment option, Parents agree to the following additional terms and conditions:(i) Automatic Electronic Check or Credit Card Sign-Up

a. Parents understand that the bank account/credit card designated on this payment authorization form will be charged automatically,originating from the school of attendance, if Parents have selected the Electronic Check or Credit Card payment option.

b. Parents understand that they must contact the School business office no less than 14 days prior to a scheduled payment tomake a change to the bank account/credit card designated or otherwise cancel the charge.

c. In accordance with the Tuition Schedule, Parents authorize the School to debit the bank account or charge the credit carddesignated on this payment authorization form no later than 10 days following the payment due date(s).

(ii) Update Bank/Credit Card Informationa. Parents understand that if there is a change to their bank account/credit card, Parents must submit a new payment authorization

form to the business office no later than 14 days in advance of a scheduled payment.b. Parents understand that the School may receive updated bank account/credit card information directly from the financial

institution.(iii) Billing Errors

a. Parents understand and agree that the School is not liable for erroneous bill statements or incorrect debits/charges.b. If a billing error occurs, the School is responsible for correcting, if and when, Parents notify the School of the error.

(iv) Returned Paymentsa. Parents understand that if their payment is rejected, refused, returned, disputed, or reversed by their financial institution for

any reason, the School has the right to charge a returned item fee and to cancel Parents’ account from the Electronic payment option.b. The School and participating financial institutions reserve the right to terminate Parents’ participation in this payment option at

any time, as authorized by applicable law.(v) Fees

a. Parents understand that the School does not impose a fee for participating in the Electronic Check/Credit Card payment method.b. Parents understand that they should verify with their financial institution to determine if additional charges apply.

Signature: __________________________________________________________ Date: _____________________________

*For Office Use Only*

Received: _____/_____/_____ Notes/Comments: _____________________________________________________________

Electronic Check* Please attach a voided check

Credit Card* Only permissiblefor ancillary charges

MasterCard

Visa

Discover

American Express

Savings

Checking

Account Number:______________________________________________

ABA Routing Number: _________________________________________

Financial Institution Name: ______________________________________

_____________________________________________________________

Credit Card Number:___________________________________________

Expiration Date: _______________________________________________

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All boarding students at Léman Manhattan should plan on participating in at least ONE of the following after-school activities per year:

1. play on or manage* an athletic team;

2. participate in the one-act play or the spring musical;

3. participate in the exercise program at NY Health & Racquet Club at least 2 times per week for one season;

4. participate in one after-school club for a full season (see list of sample clubs on the following page); or

5. serve on student government (if elected).

Please put an X next to the activity or activities that you would like to participate in during the 2016-17 school year.

Please rank your preferences from 1-3, with one being your 1st choice & three being your 3rd choice.

*A team manager assists the team in a variety of ways under the direction of the coach. A manager is a full member of the teamand is expected to attend all practices and games, though a manager is not expected to participate in the sport. Managing a team is an excellent way to gain leadership experience, be part of a team and learn new skills that will prepare you for college.

RESIDENTIAL LIFE AFTERSCHOOL PARTICIPATION REQUIREMENTS

FALL SEASONSoccer

Volleyball (girls only)

Cross Country

One-act play (theater)

Health & Racquet Club Exercise Program

WINTER SEASONBasketball

Swimming (for advanced swimmers)

Health & Racquet Club Exercise Program

Indoor Track

SPRING SEASONGolf (for advanced golfers)

Track & Field

Spring Musical

Baseball (boys only)

Table Tennis

Health & Racquet Club Exercise Program

Varsity Softball (girls only)

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Sample from 2015-16 Academic Year

RESIDENTIAL LIFEAVAILABLE AFTERSCHOOL ACTIVITIES

Pep SquadPoetry Club

RoboticsRock Band

Student Government Swimming

Table Tennis/Ping PongYoga

Youth Leadership Club Zumba

BadmintonChess

Community ServiceCooking & Baking Club

Digital Photography Film Production

Hip Hop Dance Weight Lifting

Mock TrialModel United Nations

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7:30 AM

7:30 - 8:15 AM

8:25 AM

12:00 PM

3:10 PM

3:30 - 5:30 PM

6:00 - 6:30 PM

7:30 - 9:30 PM

9:30 - 10:00 PM

Walk to School

Breakfast at Morris Café

School Day Begins

Lunch at Morris Café

School Day Ends

Afterschool Activites

Dinner at Morris Café

Study Time/Quiet Time in Apartment

Quiet Time

Lights Out 10:30 PM

Sample Weekday Schedule

Sample Saturday ScheduleBrunch at 37 Wall Street

Afternoon Activity

Dinner in Morris Café

Evening Activity

Evening Check-In

Lights Out

11:00 AM - 1:00 PM

2:30 - 5:00 PM

6:00 PM

7:00 - 9:00 PM

10:30 PM

11:00 PM

RESIDENTIAL LIFE SAMPLE SCHEDULES

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IMPORTANT HOLIDAYS & TRAVEL GUIDELINES

2016-2017THANKSGIVING BREAK: November 23-26Students may stay in the dorm during this break and take advantage of a variety of holiday-themed activities and events around New York City. Students may also stay with approved guardians during this break. We discourage international students from returning home during this short period. Students and families must confirm Thanksgiving break plans by October 1, 2016.

WINTER BREAK: December 16 – January 3The dorm is closed for this period and students must either return home or stay with a guardian. Students may not depart early or return late from this break. Students and families must confirm winter break plans by November 1, 2016.

SPRING BREAK: March 17 – April 2Students have the option of returning home for this break or staying in the dorm and participating in one excursion to Boston and one excursion to Washington, D.C. Students who remain in the dorm must participate in the residential excursions. Students may not depart early or return late from this break. Students and families must confirm Spring break plans by December 1, 2016.

END OF THE SCHOOL YEAR: June 21 at 12PMStudents must depart dorm by June 22 at 5PM. The residential program will store one box of non-valuable items in the dorm for all returning students. Students will be responsible for organizing any additional storage with a guardian or a local self-storage facility. Students (non-seniors) may not depart before June 21. Students and families must confirm end of the year plans by December 1, 2016.

GENERAL TRAVEL GUIDELINES• Students may not depart until after their last obligation (class, activity, sport or theater practice).• If students have difficulty in organizing flights to depart or arrive around the dorm schedule, we expect local guardians to provide

overnight accommodation to ensure that students do not miss any lessons. All boarders are expected to attend school for the fullduration of term. If your son/daughter needs to arrive, or leave outside of the term dates, special permission must be obtained from theHead of the Upper School in writing (or email), well in advance and before any tickets or holidays are booked.

• It takes 1-2 hours to reach the dorm from the three airports (JFK, LGA, EWR) around NYC, so please consider this when arrangingtravel plans. Please do not book your ticket to arrive after 9:00PM since this means that you will not arrive at the dorm until midnight.Only in rare cases can we accommodate students who arrive at the dorm after 11:00PM.

• Trimester and holiday dates are available well in advance so that travel arrangements can be planned accordingly. a significant number ofstudents miss lessons at any one time due to holiday or travel arrangements, not only does it affect their learning but may also disruptthe learning of others – this is especially pertinent at the beginning and end of terms. It is not the responsibility of the school to findtime to teach students work they have missed due to holiday or travel. Parents are encouraged to not withdraw their children fromschool outside of the published holiday times in order to ensure that the learning environment of the school is not detrimentallyaffected. However, the school does recognize that there may be valid reasons for leaving early/arriving late at the beginning/end of term.If this is the case the following procedures are to be followed:

1. In recognition of the difficulty of arranging flights, those students that have a long haul flight may leave school up to 24 hours before theend of term, but only if permission has been granted by the Head of the Upper School. This exception will only be made at the end ofthe trimesters – Autumn, Spring and Summer – and refers to the time the student actually leaves the school site, not the time of the flight.

2. Boarding students are expected to return to school the day before each term starts. If there are factors that prevent this then permissionmust be obtained from the Head of the Upper School.

3. If the request is authorized then it is the responsibility of the student to catch up on the work he or she has missed, preferably taking theinitiative to collect work from teachers prior to an absence. It is not the responsibility of the teacher to follow up with students who havebeen absent.

4. Any boarding students that do not have permission to leave early or return late will be marked with unauthorized absence on their attendance record and a punishment, in accordance with the school discipline policy, will be issued. A pattern of absences may involve furtheraction being taken.

5. Students who do miss school, authorized or unauthorized, at the beginning or end of trimesters will be required to make up the timethey have missed in after school makeup sessions.

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Lower School 41 BROAD STREET

MAP OF LOWER MANHATTAN

Upper School 1 MORRIS STREET

Residence Hall37 WALL STREET

LÉMAN MANHATTAN FACILITIES

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RESIDENTIAL LIFE What happens during New Student Orientation? This is a very important and fun time! New students will get to know each

other, meet their teachers, learn about safety measures in the boarding program, and become familiar with Lower Manhattan.

It is also when new students will receive their cell phone, laptop, school uniforms, and they will go get their New York Physical Exam.

When will I receive my class schedule? You will receive your class schedule on September 6 during the Upper School Open House.

What are the safety and security procedures? Student safety and security is one of our top priorities. We have alarms in every

apartment to ensure that students are inside at night, and boarding staff live on the same floor as students and frequently check

on student apartments. When signing out of our residential facility, students must get permission from staff, they must carry a

charged cell phone, and they must be with friends if they are traveling beyond the Residential Boundaries.

Will I have roommates? Yes! One of the terrific things about boarding is that you get to make friends with people from all

over the world. Each apartment is different, so you may have 1, 2, or 3 roommates depending on the size of your room. You

will share a bathroom with your roommates. We do not offer single rooms.

What is the weather like in NYC? What kind of clothes should I bring? NYC can be very hot in the summer (June-August) and

can get below freezing in the winter (December-February). In addition to your regular clothes, we definitely recommend bringing

a warm winter jacket and hats and gloves. You will receive school uniform items upon arrival and will wear that on school days.

Where do I eat meals? Healthy, nutritious meals are provided every school day in our cafeteria at 1 Morris Street. Weekend

brunches are provided at the Broad Street Café, and Saturday night students receive a voucher to go to a local restaurant.

What do I do when I’ve got jet lag? Many international students suffer from jetlag when they first arrive in the country after a

long flight. As soon as you begin your flight try to adapt your body schedule to the time in NYC. As soon as you arrive, try to

get on a sleep schedule appropriate to the time in our area. Drink plenty of water while traveling. Get up and walk around the

plane when the seatbelt sign is off and while in airports. During the daytime, get outside in the sunlight whenever possible.

How can I get an account at a NYC bank? Many of our boarding students have bank accounts through Bank of America,

which is conveniently located next to the Upper School. However, students who are under 18 may not open up a checking

account without a parent or guardian to sign for them.

How do I get a telephone? You will receive a cell phone upon arrival. If you wish to use your own phone, please remember that

it must have a number for the USA.

How do I receive mail and packages? Mail and packages are received at the front desk of 37 Wall Street and house parents pick

it up for students and deliver it to their apartments on a daily basis.

What do I bring? Bring whatever will make you feel at home. Léman Manhattan and 37 Wall Street will be your new “home

away from home,” so we want you to be comfortable and happy. That said, you can purchase almost anything you need in

NYC so don’t worry if you forget something!

What should I not bring? Do not bring medications, unless you have a written prescription from a doctor. Do not bring too

much luggage – there is limited storage space in each room. Most students bring two suitcases worth of belongings. You do not

need to bring bed linens or pillows; our program provides those items.

FREQUENTLY ASKED QUESTIONS

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What about money? Our program provides all meals and activities throughout the week, so you should not need a lot of extra money

unless you plan to eat out, go shopping, or pursue activities outside of our program’s offerings. Please do not bring large amounts of cash.

What are the resources for learning English? In addition to our mainstream curriculum and English Language Learner (ELL)

classes, we utilize these additional resources: Rosetta Stone, Bilingual Dictionaries, English Grammar in Use, texts from

Cambridge University Press, and ESL Brainpop.

Will Leman Manhattan pay for airport transportation services? We will pay for car service four times throughout the year: arrival

at the beginning of the school year, departure at winter break, arrival from winter break, departure at the end of the school year.

Additional airport car service will have to be paid for by the student, though our staff will assist students with arranging car service.

Should my student store valuable items in their apartment? We strongly advise against students storing anything valuable in

their apartments, including expensive jewelry or luxury goods of any kind. Our staff cannot ensure the safekeeping of expensive

items in a dormitory context. If students wish to purchase such items, we suggest purchasing them immediately prior to

returning home so that they are being stored in the apartment for a minimal period.

HEALTH & MEDICAL Should I bring my own medicine? Only if this medicine is prescribed by a doctor and you have written documentation by

a physician that this medication is provided. Over-the-counter medications will be available to students as needed.

Can I keep medicine in my room? Students my not store over-the-counter medicines or herbal supplements in their rooms

unless indicated as necessary by a physician and parent/guardian.

What immunizations are required to attend school? (3) DTP/DTap ;(1) Tdap (Boostrix or Adacel brand);(3) Polio (3); (2)

MMR OR (2) Mumps, (2) Measles, and (1) Rubella; (3) Hepatitis B; (1) Varicella or date of disease (month/date/year) verified

by a physician; (1) Meningitis (required for all residential boarding students at Léman). All vaccines must be completed prior

to starting the first day of school.

Do I need a physical before attending school? While we welcome all medical information to best take care of your child, a

physical is required for every student, every year by a New York State physician. This will be provided during the first few weeks of

school and is included in tuition.

What happens if I get sick while at school? We have a doctor on-call 24 hours a day, 7 days for week to assist with directing medical

care to our students. In addition, House Parents and Residential Assistants complete medical training in the beginning of the year.

What is covered by the health insurance provided by Léman Manhattan Preparatory School? The health insurance

provided by the school will pay for most trips to the doctor or emergency room for illnesses or injuries that may occur over

the school year. The insurance does not cover preventive medicine (wellness visits), nor does it cover glasses/contacts,

cosmetic dermatology, treatment for acne, or routine dental visits.

How do I stay healthy while studying? Our program strongly encourages students to get plenty of sleep, eat well, exercise

on a daily basis, and practice good hygiene. We have many options for students who want to exercise and our cafeteria serves

healthy and nutritious food. The boarding staff works with students individually to make sure they develop healthy sleep

patterns and practice good daily hygiene.

FREQUENTLY ASKED QUESTIONS