kindergarten enrollment requirements

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Kindergarten Enrollment Requirements Students must be 5 years old by August 31 st , 2021 The following are required at registration: A complete record of immunizations. (See enclosed document:What to Provide For a Complete Immunization Record) Copy of student’s birth certificate Proof of residency within the Fife School District. See the Verification of Residence form for requirements. *Forms may be submitted electronically to the email listed below. Questions? Call 253-517-1200 or email [email protected]

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Page 1: Kindergarten Enrollment Requirements

Kindergarten Enrollment Requirements

Students must be 5 years old by August 31st, 2021

The following are required at registration: □ A complete record of immunizations.

(See enclosed document:What to Provide For a Complete Immunization Record) □ Copy of student’s birth certificate

□ Proof of residency within the Fife School District. See the

Verification of Residence form for requirements.

*Forms may be submitted electronically to the email listed below.

Questions? Call 253-517-1200 or email [email protected]

Page 2: Kindergarten Enrollment Requirements

Name of School

Fife Public Schools Student Registration Form

5802 20th Street E, Tacoma, WA 98424

For Office Use Only – Please do not write in the gray boxes Student SSID Address Verification Health Alert Date

Immunization

Other ID Birth Certificate Entry Date Out of District Release Yes No

Student Information

Has the student previously attended the Fife School District? Yes No If yes, please list the last school and year(s) attended

School student is currently attending:

Has your student ever been suspended or expelled from school?

Yes No

Legal Last Name (As Listed on Birth Certificate)

Legal First Name Middle Name Preferred Name Gender Male

Grade to be Enrolled

Female Date of Birth / /

Birth City

Birth State Birth Country Required: Language Spoken at Home (other than English)

Month Day Year

Has your child been enrolled in any special Programs? Yes No Special Education ( ) ELL/Bilingual ( ) Highly Capable ( ) LAP/Title I Reading ( )

McKinney-Vento ( ) Speech Therapy ( ) Indian Heritage ( ) If yes, Please fill out appropriate forms.

Does your child have a current IEP? ( ) 504 Plan ( ) Medical Safety Plan ( )

Required: Ethnicity and Race Information – Please see Additional Page

Parent/Guardian Information #1 Student Lives With:

Parents Grandparents Guardian Self Agency Other

Last Name ( Parent/Guardian Where Student Resides) First Name Relationship to Student

Cell Phone Home Phone Work Phone Email Address

Last Name (2nd Parent/Guardian Where Student Resides) First Name Relationship to Student

Cell Phone Home Phone Work Phone Email Address

Home Street Address APT # City State Zip Code

Mailing Address (If Different) City State Zip Code

Page 3: Kindergarten Enrollment Requirements

2nd Household (if applicable)Last Name First Name Relationship to Student

Cell Phone Home Phone Work Phone Email address Check all boxes that Apply Okay to Pick-up To receive mailings

Home Street Address APT # City State Zip Code

Emergency Contact Information #1 Last Name First Name Relationship to student

Cell Phone Home Phone Work Phone Okay to pick up: Yes No

Home Street Address APT # City State Zip Code

Emergency Contact Information #2 Last Name First Name Relationship to student

Cell Phone Home Phone Work Phone Okay to pick up: Yes No

Home Street Address APT # City State Zip Code

Emergency Contact Information #3 Last Name First Name Relationship to student

Cell Phone Home Phone Work Phone Okay to pick up: Yes No

Home Street Address APT # City State Zip Code

Medical Contact Information Primary Physician Name Phone Number

Other

List other Siblings in the Household Last Name First Name School Grade

Daycare Provider Daycare Name Supervisor Phone Number

Verification of Information Parent/Guardian Statement: I certify that all the information that I have provided is true and accurate. I understand that falsification, misleading information or failure to provide supporting documents may be cause for revoking the student’s enrollment or assignment to a school in the Fife-Milton School District.

Legal Parent/Guardian Signature Date

Page 4: Kindergarten Enrollment Requirements

Verification of Residence

To verify residency within the Fife School District, one current document (dated in the last 30 days) must be presented that shows parent/legal guardian name and address. Residence is defined as the physical location of a student’s principal abode – i.e. the home, house, apartment, facility, structure, or location, etc.—where the student lives the majority of the time. (WAC 392-137-115).

Post Office box numbers are not acceptable as residence addresses. Examples of acceptable documents include:

☐ Escrow papers, mortgage book or statement, property tax form, or homeowner’s association fees statement ☐ Current Lease agreement/rental contract or receipt (with listed occupants) ☐ Utility bill with current address ☐ Government Mail – Examples include car registration, Letter from Social Security, immigration, election ballot, DMV ☐ Property tax bill

Student (print name) Parent/Guardian (print name)

By signing and providing the appropriate documentation, it is declared that the above named student resides at the address shown on the document presented at the time of registration. Any change in address during the year must be reported to the resident school within two (2) weeks. If the address is outside the school district, a Non-resident form must be submitted to be considered for continued attendance as outlined in Policy 3141 and Procedures 3141P.

Falsification of an address or residence (or conditions of living arrangement) to obtain a school assignment will be cause for the revocation of the student’s school assignment.

Signature of Parent/Guardian Date

Page 5: Kindergarten Enrollment Requirements

Kindergarten Information

Birth date Gender Student’s First and Last Name Child’s First Language

Do you need an interpreter?

What name or nickname would you like your child to use at school?

Parent/Guardian Name Telephone Number Today’s Date

Please tell us about your child.

Uses Scissors

Usually Sometimes Not At All

Uses a pencil/pen to “write” Prints some or all letters in name Recognizes own name in print Will sit and listen to a story (5-10min) Shares and takes turns Knows the eight basic colors Identifies numbers 0-10 Is able to remember songs and rhymes Identifies some letters Likes to play/do activities quietly Likes to play/do activities actively

Please check characteristics that apply to your child: cries easily temper tantrums fear of new things sucks thumb is a leader prefers to follow responds well to praise very happy child separates easily from

parents

Does your child have a history of middle ear infections? Yes No Is your child left handed, right handed or undecided? Please list any health problems and/or allergies we should be aware of.

Previous school experiences: Preschool Head Start ECEAP Other

How Often?

Please indicate any concerns regarding your child’s placement.

Page 6: Kindergarten Enrollment Requirements

English/November 2016

Office of Superintendent of Public Instruction (OSPI) Home Language Survey

The Home Language Survey is given to all students enrolling in Washington schools.

Student Name: Grade: Date:

Parent/Guardian Name Parent/Guardian Signature

Right to Translation and Interpretation Services Indicate your language preference so we can provide an interpreter or translated documents, free of charge, when you need them.

All parents have the right to information about their child’s education in a language they understand.

1. In what language(s) would your family prefer to communicate

with the school?

Eligibility for Language Development Support Information about the student’s language helps us identify students who qualify for support to develop the language skills necessary for success in school. Testing may be necessary to determine if language supports are needed.

2. What language did your child learn first?

3. What language does your child use the most at home?

4. What is the primary language used in the home, regardless of

the language spoken by your child?

5. Has your child received English language development support

in a previous school? Yes No Don’t Know_

Prior Education Your responses about your child’s birth country and previous education: • Give us information about the

knowledge and skills your child is bringing to school.

• May enable the school district to receive additional federal funding to provide support to your child.

This form is not used to identify students’ immigration status.

6. In what country was your child born?

7. Has your child ever received formal education outside of the

United States? (Kindergarten – 12th grade) Yes No

If yes: Number of months: Language of instruction:

8. When did your child first attend a school in the United States?

(Kindergarten – 12th grade)

Month Day Year

Thank you for providing the information needed on the Home Language Survey. Contact your school district if you have further questions about this form or about services available at your child’s school.

Note to district: This form is available in multiple languages on http://www.k12.wa.us/MigrantBilingual/HomeLanguage.aspx. A response that includes a language other than English to question #2 OR question #3 triggers English language proficiency placement testing. Responses to questions #1 or #4 of a language other than English could prompt further conversation with the family to ensure that #2 and #3 were clearly understood. ”Formal education” in #7 does not include refugee camps or other unaccredited educational programs for children.

Forms and Translated Material from the Bilingual Education Office of the Office of Superintendent of Public Instruction are licensed under a Creative Commons Attribution 4.0 International License.

Page 7: Kindergarten Enrollment Requirements

Name of Student: RACE ‐ ETHNICITY DATA COLLECTION 2021‐2022

Please select both ethnicity and race. Hispanic Yes or No, if yes select which one(s). Then select any race(s) that may apply. Be sure to notice the bold categories prior to selecting the race(s).

Asian Black/ African-American Continued

Black/ African-American

American Indian/Alaskan Native

Native Hawaiian/Other Pacific Islander

White

R A C E

Asian Indian Bangladeshi

Lao Malaysian

Bhutanese Mien Burmese/Myanmar

Cambodian/Khmer Cham

Mongolian Nepali Okinawan

Chinese Pakistani Filipino Punjabi Hmong

Indonesian Japanese Korean

Singaporean Sri Lankan Taiwanese Thai

Asian (Write In) Tibetan Vietnamese

Hispanic Yes No

E T H N I C I T Y

Argentine Belizean

Honduran Jamaican Mexican Mestizo Native Nicaraguan Panamanian Paraguayan Peruvian Puerto Rican Salvadoran So. Georgia

Bolivian

Brazilian Chicano

(Mexican American)

Chilean

Colombian

Costa Rican Cuban Dominican Ecuadorian

El Salvadoran Sandwich Islands Falkland Islander Spaniard French Guianese

Guatemalan Surinamese

Uruguayan

Guyanese Venezuelan Hispanic (Write In)

R A C E

South African Botswanan South African Mosotho (Lesotho) Swazi Namibian

South African (Write In)

Black (Write In)

Latin American Argentine

Belizean Bolivian Brazilian

Guatemalan Guyanese Honduran Mexican

Chilean Nicaraguan Colombian Panamanian Costa Rican

Ecuadorian Paraguayan Peruvian

El Salvadoran Falkland Islander

So. Georgia/So. Sandwich Islands

French Guianese Surinamese Latin American (Write In) Uruguayan

Venezuelan

R A C E

African American African Canadian Caribbean

Anguillan Antiguan

Dominican (Dominican Republic)

Bahamian Barbadian

Dutch Antillean (Netherlands Antilles)

Barthélemois/Barthél emoises (Saint

Grenadian Guadeloupian

British Virgin Islander Haitian Caymanian Jamaican

(Cayman Island) Martiniquais/ Cuba Dominican Martiniquaise Caribbean (Write In)

Montserratian Puerto Rican

Central African Angolan

Cameroonian Congolese

(Dem. RC of the Congo)

Central African Equatorial Guinean (Cen. African RC) Gabonese

Chadian Congolese

São Toméan Principe

(RC of the Congo) Central African (Write In)

East African Burundian Reunionese Comoran Rwandan Djiboutian

Eritrean Seychellois

Seychelloise

Ethiopian Somali Kenyan South Sudanese Malagasy Sudanese

(Madagascar) Ugandan Malawian

Mauritian (Mauritius) Mahoran (Mayotte) Mozambican

Tanzanian (United RC of Tanzania)

Zambian Zimbabwean

East African (Write In)

West African Beninese Liberian Bissau-Guinean Malian Burkinabé Mauritanian

(Burkina Faso) Nigerien (Niger) Cabo Verdean Nigerian (Nigeria) Ivorian (Cote d’lvoire) Saint Helenian Gambian

Ghanaian Senegalese

Sierra Leonean

West African (Write In) Togolese

R A C E

Washington State Tribes Chinook Tribe

Confederated Tribes and Bands

of the Yakama Nation Confederated Tribes of the Chehalis Reservation

Confederated Tribes of the Colville Reservation Cowlitz Indian Tribe Duwamish Tribe Hoh Indian Tribe Jamestown S’Klallam Tribe Kalispel Indian Community

of the Kalispel Reservation Kikiallus Indian Nation

Lower Elwha Tribal Community

Lummi Tribe of the Lummi Reservation Makah Indian Tribe of the

Makah Indian Reservation Marietta Band of Nooksack Tribe

Muckleshoot Indian Tribe Nisqually Indian Tribe Nooksack Indian Tribe of Washington Port Gamble S’Klallam Tribe Puyallup Tribe of Puyallup Reservation Quileute Tribe of the Quileute Reservation Quinault Indian Nation Samish Indian Nation Sauk-Suiattle Indian Tribe of Washington Shoalwater Bay Indian Tribe

of the Shoalwater Bay Indian Reservation Skokomish Indian Tribe

Snohomish Tribe Snoqualmie Indian Tribe Snoqualmoo Tribe Spokane Tribe of the Spokane Reservation Squaxin Island Tribe

of the Squaxin Island Reservation Steilacoom Tribe

Stillaguamish Tribe of Indians of Washington Suquamish Indian Tribe

of the Port Madison Reservation Swinomish Indian Tribal Community

Tulalip Tribes of Washington

Alaskan Native (Write In) American Indian (Write In)

R A C E

Pacific Islander Palauan Papuan Pohpeian Samoan Solomon Islander Tahitian Tokelauan Tongan Tuvaluan Yapese

Carolinian Chamorro Chuukese Fijian i-Kiribati/Gilbertese Kosraean Maori Marshallese Native Hawaiian

Ni-Vanuatu Native Hawaiian (Write In) Other Pac. Islander (Write In)

R A C E

White White Eastern European

Bosnian Herzegovinian

Romanian Russian Ukrainian

Polish

Middle Eastern and North African Algerian Israeli Amazigh or Berber Jordanian Arab or Arabic Kurdish Kuwaiti Assyrian

Bahraini Lebanese

Libyan

Bedouin Moroccan Chaldean

Copt Druze Egyptian Emirati

Omani Palestinian Qatari Saudi Arabian Syrian

Iranian Tunisian Iraqi Yemeni Middle Eastern (Write In) North African (Write In)

Page 8: Kindergarten Enrollment Requirements

Fife Public Schools PARENT/GUARDIAN MILITARY SERVICE

Please respond to the following survey.

Student Name School

Parent/Guardian Date

Is the student’s parent or guardian in the military or employed by the federal government?

Yes No

Is the student's parent or guardian a member of the active duty U.S. Armed Forces?

Yes No

Is the student’s parent or guardian a member of the reserves of the U.S. Armed Forces?

Yes No

Is the student’s parent or guardian a member of the Washington National Guard?

Yes No

Does the student have more than one parent or guardian who is a member of the active duty U.S. Armed Forces or Reserves or Washington National Guard?

Yes No

Page 9: Kindergarten Enrollment Requirements

Student Name Unaccompanied Youth? First Middle Initial Last □ Yes □ No

Birth Date / _ / Age Grade Mo Day Year

□ Male □ Female

Fife Public Schools McKINNEY VENTO Housing Questionnaire

“Does the student qualify?”

School Name Date

This form is intended to address requirements of the McKinney-Vento Act, Title X, Part C of ESSA. Responses help staff provide proper school enrollment and appropriate services.

1. Is your current residence a temporary living arrangement? □ Yes □ No 2. Is your living arrangement due to loss of housing or economic hardship? □ Yes □ No 3. Is your current residence inadequate for meeting physical and psychological needs? □ Yes □ No

If NO to all of these questions, stop here. If YES to any of these questions, complete the remainder of this form.

Where does the student stay at night? (Please check one box.)

□ In a motel/hotel □ In a shelter □ With more than one family in a house, mobile home, or apartment (doubled-up) □ In a car, park, campsite, or location not usually used for sleeping accommodations (unsheltered)

Address Street City Zip

Phone

Parent/Legal Guardian Name

I declare under penalty of perjury under the laws of the State of Washington that the information provided here is true and correct.

Parent/Guardian Signature OR

Unaccompanied Youth Signature

Date

Date

FOR SCHOOL PERSONNEL USE ONLY If student is missing enrollment records, please contact the student’s previous school for records. Following records are still missing: □ Birth certificate □ Immunizations □ Medical records □ Prior academic records

School Personnel Signature Date

I hereby certify that the above named student qualifies for rights and services under the McKinney-Vento Act.

McKinney-Vento Liaison Signature Date

Step 1 - Qualify Confidential Housing Questionnaire

McKinney Vento 08/2017

1

Page 10: Kindergarten Enrollment Requirements

How will your student get to school? Parent Drop-Off: Bus:

If by bus, please list the complete pick-up address below.

Is this address? (Please list daycare name)

Home Daycare: Other:

How will your student be going home? Parent Pick-Up: Bus:

Phone # at destination: If by bus please list the complete drop-off address below. (include apartment complex or subdivision name)

Is this address? (Please list daycare name)

Home Daycare: Other:

Student Transportation Information

Student’s Name :

Office Use Only – Do Not Write Below This Line.

Teacher:

AM bus: AM Stop:

PM bus: PM Stop:

Route: Hedden Endeavour

Page 11: Kindergarten Enrollment Requirements

Option 1: Sign up for MyIR to View, Download, and Print Your Family's Immunization Information

MyIR allows you to manage your family's immunization records securely online. Once you register, you can access the records any time you need them. You can also print your child’s Certificate of Immunization Status (PDF) for school and child care entry. You can do all of this without an extra trip to your healthcare provider or school.

Step 1: Go to https://wa.myir.net/register to begin the sign-up process. If you choose the Auto Match option and the system finds an exact match, MyIR will send you a verification code by either text or phone call. If an exact match is not found, MyIR will direct you to Step 2.

Step 2: Fill out an Authorization to Release Immunization Records (PDF) or an Autorización para entregar documentos de vacunaciones (PDF) and check the box indicating you want to access your records online via MyIR. Mail, fax, or e-mail the form to: Washington State Immunization Information System

PO Box 47843 Olympia, WA 98504-7843 Fax: 360-236-3590 E-mail: [email protected]

Once they receive your signed form, they’ll register you in MyIR and send you a temporary PIN and instructions on what to do next. When you’re done, you’ll have immediate access to your family's immunization records to view, download, or print as often as you need. If you have any questions, please contact them at 360-236-3595 or 1-866-397-0337 or by e-mail at [email protected].

Option 2: Request a Complete Immunization Record from Your Healthcare Provider

Most healthcare providers in Washington use the Washington State Immunization Information System. Please check with your provider to ask if they can give you a complete immunization record for you or your child. They can print it from the Immunization Information System or from their own medical record system.

Option 4: Request a Complete Immunization Record from the Department of Health

If you can't get a complete immunization record from your provider and you don’t want to sign up for MyIR, contact the Office of Immunization and Child Profile at 360-236-3595 or 1-866-397-0337. The Department of Health uses the Washington State Immunization Information System, but it does not have complete immunization records for all people. When you call, you'll be asked to provide identifying information, such as name, date of birth, and address. At that time, they will tell you whether or not a record exists in the system, but no other information will be released over the phone. This is to protect the privacy and confidentiality of your information.

Fill out an Authorization to Release Immunization Records (PDF) or an Autorización para entregar documentos de vacunaciones (PDF). Mail, fax, or e-mail the form to: Washington State Immunization Information System

PO Box 47843 Olympia, WA 98504-7843 Fax: 360-236-3590 E-mail: [email protected]

Once they receive the signed form, they will mail, fax, or securely e-mail the immunization record to you within five business days. If you have any questions, please contact them at 360-236-3595 or 1-866-397-0337 or by e-mail at [email protected].

What To Provide For a Complete Immunization Record: Option 1: A copy of your child’s immunizations obtained from MyIR. (You can print or email it to [email protected])

Option 2: Request a copy of your child’s immunizations from your Healthcare provider.

Option 3: Fill out the provided Certificate of Immunization based on your child’s immunization card. Bring the card, a copy will need to be made.

Option 4: Request a complete immunization record from the Department of Health. Discovery Primary may be able to access immunization records for students who received their shots in Washington.

Directions for Options 1, 2 & 4 are below.

Page 12: Kindergarten Enrollment Requirements

Free immunizations for kids

Appointment required. Call (253) 403-1767. Tacoma—Mary Bridge WIC, 316 N. L St., Tacoma, 98403 (behind Frisko Freeze).

*Wednesdays and Thursdays 8:30-4:00, 2nd and 4th Saturdays

Puyallup—Mary Bridge WIC, 1011 E. Main St., Puyallup, 98372.

*Tuesdays 9:30-3:30

Bring your child's immunization record.

**Schedules subject to change**

Please visit www.tpchd.org/healthy-people/immunizations/for-children

Page 13: Kindergarten Enrollment Requirements

▲Required for School ● Required Child Care/Preschool

Date MM/DD/YY

Date MM/DD/YY

Date MM/DD/YY

Date MM/DD/YY

Date MM/DD/YY

Date MM/DD/YY

Required Vaccines for School or Child Care Entry

● ▲ DTaP (Diphtheria, Tetanus, Pertussis)

▲ Tdap (Tetanus, Diphtheria, Pertussis) (grade 7+)

● ▲ DT or Td (Tetanus, Diphtheria)

● ▲ Hepatitis B

● Hib (Haemophilus influenzae type b)

● ▲ IPV (Polio) (any combination of IPV/OPV)

● ▲ OPV (Polio)

● ▲ MMR (Measles, Mumps, Rubella)

● PCV/PPSV (Pneumococcal)

● ▲ Varicella (Chickenpox) History of disease verified by IIS

Recommended Vaccines (Not Required for School or Child Care Entry)

Flu (Influenza)

Hepatitis A

HPV (Human Papillomavirus)

MCV/MPSV (Meningococcal Disease types A, C, W, Y)

MenB (Meningococcal Disease type B)

Rotavirus

Documentation of Disease Immunity (Health care provider use only)

If the child named in this CIS has a history of varicella (chickenpox) disease or can show immunity by blood test (titer), it must be veri- fied by a health care provider.

I certify that the child named on this CIS has: A verified history of varicella (chickenpox) disease. Laboratory evidence of immunity (titer) to disease(s) marked below.

Diphtheria Hepatitis A Hepatitis B

Hib Measles Mumps

Rubella Tetanus Varicella

Polio (all 3 serotypes must show immunity)

Licensed Health Care Provider Signature Date

Printed Name

Health Care Provider or School Official Name: Signature: Date: If verified by school or child care staff the medical immunization records must be attached to this document.

I certify that the information provided on this form is correct and verifiable.

Certificate of Immunization Status (CIS) Please print. See back for instructions on how to fill out this form or get it printed from the Washington State Immunization Information System.

Child’s Last Name: First Name: Middle Initial: Birthdate (MM/DD/YYYY):

I give permission to my child’s school/child care to add immunization information into the Immunization Information System to help the school maintain my child’s record.

Conditional Status Only: I acknowledge that my child is entering school/child care in conditional status. For my child to remain in school, I must provide required documentation of immunization by established deadlines. See back for guidance on conditional status.

X Parent/Guardian Signature

Date

X Parent/Guardian Signature Required if Starting in Conditional Status

Date

Reviewed by: Date:

Signed COE on File? Yes No

Page 14: Kindergarten Enrollment Requirements

FIFE PUBLIC SCHOOLS Health History Form

Student Name DOB / / Sex Grade

Parent/Guardian(Print) Phone Check next to any condition or illness that applies to your child.

Note: For medication questions, mark the “yes” box only if child is taking medication now. Use the “Comments” section at the bottom of the page for explanations.

1

Allergies Food Medicine _ Insect stings Environmental Other allergies Specify reaction to allergy or allergen Rash Swelling Hives Trouble Breathing Vomiting Diarrhea Local Reaction EpiPen prescribed Takes medication for any allergies List medication(s) No medication (even over the counter) can be administered at school without a doctor’s order and parent signature.

2 Arthritis Describe 3 Asthma List triggers Diagnosed at age

Takes medication List medication(s) Under doctor’s care now Yes No

4 Attention Deficit/Hyperactivity Disorder (ADD/ADHD) Takes medication List medication(s)

5 Blood disorder Sickle cell anemia Specify 6 Cancer Explain 7 Cystic Fibrosis Takes medication List medication(s) 8 Dermatological/Skin Condition Describe 9 Developmental Delay Explain 10 Diabetes (high blood sugar) Type 1 Type 2 Hypoglycemia (low blood sugar) 11 Digestive disorders Explain 12 Eating Disorder Explain 13 Endocrine Explain 14 Gynecological Problems Explain 15 Headaches Migraines Under doctor’s care for this condition Yes No

Takes medication List medication(s) 16 Head injury/Concussion Month/Year Explain

17 Trouble hearing Uses hearing aid 18 Heart condition Explain _ _

Under doctor’s care for this condition Yes No Physical restrictions Yes No If yes,explain

19 Heat Sensitivity/Heat Exhaustion Explain 20 High blood pressure (Hypertension) 21 Kidney or bladder disorder Explain 22 Muscle/bone/mobility disorder Explain

Physical restrictions No Yes Explain

Need a doctor note yearly 23 Neurological Condition Explain 24 Nosebleeds 25 Psychiatric diagnosis

Takes medication List medication(s) 26 Seizure Disorder How long ago was the last one?

Takes medication List medication(s) 27 Surgery Explain Date 28 Vision problems Explain Glasses Contacts 29 Other Explain 30 My child does not have any of the listed conditions or illnesses. Comments or other health information

I herby give permission for my child to receive emergency medical care, and information on this document may be made available to school, healthcare provider and health department authorities. Parent/Guardian Signature Date

Page 15: Kindergarten Enrollment Requirements

Student Name:

Parent/Guardian Name: Parent/Guardian Name: Email Address(es):

Parent Teacher Organization Parent volunteers are a critical part of PTO and elementary school. We welcome your help in any way! There are service opportunities/committee positions that can be accomplished a few short hours during the school year or ones that play a major role in our organization. We have a place for those with little extra time to help and those who can help in many ways. The PTO would not be possible without volunteers like you! Please see specific volunteer positions below.

Please check the box if you would like your email to be added to our volunteer list. We will send out opportunities to volunteer and monthly meeting updates for PTO.

Please indicate below by checking specific boxes that you would be interested in volunteering for.

Board Position (President, Vice President, Secretary, Treasurer) - Time commitment is significant.

Book Fair Co-Chair -Requires set-up, decorating, and staffing 2 book fairs for school (Oct/Mar).

Box Tops- Establish school goal, count & ship labels, provide incentives for turning in box tops.

Emergency Kits- Help school keep emergency kits in classrooms up to date.

Family Fun Night - Plan and execute family actives for students and families to participate in.

Fundraising - Plan and facilitate one school-wide fundraiser which raises money for the year.

Publicity (Newsletter/Website/Facebook/photography) - Provide information about PTO happenings.

Read and Lead - Change out books for our Read and Lead program for a group of classes.

Skate Night - Plan and assist in skate nights with Pattison’s West Skating rink.

Spirit Wear - Work with company to sell and distribute school spirit wear 1 or 2x a year.

Staff Appreciation - Coordinate and plan pot lucks, treats, and other activities for staff.

We are looking forward to volunteering and serving with you! Please note that in order to volunteer in the school a district volunteer clearance form must be filled out with Fife School District.

Page 16: Kindergarten Enrollment Requirements

2/25/21

KINDERGARTEN SUPPLY LIST

PLEASE BRING THESE SUPPLIES TO ORIENTATION!

5 boxes of 24 Crayola brand crayons 1 package of yellow regular size #2 pencils with erasers – sharpened – (prefer Ticonderoga) 6 large glue sticks (.77 oz. or larger) 1 pair Fiskar’s brand scissors with metal blades 1 plastic folder with bottom pockets – please no side pocket PeeChees 3 large box of 80 unscented wet wipes – the kind used for changing diapers 1 box of Kleenex 1 bottle Elmer’s white glue 1 package Crayola brand markers 1 box 3 oz. or 5 oz. Dixie cups 1 pair headphones—please label with student’s name. (Dollar store or any over-the-ear headphones are o.k.--not earbuds)

A large backpack – No wheel carts please as they do not fit in the coat cubbies. This bag should be big enough to comfortably hold a folder and a lunch box – at least 16h x 12w x 5d. Clearly write your child’s name inside the bag.

**Please keep a change of clothes (pants, underwear and socks) in a plastic bag in your child’s backpack to be used if their clothes get wet and muddy at recess and for accidents

Boys Only 1 box quart size Ziplocs – 50 count (no plastic slide zip closure style)

Girls Only 1 box gallon size Ziploc freezer bags with writing strip (no plastic slide zip closure style)

Remember: Please label coats, lunch boxes, backpacks, etc. with your child’s name! Do not label supplies!

If providing supplies is a financial burden for your family, please contact your school counselor.