STUDENT INFORMATION #1 - PRIMARY EMERGENCY CONTACT #2 - EMERGENCY CONTACT #3 - EMERGENCY CONTACT AFTERNOON - TRANSPORTATION/PICK-UP

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1 TEACHER: GRADE: STUDENT INFORMATION Name: Birth Date: Student ID #: Mailing Address: House # Apt. # Street City Zip #1 - PRIMARY EMERGENCY CONTACT #1 PRIMARY Contact Name: Relationship: Home or Cell Phone #1: Phone #2: Employer: #2 - EMERGENCY CONTACT Work Phone: #2 Contact: Relationship: Home or Cell Phone #1: Phone #2: #3 - EMERGENCY CONTACT #3 Contact: Relationship: Home or Cell Phone #1: Phone #2: AFTERNOON - TRANSPORTATION/PICK-UP Bus - route #: Car Line Pickup Parent Walkup Walker/Bike School Extended Day Program what days? Other Transportation Service - Name: REQUIRED FORMS SIGNED & RETURNED Phone: Magnet School Commitment, Uniform Policy, Acknowledgement of Commitment & Dress Code (3 pgs) Yes No Code of Student Conduct Handbook (see below) Student Network & Internet Responsibility (pg. 61) Yes No Student/Parent Acknowledgement (pg. 62) Yes No Media Release (pg. 63) Yes No Field Trip Application (Chaperone) Form (fully complete) Yes No Allergies or Special Health Problems: Siblings that currently attend Osceola: MISCELLANEOUS Name: Grade: Teacher: Name: Grade: Teacher: Name: Grade: Teacher: ACKNOWLEDGEMENT ALL OF THE ABOVE IS CORRECT AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF. The above information is accurate and will be shared on a need to know basis verbally/written/electronically. I acknowledge that it is my responsibility to inform school of all changes. In the event of an accident/illness, attempts to notify custodial/emergency contacts will be made. If contact attempt is unsuccessful after a reasonable time, the school is authorized to handle the emergency as trained and directed under Florida Statute FS SIGNATURE Parent/Guardian Signature Print Name Date:

2 Teacher: Osceola Magnet School Parent & Student Commitment The parent will: a) support the Magnet School Program, philosophy, staff, administration and PTA. b) ensure my child will abide by the school s code of behavior and dress code. c) understand that bus transportation is a privilege for magnet school students and will require that my child behave safely and respectfully or the privilege will be denied. d) ensure my child is on time 8:45-3:20 (8:50) each day. Tardy students need to be signed in at the office by an adult before being released to class. e) abide by drop off and pick up procedures. f) arrange for my child to be taken home in the event of an illness or disciplinary reason. g) schedule family vacations and out of school activities for after school hours and on school breaks. h) ensure my child is in school every day except for acceptable situations. Regular school attendance is required by law and magnet school policy. i) notify the office if my child is ill or has a medical appointment during school hours and provide a written explanation/doctor s note upon his/her return. j) immediately notify the office if a change in address or phone number should occur. k) complete a minimum of 10 volunteer hours and participate in school events. l) attend all scheduled conferences, check backpacks, agendas, folders, respond to school communication and assist with homework. m) attend all general PTA meetings (one volunteer hour earned for each meeting, an additional volunteer hour required for each meeting missed). The student will a. follow the school dress code every day. b. move around campus in a safe and orderly manner. c. be cooperative, orderly and task oriented in my classroom. d. be engaged in the learning process, including completing assignments and homework. e. bring notices from my teacher, parent, or guardian both to and from school. f. understand bus transportation is a privilege and that good behavior will allow me to ride the bus. g. respect school property by taking good care of furniture and equipment. h. speak courteously and display good manners at all times. i. treat all classmates and staff with respect and dignity; use appropriate language/behavior and refrain from intimidating, harassing or threatening behavior. j. understand school is a safe place for learning; scuffling and fighting behaviors are unacceptable. k. understand that candy, gum, and toys need to stay at home unless otherwise requested. l. behave according to these commitments in all locations (bus stop, bus, bathroom, cafeteria, recess, field trips, and after school activities) Student Name (Printed): Student Signature: x Date: Parent Signature: x Date: Failure to abide by this commitment will result in returning to your home-zoned school.

3 OSCEOLA MAGNET SCHOOL Uniform Policy Teacher: School colors are: white, pastel yellow, red, royal blue, light blue, navy Clothing and appearance are to reflect a traditional style. *** if in doubt about a special day, wear your uniform *** Shorts: navy, khaki, or Osceola Plaid. MUST extend beyond finger length. Long pants: navy or khaki Polo shirts: white, pastel yellow, red, royal blue, light blue, or navy Oxford shirts: long or short sleeve in white, pastel yellow, or light blue Blouses: Peter Pan collared, solid colors, white, pastel yellow, or light blue. Polo style dresses: royal blue, light blue, navy, or red. MUST extend beyond finger length Jumpers: navy, khaki, or Osceola plaid. Jumpers are sleeveless and are worn with a short or long-sleeved shirt. Hemline MUST extend beyond finger length. Skirts/culottes: navy, khaki, or Osceola plaid. MUST extend beyond finger length. Tights/Leggings: full length tights or long (ankle length) leggings in navy or white worn under skirts, jumpers, or polo style dresses. Socks: ankle, crew, or no-show. Any solid color listed above and black or grey. Knee Socks for girls: right under knee. Navy or white only. Shoes: sneakers are encouraged every day. Shoes are to be laced or Velcro-ed. No lighted shoes, no backless sandals, no flip-flops, no crocs, no platform shoes, no boots, or no wheeled shoes. Belts: brown, black or colors listed above. Belts must be worn when shorts or pants have belt loops. No ties (as in scarves), chains, etc. are to be used instead of a belt. Sweaters/sweatshirts/fleece: any solid color listed above. NO picture or wording other than Osceola logo. Sweatpants: any solid color listed above. NO picture or wording other than Osceola logo. Trendy items are not to be worn i.e., cargo pants, decorated jeans, skin tight clothing, no torn or frayed (un-sewn edges), logos, patterns, lace, sequins, etc. Hair may not be dyed, colored or styled in a way that would be distracting to the learning environment. Shirttails are to be tucked in. Make-up, false fingernails, dangling/distracting/expensive jewelry, etc. is not allowed. On cold days (49 degrees and below) students may wear sweat suits in any solid color listed above or blue denim jeans. All removable clothing should be labeled with your child s name. Special Days On Spirit Days students may wear the OMS Spirit or 5 th grade t-shirt with solid blue denim jeans or uniform pants. DARE t-shirt or scout uniform may be worn on meeting day. Other special days will be noted on the school calendar, website, or written notice. Parent Signature x Student Signature x

4 Teacher: Acknowlegement of Osceola Magnet School Commitment My signature indicates I have read and understand the expectations and commitments of attending Osceola Magnet School. Student Name (Printed): Student Signature: x Date: Parent Signature: x Date: Acknowlegement of Osceola Magnet School Uniform Policy/Dress Code My signature indicates I have read and understand the appropriate dress code required daily at Osceola Magnet School. Student Name (Printed): Student Signature: x Date: Parent Signature: x Date:

5 Teacher: Please carefully review the forms on the following pages with your child, complete all required information, and return them to your child s school. STUDENT NETWORK AND INTERNET RESPONSIBLE USE AND SAFETY AGREEMENT Please complete the following information and return to your child s school: Student User's Full Name (please print): School: OSCEOLA MAGNET SCHOOL Grade: Parent/Guardian's Name: Parent/Guardian As the parent/guardian of this student, I have read the Student Network and Internet Responsible Use and Safety Policy, any guidelines referenced within, and have discussed them with my child. I understand that student access to the Network/Internet is designed for educational purposes and that the district has taken available precautions to restrict and/or control student access to material on the Internet that is obscene, objectionable, inappropriate and/or harmful to minors. However, I recognize that it is impossible for the district to restrict access to all objectionable and/or controversial materials that may be found on the Internet. I will not hold the district (or any of its employees, administrators, or officers) responsible for materials my child may acquire or come in contact with while on the Internet. Additionally, I accept responsibility for communicating to my child the guidelines concerning acceptable use of the Internet: setting and conveying standards for my child to follow when selecting, sharing, and exploring information and resources on the Internet. I further understand that individuals and families may be liable for violations. To the extent that proprietary rights in the design of a website hosted on the district's servers would endow my child upon creation, I agree to assign those rights to the district. Check below to agree: I give permission for my child to use and access the Network/Internet at school and for the board to issue an account to my child. Parent/Guardian's Signature: x Date: Student I have read and agree to abide by the Student Network and Internet Responsible Use and Safety Policy, and any guidelines referenced within. I understand that any violation of the terms and conditions set forth in the policy and guidelines is inappropriate and may constitute a criminal offense. As a user, I agree to communicate over the Internet and the Network in an appropriate manner, while honoring all relevant laws, restrictions, and guidelines. Student's Signature: x Date: Teachers and building principals are responsible for determining what constitutes unauthorized or inappropriate use. The principal may deny, revoke, or suspend access to the Network/Internet to individuals who violate the Student Network and Internet Responsible Use and Safety Policy and related guidelines, and take such other disciplinary action as is appropriate pursuant to the Positive Climate and Discipline Code of Student Conduct. 61

6 STUDENT/PARENT ACKNOWLEDGMENT FORM Teacher: The Positive Climate and Discipline Code of Student Conduct has been developed to help your child gain the greatest possible benefit from their school experiences. The Code defines the responsibilities and the rights of students attending Indian River County Public Schools, and clearly identifies the consequences for student actions which violate this Code. The school is in need of your help and cooperation. Students, parents, and schools working together can maintain a safe and purposeful atmosphere in the schools where students can learn to their full potential. Since parents/guardians share responsibility for the actions of their children, they should also become familiar with the rules and expectations described in this handbook. Please read and discuss this important document with your child, then sign this form and return it to your child s school, where it will be kept on file. ID#: Student Name (Print) / School: / OSCEOLA MAGNET SCHOOL DOB: Student Signature / Date: x Cellular phone number: Parent/Guardian Name (Print) / Date: Parent/Guardian Signature / Date: x Note: Failure to return this acknowledgment form will not release a student or the parents/guardians of the student from responsibility for knowledge of the contents of the Positive Climate and Discipline Code of Student Conduct and will not excuse noncompliance with the Positive Climate and Discipline Code of Student Conduct by the student. Statement of Academic Honesty The School District of Indian River County strongly believes that academic honesty must be practiced by all its students. In accordance with the school district s mission to serve all students with excellence, the district must take an unwavering stand on academic integrity. Cheating and plagiarism are wrong. Cheating and plagiarism in any form as defined by this Code will be considered a critical breach of character and integrity, as well as a serious violation of the Positive Climate and Discipline Code of Student Conduct. The School District of Indian River County defines cheating as: The inappropriate and deliberate distribution or use of information, notes, materials, or work of another person in the completion of an academic exam, test, or assignment without specific teacher permission and proper crediting of the source (plagiarism). Refer to the Levels of Interventions and Consequences sections within this handbook for a listing of consequences relating to violations of academic honesty. In addition to the consequences applied by the teacher, a cheating or plagiarism violation will be referred to the administration and may result in the loss of eligibility or removal from an academic club, loss of academic honors and awards, and loss of eligibility to apply for or receive local academic scholarships. These decisions, any or all, would be decided by a committee of teachers appointed by the principal. I have read and understand the SDIRC s policy concerning academic honesty. Parent/Guardian's Signature: x Date: 62

7 Teacher: Media Release As the parent/guardian of a student in the Indian River County School District, I hereby grant the School Board of Indian River County, Florida, and its officers and employees, permission to photograph and/or record my student while involved in any and all school activities. I understand that my student s photograph, name (both verbally and in print), face, likeness, voice, and appearance contained in such media productions may be used for purposes including but not limited to public service announcements, professional development, school publicity, and other programs shown to the school community and the general public, and may appear in newspapers, on television, on district and public websites, in district publications (such as school yearbooks, school newspapers, and class pictures), and other communication tools inside and outside the district. Indicate preference by checking the box below: I WILL allow my student to be photographed and/or recorded for the purposes explained above. I will ONLY allow my student to be photographed for school and yearbook pictures. I will NOT allow my student to be photographed and/or recorded for the purposes explained above NOTE: The Request to Withhold Information (for junior and seniors only) form which was previously included in the code is now available on the SDIRC website: and in high school guidance offices. Student Name: x Parent/Guardian Signature Date 63

8 PTA Parent Information Request Our Room Parents are an important link in our classrooms. This form will be used by your lead room parent to help communicate information about class parties, the fall festival, teacher appreciation week, and items that help your teacher throughout the year. It also provides them with your interest and availability for special events, volunteering, or making donations. Thank you for taking the time to share your information, ideas and contributions! Student Information *Please Print Clearly* Name: (Last) (First) (Nickname) Teacher: Grade: Parent/Guardian #1 Information Name: (Last) (First) (Relationship) Phone Number: Receive Texts? Yes No address: Parent/Guardian #2 Information Name: (Last) (First) (Relationship) Phone Number: Receive Texts? Yes No address: Please check areas where you are able to help: In-class activities At home preparation of materials Donations for in class celebrations/projects Other skills or interests that might be helpful:

9 Student s Name and Grade Complete this form only if you are new to OMS Simply Circle Already signed up for OMS Simply Circle? You do not need to complete this form when your student graduates to the next grade level or if you have an additional sibling starting at OMS. Need to update your address? Please login to your Simply Circle account at go to the dropdown menu in the upper right corner where your name appears and select Settings. What is SimplyCircle? SimplyCircle is a management and communications system that is used by the Osceola PTA to broadcast information from school administrators, teachers and the PTA. How does OMS PTA use SimplyCircle? Throughout the year you can expect to receive s on upcoming Osceola events, important days, fundraising, and volunteer opportunities. From your PC or smart phone you will be able to access your personal calendar with just a click of a button. You can also download a free mobile app from the App Store or Google Play. Will my information be secure with SimplyCircle? Yes, SimplyCircle is a secure, private system. Your address is not shared with anyone else and will not be listed on notices sent to other members. *Please Print Clearly* Parent s name Primary Address (where notices will be sent) Parent s name Secondary Address (optional) Phone number (Only to be used if there is a question on this registration) Questions? Contact the OMS SimplyCircle Coordinator at OsceolaPTA@gmail.com

10 PLEASE PRINT School District of Indian River County School Volunteer Program th Street Vero Beach, Florida (772) Field Trip Application (Chaperone) PLEASE NOTE: Must be submitted 3 weeks prior to field trip Date: / / Teacher: School: Osceola Magnet Elementary _ Child s Name: Last First Middle Chaperone s Name: Relationship to Child: Last First M Address: Phone/Cell: ( ) Street City State Zip Driver s License #: Date of Birth: / / Social Security #: XXX - XX - For the safety and protection of our students, please answer the following: Have you ever been convicted, pled nolo contendere (no contest), had a record sealed or expunged, been placed on probation, enrolled in a pretrial diversion program or had adjudication withheld in a criminal offense, felony, misdemeanor or otherwise, or are there any criminal charges pending against you other than a non-criminal or minor traffic violation? Yes If yes, give details below. Note: Failure to record such an offense may result in disqualification as a Volunteer. DUI/DWI are criminal offenses. (This is not inclusive. Other traffic offenses are criminal as well. If you are in doubt concerning this, consult an attorney). Where Arrested Date(s) Nature of Charge(s) Disposition(s) No / / / / / / * It is the policy of the School District of Indian River County to conduct Criminal Background checks for persons who participate in student contact activities. Please note the rules for field trips in our Indian River County Public Schools: All chaperones must be 21 years of age. Attend chaperone training as requested by your school. Dress appropriately. No siblings can attend. Supervise your group at all times. Get to know the students in your group. Make the trip a great experience for everyone in the group. Follow the planned timeline and itinerary. Be sure your group is in the right place at the right time. Accompany your students to the restroom area. The entire group must stay together. Never permit students to leave your group. Smoking, tobacco products, and alcohol are not permitted by School Board Policy. Do not use profane or inappropriate language. Do not buy drinks, snacks, treats or souvenirs for your group unless it has been planned as part of the trip. Do not ask other chaperones to supervise your group. Do not use cell phones except for emergency purposes. In an emergency, always contact lead teacher first. In an EXTREME emergency, call 911. Always remain calm. Failure to comply with Field Trip rules could result in disciplinary action being taken. Chaperone Signature: Date: / / Teachers Signature: Principal s Signature:

11 Everyone Deserves a HERO Helping Explorers Learn to Read on Their Own Osceola Magnet is looking for H.E.R.O's. A H.E.R.O is a volunteer that is trained to work one-on-one with students to help improve their reading skills. No Experience Necessary. All H.E.R.O's are asked to give a 9 week commitment so relationships can be established. If you are interested in becoming a H.E.R.O, please fill out the bottom and return to the front office Name: Telephone: Yes, I am interested in being a H.E.R.O Student Name: Grade: