Kinder Enrollment Form - Oasis Charter Public School

Oasis Charter Public School

Kinder Enrollment Form

Kinder Oasis Enrollment Online (English)

Child's Information

Name(Required)

First Middle Last

Child's Nickname

Birth Date(Required)

Birth Place (City/State)(Required)

Gender(Required)

Male

Female

Age(Required)

Grade Child Will Enter 2025-2026(Required)

District of Residence(Required)

Last School Attended(Required)

Preferred Correspondence Language(Required)

Student Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Student Lives With(Required)

Family Information

Mother/Stepmother/Guardian 1(Required)

Mother

Step Mother

Guardian 1

Mother/Guardian 1's Name(Required)

First Last

Mother/Guardian 1's Home Phone(Required)

Mother/Guardian 1's Cell Phone(Required)

Mother/Guardian 1's Work Phone(Required)

Mother/Guardian 1's Physical Address(Required)

Street Address Address Line 2 City State ZIP Code

Mother/Guardian 1's Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Father/Step Father/Guardian 2(Required)

Father

Step Father

Guardian 2

Father/Guardian 2's Name(Required)

First Last

Father/Guardian 2's Home Phone(Required)

Father/Guardian 2's Cell Phone(Required)

Father/Guardian 2's Work Phone(Required)

Father/Guardian 2's Physical Address(Required)

Street Address Address Line 2 City State ZIP Code

Father/Guardian 2's Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Mother's Education Level:(Required)

Not a high school graduate

Some College (includes AA degree)

Graduate school/postgraduate training

High school graduate

College graduate

Father's Parent Education Level(Required)

Not a high school graduate

Some College (includes AA degree)

Graduate school/postgraduate training

High school graduate

College graduate

Ethnicity: Is this student/staff member Hispanic or Latino?(Required)

No, not Hispanic or Latino

Yes, Hispanic or Latino

The above part of the question is about ethnicity, not race. No matter what you selected above, please continue to answer the following by marking one or more boxes to indicate what you consider your race to be.

Race: What Is the race of this student? (Select one or more)(Required)

Oasis Charter School welcomes all students to our family! Understanding our students' history with special education assessments, services, and placements better positions our entire staff to support your child. Disclosing your child's educational history will in no way affect their admission into Oasis, but it WILL allow us to have a conversation about supports we can immediately put into place so your child starts the year off on the path to success!

Has your child ever been evaluated for special education or received special education services?(Required)

Yes

Has your child ever attended a special education class?(Required)

Yes

Which class or service did your child attend? (Check all that apply).(Required)

SPEECH

LH/SDC

ED/SDC

CH/SDC

ADAPTIVE P.E.

OTHER

If so, when did they attend a special education class?(Required)

Are they still receiving services?(Required)

Yes

Was this in a(Required)

Public School

Private School

Name of last school where services were received(Required)

Parent/Guardian Signature(Required)

Date(Required)

OCPS will not discriminate on the basis of race, color, sex, national and ethnic origin, age, religion, or disability in the administration of its educational, admission and athletic policies and other school-administered programs.

Language Spoken at Home(Required)

Mother/Guardian 1's Employer(Required)

Mother/Guardian 1's Email(Required)

Mother/Guardian 1's Cell Phone(Required)

Father/Guardian 2's Employer(Required)

Father/Guardian 2's Email(Required)

Father/Guardian 2's Cell Phone(Required)

In case my child becomes ill or injured at school and parent contact cannot be made, you may contact or release my child to the following people. The following people are also allowed to pick my child up after school.

Emergency Contact Name 1(Required)

Emergency contacts should be able to answer calls from the school during the day and be available to pick up your child from the school in a timely manner when called.

Em. Contact 1's Relationship(Required)

Em. Contact 1's Home Phone(Required)

Em. Contact 1's Work/Cell/Daytime Phone(Required)

Emergency Contact Name 2(Required)

Em. Contact 2's Relationship(Required)

Em. Contact 2's Home Phone(Required)

Em. Contact 2's Work/Cell/Daytime Phone(Required)

Emergency Contact Name 3(Required)

Em. Contact 3's Relationship(Required)

Em. Contact 3's Home Phone(Required)

Em. Contact 3's Work/Cell/Daytime Phone(Required)

Health Care Provider(Required)

Health Care Provider Phone(Required)

Name of Medical Insurance(Required)

Policy Number(Required)

Medical Condition

Yes

My Child receives regular care for the following medical conditions

Allergies

Date of last reaction

Check all that apply

Requires Epinephrine

Asthma

Diabetes

Insuline Required

Seizures

Does your child have any other major health issue(s)? Please list:

Is your child taking medication that needs to be given at school?(Required)

Prescriber's Name/Title(Required)

Prescriber's Telephone Number(Required)

Prescriber's Fax Number(Required)

Prescriber's Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

A signature from your medical prescriber will be required on our official document before we can administer medication at school. Thank you so much!

Medication 1 name(Required)

Medication 1 Strength(Required)

Type of medication (1)(Required)

Required Dose for medication 1(Required)

Times medication 1 is to be given at school(Required)

Reason for giving medication 1(Required)

Relevant side effects for medication 1(Required)

If medication 1 is PRN, frequency:

If medication 1 is PRN, for what symptoms?

How soon can medication 1 dose be repeated?(Required)

Medication 1 shall be administered from [date] to [date] or remainder of year:(Required)

Additional instructions for medication 1

Medication 2 name

Medication 2 Strength

Type of medication (2)

Required Dose for medication 2

Times medication 2 is to be given at school

Reason for giving medication 2(Required)

Relevant side effects for medication 2

If medication 2 is PRN, frequency:

If medication 2 is PRN, for what symptoms?

How soon can medication 2 dose be repeated?

Medication 2 shall be administered from [date] to [date] or remainder of year:

Additional instructions for medication 2

I give consent for school personnel to administer the above medication to my child per the instructions of the above Health Care Provider (HCP). I give my consent for exchange of information and communication directly between the HCP listed above or dispensing pharmacist and an Administrative Assistant, regarding the HCP's written statement or any other questions about teh medication or mediation administration. I understand that I may refuse consent for this permission at any time by notifying the school director in writing. I understand and agree to the following responsibilities regarding medication administration:

Prescription medication must be in a container labeled by the pharmacist or healthcare provide.(Required)

Non-prescription medication must in the original container with the label intact.(Required)

An adult must bring the medication to the school and pick up any outdated or unused medication.(Required)

Pill splitting must be done by parent/guardian prior to providing medication to school officials.(Required)

Parents will notify the school nurse or administrator and provide new consent to any changes to the above authorization.(Required)

Any modifications or changes to the above authorizations may only be made after written notification is received from the HCP.(Required)

Parents/Guardians provide all materials or necessary equipment (e.g. measuring spoon, pill crusher).(Required)

Parent/Guardian Signature(Required)

Other children in the family:

Child 1 Name

Child 1 Relationship

Child 1 Grade

Child 1 Date of birth

Child 1 Age

Child 1 Male or Female

Child 2 Name

Child 2 Relationship

Child 2 Grade

Child 2 Date of birth

Child 2 Age

Child 2 Male or Female

Child 3 Name

Child 3 Relationship

Child 3 Grade

Child 3 Date of birth

Child 3 Age

Child 3 Male or Female

Child 4 Name

Child 4 Relationship

Child 4 Grade

Child 4 Date of birth

Child 4 Age

Child 4 Male or Female

I certify that my child is a resident of California.(Required)

In an emergency, when we cannot be contacted, the school authorities or parent volunteers have our permission to use their best judgment in the interest of our child’s health and welfare. The school assumes no financial responsibility or legal liability. If emergency service involving medical action or treatment is required and neither parent nor the family physician can be reached for consent, the parent hereby consents to the rendering of such emergency medical service for the above named students as shall be necessary in the opinion of the adult performing supervision.

Signature of Parent or Guardian(Required)

Birthday of Student

Birth Month(Required)

Birth Day(Required)

Birth Year(Required)

Date first enrolled in a California public school:

First CA Enrollment Month(Required)

First CA Enrollment Day(Required)

First CA Enrollment Year(Required)

Date first enrolled in any school in the United States:

First USA Enrollment Month(Required)

First USA Enrollment Day(Required)

First USA Enrollment Year(Required)

The California Education Code requires schools to determine the language(s) spoken at home by each student and the dates they first enrolled in schools in the United States. This information is essential for schools to provide meaningful instruction for all students. Your cooperation in helping us meet this important requirement is requested. Please answer the following questions and return this form to the office. Thank you for your help.

Which language did your son or daughter learn when he or she first began to talk?(Required)

What language does your son or daughter most frequently use at home?(Required)

In what language do you most frequently speak to your son or daughter?(Required)

What language is spoken most often by the adults at home?(Required)

Signature of Parent or Guardian(Required)

Typed Name of Parent or Guardian(Required)

This information is confidential and will only be used to determine eligibility for state funds through the California Department of Education for the 2025-26 school year. This information will not be divulged for any other reason.

How many adults are there in the household?(Required)

How many children are there in the household?(Required)

For School use only, total monthly income:(Required)

Please circle all services that you are receiving:

CalFRESH

CalWORKS

Kin-GAP

FDPIR

Parent/Guardian Signature(Required)

I hold Monterey County Office of Education, the UCEN Board of Directors, and Oasis Charter Public School, its Faculty, Agents and Employees harmless from any and all liability or claims which may arise out of or in connection with my child’s participation in any school authorized field trip.

In an emergency when I cannot be contacted, the school authorities have my permission to use their best judgment in the interest of my child’s health and welfare. The school assumes no financial responsibility. If emergency services involving medical action or treatment is required and neither parent nor the family physician can be reached for consent, I consent to the rendering of such emergency medical service for the above named student as shall be necessary in the opinion of the medical staff rendering service.

PERMISSION SLIP FOR PHOTOGRAPHING YOUR CHILD

From time to time we take pictures during activities. We would like your permission to use these pictures on our website, advertisement, or in our tri-fold. We will never reference your child by name or provide any specific information regarding your child. We also will never sell these pictures; we will use them exclusively for Oasis purposes.

Please take a moment to let us know your preferences regarding our use of photos of your children:(Required)

Yes

Parent/Guardian’s Signature:(Required)

Family Participation Agreement for the 2025-26 School Year

By enrolling my child at Oasis Charter Public School, in agreement with the school’s charter, I commit to support the school and my child’s education by:

Attending BOTH All Family Meetings.(Required)

Please initial

Attending the parent-teacher conferences.(Required)

Please initial

Participating in school wide events.(Required)

Please initial

Having my child to school on time and making every effort to ensure my child attends school every day.(Required)

Please initial

Supporting the Oasis Charter Public School by modeling appropriate behavior at school.(Required)

Please initial

Reading and holding my child accountable to the Oasis Code of Conduct, understanding there is no tolerance for unwanted physical contact between 2 or more students, or a student against a staff member, at any time, for any reason.(Required)

Please initial

Parent/Guardian’s Signature(Required)

The information provided below will help determine what services you and/or your child may be eligible to receive. This could include additional educational services through Title I, Part A and/or the federal McKinney-Vento Assistance Act. The information provided on this form will be kept confidential and only shared with appropriate school district and site staff.

PLEASE SELECT BELOW WHICH BEST DESCIBES YOUR CURRENT LIVING ARRANGEMENT(Required)

Rent or own a home, mobile home, apartment, or condominium.

Moving from place to place/couch surfing

Living in car, RV, park, campsite, encampment, or on the street

Sharing housing with other(s) due to loss of housing,economic hardship, natural disaster, lack of adequate housing

Living in a residence with inadequate facilities (no water, no heat, or no electricity), shed, or unconverted garage

Temporarily living in a motel or hotel due to loss of housing, economic hardship, natural disaster, or similar reason

Staying in a shelter (family shelter, domestic violence shelter, youth shelter) or transitional housing

Your child or children may have the right to immediate enrollment in the school they last attended or the local school where you are currently staying, even if you do not have all the documents needed to enroll, continued attendance at their school of origin, transportation to and from their school of origin, special programs and services, free school meals, and/or full protections and services provided under all federal and state laws, as it relates to homeless children and youth.

As the parent/guardian of the above-named child, I declare under penalty of perjury under the laws of the State of California that the information provided here is true and correct.(Required)

Parent/Guardian’s Signature(Required)

Kindergarten Acknowledgement & Agreement

I (we) acknowledge and agree to the Kindergarten program that Oasis will offer to my child for the 2025-26 school year. The program is based on the following: An appropriate and well-designed play-based approach which supports children to develop the following skills:

An appropriate and well-designed play-based approach which supports children to develop the following skills: ➢ Social, Emotional, Cognitive, and Academic(Required)

Please Initial

Developmentally Appropriate Activities ➢ Organized games and planned academic/learning centers(Required)

Please Initial

Evaluations and Assessments ➢ Observations, student’s work, narratives, rubrics, and formal online assessments(Required)

Please Initial

Children born after Sept. 1, 2020.(Required)

Please Initial

**School Hours if your child is NOT ready for a full day of school: 8:30am- 12:30pm Monday through Friday . This determination will be made by teachers and administrators with the collaboration of parents. A meeting will be held before determination is made.(Required)

Please Initial

Parent/Guardian’s Signature(Required)

Oasis Charter Public School

Kinder Oasis Enrollment Online (English)

Child's Information

Family Information

Other children in the family:

Birthday of Student

Date first enrolled in a California public school:

Date first enrolled in any school in the United States:

PERMISSION SLIP FOR PHOTOGRAPHING YOUR CHILD

Family Participation Agreement for the 2025-26 School Year

Kindergarten Acknowledgement & Agreement

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