Required Forms - The Acorn-A School for Young Children

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Thank you for completing the following information for the 2020-21 school year. Please make sure that every space is filled. Rather than leaving something blank, please type NONE or N/A. Please complete and submit your questionnaire by Monday, July 20. It will be printed and the teachers will have the forms available for your signatures on your home visit.

As a final step in completing the student questionnaire (below), please make sure to download the required forms:

Health Form
Health Concerns, Acknowledgement, and Release of Liability
Volunteer Waiver Please note, at this time, we are not allowing volunteers in the building.
Allergy Emergency Care Plan (if applicable)
Please also email a picture of your child to: Carrie@theacornschool.net

Also, please download, read, and keep for your records this important information:

Policy Letter for parents
Updated Policies and Procedures
COVID-19 Policy insert
(Kindergarten Only) The Race: Tortoise and the Hare Geography information (coming soon).

Class introductory letters are available!

If you complete your questionnaire for your child's records before the class introductory letter download is available, please make sure you return to obtain it. Thanks!

Student Records Forms 2020-21

Child's Class *
Child's Last Name *
Child's First Name *
Child's DOB *
Gender * (1 required)
Female Male
Child Address *
Child City/State *
Child Zip Code *
Parent 1 Title *
Parent 1 First Name *
Parent 1 Last Name *
Parent 1 preferred phone *
Parent 1 email *
Parent 1 Address, if different from child
Parent 1 City State
Parent 1 Zip Code
Parent 2 Title
Parent 2 First Name
Parent 2 Last Name
Parent 2 preferred phone
Parent 2 Email
Parent 2 Address, if different from child
Parent 2 City/State
Parent 2 Zip Code
Parent 1 Primary Emergency # *
Parent 2 Alternate Emergency # *
Other Emergency #
Parent 1 Employer or n/a *
Parent 1 business address or n/a *
Parent 1 business city/state/zip code or n/a *
Parent 1 Business # or n/a *
Parent 2 Employer or n/a
Parent 2 business address or n/a
Parent 2 business city/state/zip code or n/a
Parent 2 Business # or N/A *
Emergency Contact 1 to be Notified (When Parents Cannot be Reached) *
child may also be released to person noted above from school * (1 required)
Yes No
Relationship 1 *
Emergency Contact 1 Primary # *
Emergency Contact 1 alternate #
Emergency Contact 1 Address *
Emergency Contact 1 city/sate/zip *
Emergency Contact 2
child may also be released to Emergency Contact 2 from school
Yes No
Relationship 2
Emergency Contact 2 Primary #
Emergency Contact 2 alternate #
Emergency Contact 2 Address
Emergency Contact 2 city/state/zip
Name 3 Emergency Contact
child may also be released to Emergency Contact 3 from school
Yes No
Relationship 3
Emergency Contact 3 Primary #
Emergency Contact 3 alternate #
Emergency Contact 3 Address
Emergency Contact 3 city/state/zip
Physician Name *
Physician Phone # *
Physician Address *
Physician city/state/zip *
Hospital Preferred for Emergency Treatment - closest or name: *
Health Insurance Company *
Group/Subscriber # *
Allergies or N/A *
Other special medical issues or N/A *
Current Medications or N/A *
Specific instructions as needed or N/A *
Carpool/Nannies/Other to whom child may be released *
Carpool/Nannies/Other 1 relationship *
Carpool/Nannies/Other 1 phone number *
Carpool/Nannies/Other 2 to whom child may be released
Carpool/Nannies/Other 2 relationship
Carpool/Nannies/Other 2 phone number
Carpool/Nannies/Other 3 to whom child can be released
Carpool/Nannies/Other 3 relationship
Carpool/Nannies/Other 3 phone number
I give permission for the following to be listed in the private student directory (login required): * (1 required)
all: parent name, address, mobile numbers, emails parent(s) name(s) address mobile numbers email addresses I give permission for my child's name only (this will limit a class parent from getting in touch)
Field trips are currently on hold, but please complete for our records in the event circumstances change.
I give permission for my child to go on field trips planned by The Acorn (choose one):
I give permission for my child to participate in playground water activities: *
I give permission for my child to be photographed and/or recorded by staff, parents, or media: *
I give permission for my child to have artwork shown in school-sponsored gallery displays at museums *
I give The Acorn staff permission to apply mosquito repellant or topical lotions, as needed*
I give permission for images/recordings of my child to be used publicly on the website/social media*
Does your child have any allergies? Any chronic or contagious conditions? If yes, please describe. *
Any special services (speech, motor lab, etc.) he/she receives currently or in the past? *
Any special needs? Are there any unique circumstances in birth and/or development? *
Is your child extremely afraid of anything? *
What special interests, favorites, does your child have? (dinosaurs, insects, sports, trains, etc.) *
Any themes you would rather we avoid? *
What hobbies/interests/professions do you have that you might share with the class?
What family passes do you have? Zoo, The Witte, Botanical Gardens, DoSeum, The McNay? etc. *
Any other pertinent information regarding your child/family? (family traditions, celebrations, etc. *
FOR YOUNGER CHILDREN: Please describe your child’s toileting habits/words used. *
FOR YOUNGER CHILDREN: What are your child’s favorite songs/games/toys? *
FOR YOUNGER CHILDREN: What comfort techniques do you use with your child? *
Volunteer Opportunities: NOT allowed at this time, in case this changes, Check all that apply
Class Helper (get to know you picnic, organize special activities and days, etc.) Office Helper (Laminating, activity prep, sewing, filing, data entry, phone calls, etc.) Children’s Library Organizer (enter new books into database, add to collection, etc.) Substitute Teachers (Parents most often use this as a way to volunteer in the classroom) Handy Helpers (fix up around school as needed, Sat. work day. etc.) Book Order Helper (Sort and distribute book orders) Box Tops Helper (Oct.; Feb.) (Count donations, etc.) New Parent Coffee (October) (provide snacks, etc.) Fall Family Event: Potluck, Picnic (hopefully at Kiddie Park again)
Fundraising/Donations 2020-2021 (Live Event currently on hold) * (1 required)
Will contact a business regarding supply donations (cleaning supplies, paper products, etc) Will contact a business regarding monetary donations Will donate supplies (cleaning materials, paper products, etc) myself or through my company Will provide a monetary donation to The Acorn, myself or through my company Will help contact businesses and gather prizes/silent auction items Will help with underwriting
Enter Your Email Address: *