Book A Tour
About
About Us
Staff
What Our Families Are Saying
School Year Calendars
Parent Handbook
One Tree’s Statement on Diversity, Equity and Social Justice
2024 Summer Camp Info
Summer Camp Required Forms
Admissions
Admissions Information and Process
Student Recommendation Form
Homeschooling Resources
For Current Families
One Tree Family Directory
After School Outside Play
Primary Class Parent-Teacher Conferences
Lower Elementary Parent-Teacher Conferences
Upper Elementary Parent-Teacher Conferences
Required Forms
For One Tree Staff
One Tree Campout November 2021
Employment Recommendation
Blog
One Tree Tutorial & Enrichment
Book A Tour
About
About Us
Staff
What Our Families Are Saying
School Year Calendars
Parent Handbook
One Tree’s Statement on Diversity, Equity and Social Justice
2024 Summer Camp Info
Summer Camp Required Forms
Admissions
Admissions Information and Process
Student Recommendation Form
Homeschooling Resources
For Current Families
One Tree Family Directory
After School Outside Play
Primary Class Parent-Teacher Conferences
Lower Elementary Parent-Teacher Conferences
Upper Elementary Parent-Teacher Conferences
Required Forms
For One Tree Staff
One Tree Campout November 2021
Employment Recommendation
Blog
About
About Us
Staff
What Our Families Are Saying
School Year Calendars
Parent Handbook
One Tree’s Statement on Diversity, Equity and Social Justice
2024 Summer Camp Info
Summer Camp Required Forms
ONE TREE Summer Camp Forms
All forms are required
before
your child can attend
One Tree Tutorial & EnrichmenT Summer Camp
Emergency Care Information Form (One needed for EACH child)
Emergency Care Forms 2
In case of an emergency, One Tree Tutorial & Enrichment will contact 911. Every attempt will be made to contact a parent/guardian or a designated emergency contact.
Student Name 1
*
First Name
Last Name
Date of Birth
*
MM
DD
YYYY
Current Grade Level
*
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
Parent/Guardian 1
*
First Name
Last Name
Relationship to Child
Mother
Father
Legal Guardian
Primary Phone Number for Parent/Guardian 1
*
(###)
###
####
Secondary Phone Number for Parent/Guardian 1
(###)
###
####
Email for Parent/Guardian 1
*
Address for Parent/Guardian 1
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Parent/Guardian 2
*
First Name
Last Name
Relationship to Child
Mother
Father
Legal Guardian
Primary Phone Number for Parent/Guardian 2
*
(###)
###
####
Secondary Phone Number for Parent/Guardian 2
(###)
###
####
Email for Parent/Guardian 2
Address for Parent/Guardian 2 (if different from above)
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Emergency Contact 1
*
Please list at least 2 people we may call if the parent(s)/guardian(s) cannot be reached.
First Name
Last Name
Emergency Contact 1 Phone Number
*
(###)
###
####
Relationship to Child
*
Emergency Contact 2
*
First Name
Last Name
Emergency Contact 2 Phone Number
*
(###)
###
####
Relationship to Child
*
Current Health Conditions
Allergies
*
Please check below any health condition that may require attention during the school day.
Foods
Medicines
Bee stings
Insect Bites
Poison Ivy
Other
None of the Above
Allergy Specifics
Please be specific regarding any condition checked above.
Other Health Conditions
*
Please check any current health condition that may require attention during the school day.
Asthma
Diabetes
Hearing Problems
Heart Problems
Physical Disability
Seizures
Vision Problems
Other Respiratory Problems
Other not listed
None of the Above
Sepcifics
Please be specific about any condition checked above.
Other Health Conditions
Please note here any other health conditions, special medical information or personal information you would want an emergency care provider to know.
Medicines
Please list all medications and dosages your child receives on a continual basis.
Physician Name
*
Please provide the name of your child's current physician.
First Name
Last Name
Physician's Phone Number
*
(###)
###
####
Insurance Company
*
Insurance Policy Number
*
Insurance Phone Number
*
(###)
###
####
Preferred Hospital
AUTHORIZATION AND CONSENT OF PARENT(S) OR LEGAL GUARDIAN(S)
Agreement of Authorization & Consent
*
By selecting "Agree" I am providing One Tree Tutorial & Enrichment consent for the following: I do hereby state that I have legal custody of the aforementioned Minor. I grant my authorization and consent for One Tree Tutorial and Enrichment staff, (hereafter “Designated Adult”) to administer general first aid treatment for any minor injuries or illnesses experienced by the Minor. If the injury or illness is life threatening or in need of emergency treatment, I authorize the Designated Adult to summon any and all professional emergency personnel to attend, transport, and treat the minor after every attempt has been made to contact the parent(s) or legal guardian(s). It is understood that this authorization is given in advance of any such medical treatment, but is given to provide authority and power on the part of the Designated Adult in the exercise of his or her best judgment upon the advice of any such medical or emergency personnel. This authorization is effective through July 31, 2024.
Agree
Date
*
MM
DD
YYYY
Signature
*
First Name
Last Name
Thank you!
General Permission Form (Only one needed per family)
General Permission (Only One Needed Per Family)
Student Name
*
First Name
Last Name
Student Name 2 (If applicable)
First Name
Last Name
Student Name 3 (If applicable)
First Name
Last Name
PERMISSION TO USE PHOTOS
Permission to Use Photos
*
Please choose one.
I hereby give MY EXPRESS CONSENT to One Tree Tutorial & Enrichment to use pictures of my child(ren) in publications such as brochures, school handbooks, web page, social media, advertising, etc.
I hereby DECLINE One Tree Tutorial and Enrichment to use pictures of my child(ren) in publications such as brochures, school handbooks, web page, social media, advertising, etc.
Electronic Signature
*
First Name
Last Name
Date
*
MM
DD
YYYY
SUNSCREEN & BUG SPRAY*
* We ask parents to please apply sunscreen and bug spray before arriving to school. However, we also encourage students to re-apply when needed.
Authorization for child(ren) to SELF-APPLY SUNSCREEN
*
* If answering yes below, please provide a bottle of sunscreen, labeled with your cihld's name, to be kept at school.
YES
NO
Authorization for child(ren) to SELF-APPLY BUG SPRAY
*
* If answering yes below, please provide a bottle of bug spray, labeled with your child's name, to be kept at school.
YES
NO
Electronic Signature
*
First Name
Last Name
Date
*
MM
DD
YYYY
Thank you!
Child Pick Up Form (Only one needed per family)
Child Pick Up Form 2
CHILD PICK UP FORM
Student Name
*
First Name
Last Name
Student Name 2 (if applicable)
First Name
Last Name
Student Name 3 (if applicable)
First Name
Last Name
Please list below the names of people who may pick up your child in the event of an emergency or when you are unable to get here in time.***
Name 1
First Name
Last Name
Phone 1
(###)
###
####
Relationship to child
Name 2
First Name
Last Name
Phone 2
(###)
###
####
Relationship to child
Name 3
First Name
Last Name
Phone 3
(###)
###
####
Relationship to child
Name 4
First Name
Last Name
Phone 4
(###)
###
####
Relationship to Child
Please list anyone who you DO NOT want to pick up your child.
If there are any parents of currently enrolled One Tree students who have permission to "check-out" your child, please list them below:
e.g, if you are running late and this parent let's us know they are checking your child out, we have permission to release them to this parent
Please fill out a password that will be used by the above persons listed to pick up your child.
Password***
***Please keep this information current. If there is someone who is not currently on this list that will be picking up your child, be sure and call One Tree and/or let your child’s teacher know. If your child doesn’t recognize the other person (such as “Hi Grandma!”), then we will need to see some form of identification, unless the adult picking up the child knows the password.
Electronic signature indicating that the above information is accurate and that persons listed have your explicit permission to pick up your child from One Tree Tutorial and Enrichment.
*
First Name
Last Name
Date
*
MM
DD
YYYY
Thank you!
Release and Hold Harmless Authorization for Minor (Only one needed per family)
Release and Hold Harmless - General Liability 2
Student Name
*
First Name
Last Name
Student Name 2 (if applicable)
First Name
Last Name
Student Name 3 (if applicable)
First Name
Last Name
RELEASE AND HOLD HARMLESS AUTHORIZATION FOR MINOR : By clicking agree, you are agreeing to the following: The undersigned agrees to release and hold harmless One Tree Tutorial and Enrichment, its agents and employees from all claims, damages or other liabilities for injuries to their child or children which are not the result of gross negligence by One Tree Tutorial and Enrichment, its agents or employees.
*
AGREE
Electronic Signature
*
First Name
Last Name
Date
*
MM
DD
YYYY
Thank you!