Classroom Management Plan

Table of Contents Letter to Parents

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Letter to Students

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Teacher Parent Contract

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Teacher Student Contract

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Supply List

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Volunteer Flyer

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Student/Parent Contact Sheet

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Food Allergy Sheet

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Medical Release Form

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Student Release Form

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Mission Statement

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School Mission Statement

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Schedule

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School Calendar

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Classroom Procedures

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Classroom Rules

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Behavioral Log

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Detention Form

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Parental Contact Record Sheet

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Meeting Agenda

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Visit to Nurse

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Restroom Log

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IEP Form

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Substitute Teacher Form

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Classroom Handbook

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Technology Usage Form

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Welcome Students

Dear Students, We are very happy to have you all in our class this year. I hope you are all as excitedas we are for this upcoming school year. We think that you will all enjoy this year. We will take you on a journey. If any of you have any questions or any suggestions – providing the request goes along with the school curriculum, we will gladly consider the request. Please talk to us if there is anything that is bothering you, you will find that we are great listeners and that we will accommodate your needs if need be. Hope this year is a memorable one for all of us.

Sincerely,

Your Teacher

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Volunteer Leadership

Chaperone

Help recruit, coordinate and schedule volunteers for various activities.

Adults are needed to chaperone the corps members while on tour and help them with any problems which may arise.

Cooks Prepare and serve meals to members, staff and volunteers during band camp.

Drivers Help is needed moving equipment on and off the field, loading the equipment truck

Tailors & Seamstresses Volunteers are needed to fit and hem uniforms and sew flags for field competition.

Carpentry & Welding Design and build a variety of different equipment such as storage racks for instruments and uniforms for the truck.

Uniform Maintenance These volunteers assign uniforms and maintain them by laundering and making the needed repairs Instrument maintenance is usually completed at the end of season; however, minor repairs may be needed from time to time.

Medical Volunteers who have a medical background can help members with first aid or other minor needs.

Fundraising 7

Adults are needed to help raise monies for equipment and other items needed for competition.

In Kind Donations Donations of goods are always needed to help keep fees and fundraising to a minimum. Help here can include finding donations of food, materials and labor for special projects.

General Office If you would like to help with correlating mail outs, designing fliers, stuffing envelopes and various other tasks we need your help. Many times people are reluctant to volunteer because they do not have a lot of spare time or do not feel they have anything to

offer. At Jester Corps we will use anyone who is willing to spare some of their valuable time to help the young adults in our program be successful. If you would like to help or would like more information please feel free to contact ____________________ at ________.

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Food Student/ Parent Information Form Student Name__________________________________ Cell Phone (

)

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E-Mail Address_________________________ Birthday ____/ ____/ ____ Home Address _____________________________________ City __________________________________ State _______ Zip Code _____________ Phone (_____) _____- ________________ Instrument What instrument do you play? ___________________________________________ Do you need a school instrument?

YES

NO

Mother/ Guardian Name________________________________

Occupation _________________________

Email________________________________

Cell Phone__________________________

Fill this in if different than home address above: Home Phone (_______) ________-___________________________ Address_____________________________________________________________________ City________________________________________________State_______Zip___________ Father/ Guardian Name________________________________

Occupation _________________________

Email________________________________

Cell Phone__________________________

Fill this in if different than home address above: Home Phone (_______) ________-___________________________ Address_____________________________________________________________________ City________________________________________________State_______Zip___________

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Allergies & Nutritional Needs Last Name_________________________________ First Name_________________________________

Indicate if non-applicable

Please list any food allergies 1. ________________________________________ 2. ________________________________________ 3. ________________________________________

Indicate if non-applicable

Please list any special nutritional needs 1. ________________________________________ 2. ________________________________________ 3. ________________________________________

Member signature

Parent/guardian signature

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MEDICAL AND RELEASE FORM Name _______________________ _____________________________________ B irthdate ______/______/ _____ Home Address __________________________ ___________________________ City _______________________________________ State ________________ _________ Zip ________________ Parent’s Home Phone (____) _______ - ________________ Social Security Number _____________________ ******************************************************************************************** Physician Name __________________ __________________ O ffice Phone (____) _______ - ______________ Physician Address _______________________ ___________ Home Phone (_____) _______ - ______________ City _______________________________________ State _________________________ Zip ____________ ____ Parents: Father’s Name _____________________ _______ Mother’s Name _____________________________ Work Phone (_____) _______ - ______________ Work Phone (_____) _______ - _______________ Name of other adults in case of emergency: Name ______________ __________________ ( or) Name _______________ ______________________ Home Phone (_____) _______ - ______________ Home Phone (____) _______ - ______________ Work Phone (_____) _______ - ______________ Work Phone (_____) _______ - ______________ ******************************************************************************************** Medicine allergies and use: Place an “X” in the proper column to indicate which medications you use or are allergic to: (Use) (Allergy) (Use) (Allergy) _____ _____ Aspirin _____ _____ Demerol _____ _____ Penicillin _____ _____ Antibiotics _____ _____ Sulfa _____ _____ Sedatives _____ _____ Codeine _____ _____ Other__________________ History of Treatments: Please describe medical attention given to the member during the past two years, and describe the illness, treatment or injury involved. Date Illness, symptom, injury Treatment . . . ******************************************************************************************** Insurance: Company Name ___________________________________ Policy # _________________________________ __ Company Address __________________________________ Phone (_____) _______ - ___________________ City ________________________________ _______ State _________________________ Z ip ________________ Agent’s Name, or name of company for group policy ___________________ _____________________________ Agent or company benefits office phone (_____) _______ - ___________________ Member is insured under: _____ Father’s Policy _____Mother’s Policy _____Own Policy _____ Other (explain: ) ******************************************************************************************** Medications: Are you currently taking any prescription medications on a regular basis? _____ Yes ______ No If yes, answer the following: Medication Dosage When taken For ____________________ ____________________ __________________ __ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ ____________________ __________________ __ ____________________ Date of last tetanus shot ______ / ______ / _______ Do you wear glasses? ______ Yes _______ No Contacts? ______ Yes _______ No Do you smoke cigarettes? ______ Yes _______ No Medical History: Place an “X” next to any of these illnesses you have had or are prone to have: _____ Eczema _____ Measles _____ Rheumatic fever _____ Hives _____ Mononucleosis _____ Nervous exhaustion _____ Bronchitis _____ Mumps _____Tonsillitis _____ Diverticulitus _____ Chicken Pox _____ Epilepsy _____ Hemorrhoids _____ Polio _____ Diabetes _____ Hernia _____ Hepatitis _____ Asthma

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(complete both sides)

Any other serious illnesses or operations you have had: ____________________________________________________________________________________________ Place an “X” next to any of these symptoms you may have, whether sometimes or frequently: Nose and Throat: Head and Neck: _____ Congested nose _____ Frequent headaches _____ Runny nose _____ Neck pains and swelling _____ Sneezing spells Respiratory: _____ Head colds _____ Wheezes _____ Nose bleeds _____ Coughing spells _____ Sore throat _____ Coughs up blood _____ Enlarged tonsils _____ Excessive swelling _____ Hoarse throat _____ Inadequate sweating _____ Bee sting allergy _____ Sun “poisoning” Mouth: Cardiovascular: _____ Dental problems _____ High blood pressure _____ Itching or burning _____ Racing heart _____ Sore tongue _____ Chest pains _____ Taste changes _____ Dizzy spells Skin: _____ Shortness of breath _____ Acne _____ Swollen feet or ankles _____ Itching and bleeding _____ Leg cramps _____ Bleeds easily Musculoskeletal: _____ Bruises easily _____ Aching muscles or swollen joints _____ Sunburns easily _____ Swollen joints ********************************************************************************************

Consent _______________________________________ is a member of the Jester Drum and Bugle Corps and as a member engages in practice, tours and performances. The undersigned parent or guardian desires that said member receive the proper medical treatment in the event of illness or accident. Said parent or guardian consents to the administration of all medical treatments as may be deemed necessary, and accepts financial responsibility for said treatments. In accepting this consent, Jester Drum & Bugle Corps agrees to notify promptly the undersigned parent or guardian in the event of any serious accident or illness. ____________________________ ____ / ____ / ____ Parent or Guardian Date

____________________________ ____ / ____ / ____ Parent or Guardian Date

To the hospital: In case of emergency, I/we authorize the attending Jester Corps staff member to sign release forms for admitting and treatment of: _______________________________________________(Name of son or daughter) ____________________________ ____ / ____ / ____ Parent or Guardian Date

____________________________ ____ / ____ / ____ Parent or Guardian Date

To the hospital and surgeon: If emergency surgery is required, and I/we cannot be reached, I/we authorize the attending Jester Corps staff member to sign proper release forms for surgery and related treatment of: _______________________________________________(Name of son or daughter) ____________________________ ____ / ____ / ____ Parent or Guardian Date

____________________________ ____ / ____ / ____ Parent or Guardian Date

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Avondale Elementary School District #44 MAS

ECF

LCE/W

WF

DS

DT

CM

Student Release Form Students at Avondale Elementary School will only be released to those authorized by the parent or guardian. If someone other than the parent or guardian will be picking up the students that person’s name must be listed below. Photo identification must be presented when the person arrives to sign out the child. Please understand that this is for the safety of your child. Listed below are the names of those who are authorized to pick up my child. Child’s Name_____________________________ Date______ Teacher _______________________________ Parent’s Name(s)____________________________________________________________________________ Address_________________________________________________________ City______________________ Home Phone____________________________________ Parents Work Phone__________________________ Where does your child go after school? _____Home -- Write in if a different address than above ___________________________________________________________________________________ ____Day Care -- Center Name_________________________________________________________________ _____Baby Sitter – Name of Sitter______________________________________________________________ Address of Sitter______________________________________________________________________ Phone of Sitter_______________________________________________________________________ _____Daycare Van/Bus How will your child get there? ______Walk _____Picked up – Who will pick up your child?_________________________________ _____Bus – Route #_______(school secretary will fill in) Other than a parent, who may check your child out of school? Name: _________________________ ____________________________ _________________________ ____________________________ _________________________ ____________________________ ___

_________________________ _________________________ _________________________ ___

Phone:

Relationship to Child: If applicable, may not check your child out of school? ____________________________ _________________________ ____________________________ _________________________ ____________________________ _________________________ ___

_________________________ _________________________ _________________________ ___

(The office must be provided with the proper legal documents: divorce, separation, custody situations) I understand that the Avondale School District will provide transportation to the address indicated above, if it is within the bus route area. *If there are any daily changes in the child’s transportation, it must be provided by the parents. Any permanent changes in transportation must be submitted in writing to the school office three (3) days in advance*

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Visit to Nurse Date:______________ Student’s Name:________________________________________________ Teacher:______________________________ Time leaving room:________ Complaint:

(Please circle as many as applies)

Stomach-ache Cold Symptoms Injury Headache Rash

Insect bite Nausea Toothache Skin infection Emesis

Earache Sore throat Coughing

Other:________________________________________________________

Visit to Nurse Date:______________ Student’s Name:________________________________________________ Teacher:______________________________ Time leaving room:________ Complaint: Stomach-ache Cold Symptoms Injury Headache Rash

(Please circle as many as applies) Insect bite Nausea Toothache Skin infection Emesis

Earache Sore throat Coughing

Other:________________________________________________________ 23

Restroom Log Teacher: Month: Student’s Name

Homeroom

Date

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Time Left

Time Arrived

Total Time

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