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Waverly Registration Forms
This section of our website is for currently enrolled Waverly families.

July 3, 2008 -- Dear Waverly Families, We hope you are having a great summer. We are working hard to prepare for the new school year but we need your assistance in completing registration forms for your child. This year, all registration forms are available for download right here on our website. Checklists of required documents categorized by level (YK, ES, MS, HS) are directly below. Please follow the checklists carefully so that you do not miss a form. All forms should be filled out and returned to The Waverly School (67 West Bellevue Drive), attention Registration, by August 1, 2008, for processing.

In order to download the documents, you will need Adobe Reader. If you do not have Adobe Reader, you can download it for free here: http://www.adobe.com/products/reader/. If you experience technical difficulties and prefer hard copies of the registration forms, please contact the school at 626.792.5940 to arrange a pick-up of the materials that you need.

Please keep in mind the due date for submitting all registration forms:
August 1, 2008
Your child will not be able to start school unless these forms are on file in the school office. Please do not wait until the first day of school to hand them in. Thank you!


YOUNG KINDERGARTEN
• ID & Emergency Information Form—3 signed copies.
    Please carefully read these instructions:
ProlinkParentInstructions08-09.pdf
    Go to http://reports.thewaverlyschool.org to complete the ID & Emergency Information form.
• Child’s Preadmission Health History—Parent’s Report
    Please complete this form in full: YKHealthHistoryParentsReport.pdf
• Child’s Preadmission Health Evaluation—Physician’s Report
    Please have your child's physician complete this form in full: YKHealthHistoryPhysiciansReport.pdf
• Personal Rights
    Complete, sign and return bottom portion: YKPersonalRights.pdf
• Child Care Center Notification of Parents’ Rights
    Complete, sign and return bottom portion: YKParentsRights.pdf
• Earthquake/Emergency Backpack w/Checklist
    Read more on the required Earthquake/Emergency backpack here.
    Download this checklist and place it in your child's emergency backpack: ESBackpack.pdf
• Elementary School Authorization for Pick-Up
    Read more about this form here.
    Download the authorization form here: ESPickup.pdf
• Family Participation Form
    Download this required form here: FamPartForm.pdf
• Field Trip Driver form
    Read more about this form here.
    Download the form here: FieldTripDriver.pdf
• Grandparents Contact Sheet
    The Waverly School would like to keep our students’ grandparents informed about school events and goings-on. This form is required from all families. If you submitted this form last year, kindly complete and submit the form again as information may have changed. Download the form here: GrandparentsContact.pdf
• Internet Publishing Release
    Read more about this form here.
    Download the form here: InternetRelease.pdf

ELEMENTARY SCHOOL (K-6)
• ID & Emergency Information Form—3 signed copies.
    Please carefully read these instructions:
ProlinkParentInstructions08-09.pdf
    Go to http://reports.thewaverlyschool.org to complete the ID & Emergency Information form.
• Physician’s Pre-Admission Health Evaluation
    This form is required of all new students, all students entering Kindergarten or first grade or students beginning in fifth or sixth grade who will participate in the Waverly sports program. The form must be completed by your child's physician.
    Download the form here: PhysiciansHealthEval.pdf
• Earthquake/Emergency Backpack w/Checklist
    Read more on the required Earthquake/Emergency backpack here.
    Download this checklist and place it in your child's emergency backpack: ESBackpack.pdf
• Elementary School Authorization for Pick-Up
    Read more about this form here.
    Download the authorization form here: ESPickup.pdf
• Family Participation Form
    Download this required form here: FamPartForm.pdf
• Field Trip Driver form
    Read more about this form here.
    Download the form here: FieldTripDriver.pdf
• Grandparents Contact Sheet
    The Waverly School would like to keep our students’ grandparents informed about school events and goings-on. This form is required from all families. If you submitted this form last year, kindly complete and submit the form again as information may have changed. Download the form here: GrandparentsContact.pdf
• Internet Publishing Release
    Read more about this form here.
    Download the form here: InternetRelease.pdf

MIDDLE SCHOOL (7-8)
• ID & Emergency Information Form—3 signed copies.
    Please carefully read these instructions:
ProlinkParentInstructions08-09.pdf
    Go to http://reports.thewaverlyschool.org to complete the ID & Emergency Information form.
• Physician’s Pre-Admission Health Evaluation
    This form is required of all new students, all students entering seventh grade, or students who will participate in the Waverly sports program. The form must be completed by your child's physician.
    Download the form here: PhysiciansHealthEval.pdf
• Earthquake/Emergency Backpack w/Checklist
    Read more on the required Earthquake/Emergency backpack here.
    Download this checklist and place it in your child's emergency backpack: MSHSBackpack.pdf
• Computer Use Aggreement
    Read more on this form here.
    Download the agreement here: ComputerUse.pdf
• Middle School After School Plan/Authorization for Pick-up
    Read more on this form here.
    Download the agreement here: MSPickup.pdf
• Family Participation Form
    Download this required form here: FamPartForm.pdf
• Field Trip Driver form
    Read more about this form here.
    Download the form here: FieldTripDriver.pdf
• Grandparents Contact Sheet
    The Waverly School would like to keep our students’ grandparents informed about school events and goings-on. This form is required from all families. If you submitted this form last year, kindly complete and submit the form again as information may have changed. Download the form here: GrandparentsContact.pdf
• Internet Publishing Release
    Read more about this form here.
    Download the form here: InternetRelease.pdf

HIGH SCHOOL (9-12)
• ID & Emergency Information Form—3 signed copies.
    Please carefully read these instructions:
ProlinkParentInstructions08-09.pdf
    Go to http://reports.thewaverlyschool.org to complete the ID & Emergency Information form.
• Physician’s Pre-Admission Health Evaluation
    This form is required of all new students and any high school student who will participate in the Waverly sports program. The form must be completed by your child's physician.
    Download the form here: PhysiciansHealthEval.pdf
• Earthquake/Emergency Backpack w/Checklist
    Read more on the required Earthquake/Emergency backpack here.
    Download this checklist and place it in your child's emergency backpack: MSHSBackpack.pdf
• Computer Use Aggreement
    Read more on this form here.
    Download the agreement here: ComputerUse.pdf
• High School Off-Campus Lunch Agreement/Parental Permission Form
    Read more about this agreement/permission form here.
    Download this form here: HSOffCampusLunch.pdf
• High School Student Driver/Passenger Permission Form
    Read more about this form here.
    Download this form here: HSStudentDriver.pdf
Seniors only: Senior Open Campus Privilege Form
    Read more about this form here.
    Download this form here: SeniorOpenCampus.pdf
• Family Participation Form
    Download this required form here: FamPartForm.pdf
• Field Trip Driver form
    Read more about this form here.
    Download the form here: FieldTripDriver.pdf
• Grandparents Contact Sheet
    The Waverly School would like to keep our students’ grandparents informed about school events and goings-on. This form is required from all families. If you submitted this form last year, kindly complete and submit the form again as information may have changed. Download the form here: GrandparentsContact.pdf
• Internet Publishing Release
    Read more about this form here.
    Download the form here: InternetRelease.pdf












Internet Publishing Release
The Waverly School’s website offers information about Waverly, its staff and community events. We also highlight school activities and classroom projects. The site might include photographs of students at school activities, working on class projects and participating in school events; it may also include examples of individual student work.

Prior to a student’s photograph or individual work being included in the website, the school is required to obtain written permission from the student’s parents or guardians. To give or to refuse permission for your child’s photograph or individual work to be featured on the site, parents/guardians should complete the form and return it to the school office by August 1, 2008.
Please note:
All materials featured on the website will be approved by Head of School Heidi Johnson before they are published.

A signed Internet Publishing Release must be on file prior to the posting of any student work or photograph(s) on the website.

Student photographs and student work will not be identified with student names.

Students’ personal information, including addresses, phone numbers, and daily schedules, will not be published or made available on the website.
If you have any questions, please feel free to contact
Heidi.

Click back to: YK Checklist / ES Checklist / MS Checklist / HS Checklist

Field Trip Driver Form
All Waverly parents/guardians who plan to drive on school/class field trips must complete the Field Trip Driver form. A separate form should be completed for each child. Before completing this form, please check your auto insurance policy to be sure you are covered when carrying children in your car who are not members of your immediate family. Do not assume the coverage you have is adequate. Waverly’s insurance carrier requires that each driver have a minimum of $100,000 of liability coverage. If you plan to drive, a copy of your insurance card must be attached in order for this form to be effective. Parent/guardians who do not have this form on file (with a copy of their auto insurance card attached) will not be able to drive on any school/class field trips.

If you do not wish to drive on field trips, still complete the top part of the form and return it to the school office. Simply check off "We DO NOT plan to drive on any field trips."


Click back to: YK Checklist / ES Checklist / MS Checklist / HS Checklist

Elementary School Authorization for Pick-Up
This form is for elementary school only (grades YK through 6). Complete the form with the names and phone numbers of individuals to whom you give permission to pick up your child from school. This would include anyone not listed on the ID & Emergency Information form (other Waverly parents, relatives, etc.). You can add names to the list as the school year goes on. It is kept on file at the elementary school reception desk.

As stated in the parent handbook, we are not able to allow anyone to pick up your child without a signed note from you, unless his/her name appears on the elementary school permission form or ID/Emergency form and you have notified the elementary school receptionist of the pick-up plan.


Click back to: YK Checklist / ES Checklist / MS Checklist / HS Checklist

Middle School After School Plan/Authorization for Pick-up
This form is for middle school only (grades 7 and 8). Please complete this form to indicate whether your child has permission to leave The Waverly School at the end of each school day by him/herself, does not have permission to leave The Waverly School at the end of each school day by him/herself, or if your child will be enrolled in Tom Sawyer after school camp. Also, complete the bottom portion of the form with the names and phone numbers of individuals to whom you give permission to pick up your child from school.


Click back to: YK Checklist / ES Checklist / MS Checklist / HS Checklist

Earthquake/Emergency Backpack Supply Lists
The possibility of an earthquake or other emergency occurring in our area is just a matter of time. In the event of a major earthquake, freeways and surface streets may be impassable, and public services may be interrupted. Everyone must be prepared, therefore, to provide for their own needs for the first 72 hours, at home or school. In the event of a major disaster, Waverly must be prepared to care for over 300 students. We hope the steps we have taken will give you more peace of mind!

We ask parents for their cooperation in the preparation of emergency backpacks to be stored at school throughout the year. You are requested to bring your child’s emergency backpack to school by August 15, 2008 (definitely no later than the first day of school). We will check backpacks to insure they are complete, and then put them in the disaster preparedness storage bin.

Each child must have a backpack with his/her full name written prominently on the back side of the backpack with a permanent marker. If your child's backpack is not turned in by the morning of the first Friday after school starts (September 5, 2008), an emergency backpack will be made for your child by the WPO and you will be charged $50. This emergency backpack will contain the bare essentials. It is best to complete your own emergency backpack using the guidelines below.
The elementary school list is different from the middle/high school list. Please refer to the appropriate list for your child's backpack. The elementary school list is directly below. Please scroll down for the middle/high school list.
Elementary School List (grades YK through 6):
The following items must be in each child's backpack:
1. Clothing: 1 pair long pants; 1 t-shirt; 1 sweatshirt or light jacket; 2 pairs underwear; 2 pairs socks; sturdy walking shoes (all clothes/shoes should be at least 1 size larger than your child’s current clothing/shoe size; shoes can be purchased cheaply from Target or Payless Shoes).
2. A space blanket (sold in sporting goods sections/stores); do not include a regular blanket of any kind.
3. A small flashlight that your child can easily carry.
4. An extra set of batteries for the flashlight.
5. A travel toothbrush and small toothpaste container.
6. A small comb or hairbrush.
7. Comfort items --a book; a magazine; a small notebook to write or draw in; pencil/pen.
Please do not include food of any kind.

Put the following items in a Ziploc or other plastic “zipper” bag that closes, and include the Ziploc bag in the earthquake backpack —

8. A 3”x5” or 4”x6” index card containing emergency information -- a) child’s name, address, telephone number; b) child’s birthdate (including year); c) child’s parents’ names; d) daytime telephone numbers for both parents; d) an out-of-state contact, including names, phone number (with area code), and relationship to your child.
9. A 8-1/2”x11” piece of paper listing your family’s “reunification plan.” This plan should be discussed with each member of your family, especially your child, in a calm, thoughtful manner. Who will pick up your child from school after the earthquake? If that individual is farther away or unable to pick up your child, who will be the second choice (relatives or friends)? Third choice? After your child has been picked up from Waverly, where will your family members reunite if you aren’t able to reach home due to damage, downed power lines or bridges, etc.? It is extremely important that each family have a reunification plan and all people who are included in this plan are aware of its details.
10. A family photo (at least one); include a picture of pets, if your child has any.
11. A note from each parent.

Special information about medications:
Medications for emergency use will be stored in a locked cabinet behind the reception desk (rather than being kept in backpacks). If your child takes any medication on a regular basis (i.e., daily or weekly), this medicine must be in your child’s emergency backpack. All medicine must be in a prescription bottle, officially labeled with the name, address, and phone number of both the pharmacy and doctor who prescribed the medication, as well as the expiration date. (The label must be from the pharmacy or doctor.) Place the prescription bottle in a Ziploc bag and include your own written instructions for its use on a 3”x5” or 4”x6” card. Include your child’s full name and grade on the instruction card. Place the Ziploc bag inside the backpack on top of the contents, directly under the checklist.

Special Notes:
1. Your child’s emergency backpack must be light enough for your child to carry.
2. Earthquake backpacks will not be available for changes of clothing during the year. The bin will be unlocked only in the event of a natural disaster, so plan carefully!
3. Every item must be labeled with your child’s full name.
4. A checklist of all required items is located here:
ESBackpack.pdf. Please download the list, print it out and check off each item as you pack your child’s backpack. THIS IS REQUIRED.
5. IMPORTANT: Place the completed checklist inside the backpack, on top of all contents.
6. Write your child’s full name on the outside of the backpack with a permanent marker.

Middle and High School List (grades 7 through 12):
Below is a list of items that must be in each middle and high school student's backpack. Read the list and then download a "check off" version that must be placed in the backpack on top of the contents. Download the checklist here: MSHSBackpack.pdf.

The following items must be in each student's backpack:
1. Clothing: 1 pair long pants; 1 sweatshirt or light jacket; a change of underwear and socks (all clothes should be at least 1 size larger than your child’s current clothing/shoe size).
2. A space blanket (sold in sporting goods sections/stores); do not include a regular blanket of any kind.
3. Essential travel-size toiletries.

Put the following items in a Ziploc or other plastic “zipper” bag that closes, and include the Ziploc bag in the earthquake backpack —

4. A 3”x5” or 4”x6” index card containing emergency information -- a) child’s name, address, telephone number; b) child’s birthdate (including year); c) child’s parents’ names; d) daytime telephone numbers for both parents; d) an out-of-state contact, including names, phone number (with area code), and relationship to your child.
5. A “reunification plan.” This plan should be discussed with each member of your family, especially your child, in a calm, thoughtful manner. Who will pick up your child from school after the earthquake? If that individual is farther away or unable to pick up your child, who will be the second choice (relatives or friends)? Third choice? After your child has been picked up from Waverly, where will your family members reunite if you aren’t able to reach home due to damage, downed power lines or bridges, etc.? It is extremely important that each family have a reunification plan and all people who are included in this plan are aware of its details.

The following items are recommended but not required:
1. Clothing: 1 t-shirt; additional underwear and socks; sturdy walking shoes (strongly recommended if your child does not usually wear closed shoes to school; shoes can be purchased cheaply from Target or Payless Shoes).
2. A family photo (at least one); include a picture of pets, if your child has any.
3. A note from one or more parents.
4. A small flashlight and an extra set of batteries for the flashlight.
5. Comfort items--a book; a magazine; a small notebook to write or draw in; pencil/pen.
Please do not include food of any kind.

Special information about medications:
If your child takes any medication on a regular basis (i.e., daily or weekly), this medicine must be in your child’s emergency backpack. All medicine must be in a prescription bottle, officially labeled with the name, address, and phone number of both the pharmacy and doctor who prescribed the medication, as well as the expiration date. (The label must be from the pharmacy or doctor.) Place the prescription bottle in a Ziploc bag and include your own written instructions for its use on a 3”x5” or 4”x6” card. Include your child’s full name and grade on the instruction card. Place the Ziploc bag inside the backpack on top of the contents, directly under the checklist.

Special Notes:
1. Earthquake backpacks will not be available for changes of clothing during the year. The bin will be unlocked only in the event of a natural disaster, so plan carefully!
2. Every item must be labeled with your child’s full name.
3. A checklist of all required items is located here: MSHSBackpack.pdf. Please download the list, print it out and check off each item as you pack your child’s backpack. THIS IS REQUIRED.
4. IMPORTANT: Place the completed checklist inside the backpack, on top of all contents.
5. Write your child’s full name on the outside of the backpack with a permanent marker.

Click back to: YK Checklist / ES Checklist / MS Checklist / HS Checklist

Computer Use Agreement
This form is for middle and high school only (grades 7 through 12). The Waverly School established computers and internet access for educational purposes. Using these computers is a privilege, one that can be revoked if the rules are not followed.

Students are expected to make responsible, ethical and appropriate use of computers and information services at all times.

Students are responsible for their activity on the computer. Students may report to school personnel any message or posting about or to them that they feel is inappropriate or makes them uncomfortable. The school recognizes that electronic communication (postings, messages, chats) can be a form of harassment.

All printing of homework must be done at home. During study blocks, students may sign up to use computers for word processing. If assignments are completed during study block, a student may request permission to print from a faculty/staff member.


Click back to: YK Checklist / ES Checklist / MS Checklist / HS Checklist

High School Off-Campus Lunch Form
Beginning September 5, 2008, each high school student will have the option to leave campus without adult accompaniment for lunch on FRIDAYS. This parental permission slip and student agreement must be completed and returned to the school in order for the student to take advantage of this option. If you do not want your son/daughter to go off-campus, please indicate this and return the form to the school.

Guidelines for off-campus lunch are as follows:
1. Students must stay within an area defined by Del Mar to the north, Pasadena Avenue to the west, Congress to the south, and Arroyo Parkway to the east.
2. Each student must be with at least one other student when off-campus.
3. Students must return to campus by the end of the lunch period.
4. Students other than seniors cannot drive to lunch.

Failure to follow these guidelines will result in the loss of off-campus privilege.


Click back to: YK Checklist / ES Checklist / MS Checklist / HS Checklist

High School Student Driver/Passenger Permission Form
This form is for high school only (grades 9 through 12). Parents, use this form to indicate whether you give permission for your child to be a passenger in other students' cars, permission to drive other students, permission to drive herself/himself, or if your child does not have permission to drive himself/herself or other students or ride in other students’ cars. This form is required for all high school students.


Click back to: YK Checklist / ES Checklist / MS Checklist / HS Checklist

High School Senior Open Campus Privilege Form
Beginning September 2, 2008, the first day of school, each senior will have the option to leave campus without adult accompaniment during open periods and lunches. This parental permission slip and student agreement must be completed and returned to the school in order for the student to take advantage of this option. If you do not want your son/daughter to leave campus, please indicate this and return the form to the school.

Guidelines for senior open campus privilege are as follows:
1. Students must maintain a satisfactory record in all classes.
2. Students must sign out when leaving campus and sign in when returning to campus.
3. Students must return to campus in a punctual manner.
4. Students must have a signed Student Driver/Passenger Permission Form on file before driving or being driven by other students.
5. Students must attend all student assemblies and class meetings.

Failure to follow these guidelines will result in the loss of senior open campus privilege.


Click back to: YK Checklist / ES Checklist / MS Checklist / HS Checklist