SPECIAL PROGRAMS:  This information assists in making educational placement decisions for the student.

Schools are permitted to disclose information on students if it has been properly designated as directory information. By law, directory information includes things that would generally not be considered harmful or an invasion of privacy if disclosed, such as name, address, photograph, and date of birth. Directory Information may not include things such as a student's social security number or grades. If a school has a policy of disclosing directory information, it is required to give public notice to parents of the types of information designated as directory information, and the right to opt out of having your child's information so designated and disclosed. Also secondary school students' names, addresses, and telephone numbers may be released to military recruiters and/or institutions of higher education. Parents have the right to deny release of directory information.

The Student Health Information Form should be completed ANNUALLY for ALL students attending Baltic School District. The information you provide on this form will be used to alert us to any health conditions your child may have. Please make sure to keep our records current by sending in writing if your child develops any new medical conditions/issues or if medications change during the school year.  Our records can only be as accurate as the information we receive, keeping up to date information will help us to better serve you and your child.

Only fully completed forms are accepted.

I am the mother/father/legal guardian of the above child(ren), who attends Baltic School District 49-1. I hereby consent to any medical services & hospital care that may be required while said student is under the supervision of an employee of the Baltic School District 49-1. I hereby appoint said employee to act on my behalf in securing necessary medical services & hospital care from any duly licensed health care provider. I authorize officials of the District to contact persons I have designated as emergency contacts (above) for medical emergencies and in the event that I or my designated emergency contacts cannot be reached, school officials are authorized to take whatever action is deemed necessary for the health and safety of my child/children. Expenses incurred, including ambulance user or treatment by a physician, will not be borne by the District.

1) I authorize the use of disclosure of the above individual’s health information. Also if the student is involved in athletics/activities at Baltic School the Pre-Participation History and Physical Exam information pertaining to a student’s ability to participate in South Dakota High School Activites Association sponsored activities. Such disclosure may be made by any Health Care Provider generating or maintaining such information.

2) The information identified above may be used by or disclosed to the school nurse, athletic trainer, coaches, medical providers and other school personnel involved in the care of this student.

3) This information for which I am authorizing disclosure will be used for the purpose of determining the student’s eligibility to participate in extracurricular activities, any limitations on such participation and any treatment needs of the student.

4) I understand that I have a right to revoke this authorization at any time. I understand that if I revoke this authorization, I must do so in writing and present my written revocation to the school administration. I understand that the revocation will not apply to the information that has already been released in response to this authorization. I understand that the revocation will not apply to my insurance company when the law provides my insurer with the right to contest a claim under my policy.

5) I understand that once the above information is disclosed, it may be re-disclosed by the recipient and the information may not be protected by federal privacy laws or regulations. I understand authorizing the use or disclosure of the information identified above is voluntary.

6) However, a student’s eligibility to participate in extracurricular activities depends on such authorization. I need not sign this form to ensure healthcare treatment.

I understand authorizing the use or disclosure of the information identified above is voluntary. However, a student’s eligibility to participate in extracurricular activities depends on such authorization. I need not sign this form to ensure healthcare treatment.

 Student Acceptable Use of Computers & Network Agreement

I understand and will voluntarily abide by the school district's "Acceptable Use Policy on Computers and Networks".  I further understand that any violation of this policy may result in the loss of my Internet access privileges and school disciplinary action may be taken.  I promise to make no attempt to access inappropriate material through use of my Internet access.  Should I encounter embarrassing, obscene, or lewd material, I will not display it to any other student.  The signature on this document indicates that I have read the school district's "Acceptable Use Policy", understand its significance, and voluntarily agree to comply fully with all its terms and conditions.  I understand that my use of the Internet is subject to monitoring by District officials.

The SDHSAA recommends that all member schools receive consent from all students and parent/guardians prior to activities, to ensure that medical care can be provided to the student during any activity away from home. This form should be kept both on-file at the school, as well as in the possession of a student’s coach/sponsor authorizing as below.

I hereby consent to necessary medical services that may be required while said child is under the supervision of an employee of the fore-mentioned high school while on a school-sponsored activity, and hereby appoint said employee to act on behalf of myself in securing medical services from any duly licensed medical provider. Signatures on this form do not constitute consent for vaccinations of any kind.

What is a concussion?
A concussion is a brain injury that:
• Is caused by a bump, blow, or jolt to the head or body
• Can change the way your brain normally works
• Can occur during practices or games in any sport or recreational activity
• Can happen even if you haven’t been knocked out
• Can be serious even if you’ve just been “dinged” or “had your bell rung”

All concussions are serious. A concussion can affect your ability to do schoolwork and other activities (such as playing video games, working on a computer, studying, driving, or exercising). Most people with a concussion get better, but it is important to give your brain time to heal.

What are the symptoms of a concussion?
You can’t see a concussion, but you might notice one or more of the symptoms listed below or that you “don’t feel right” soon after, a few days, or even weeks after the injury.
• Headache or “pressure” in head
• Nausea or vomiting
• Balance problems or dizziness
• Double or blurry vision
• Bothered by light or noise
• Feeling sluggish, hazy, foggy, or groggy
• Difficulty paying attention
• Memory problems
• Confusion

What should I do if I think I have a concussion?
• Tell your coaches and your parents. Never ignore a bump or blow to the head even if you feel fine. Also, tell your coach right away if you think you have a concussion or if one of your teammates might have a concussion.
• Get a medical check-up. A doctor or other health care professional can tell if you have a concussion and when it is OK to return to play.
• Give yourself time to get better. If you have a concussion, your brain needs time to heal. While your brain is still healing, you are much more likely to have another concussion. Repeat concussions can increase the time it takes
for you to recover and may cause more damage to your brain. It is important to rest and not return to play until you get the OK from your healthcare professional that you are symptom-free.

How can I prevent a concussion?
Every sport is different, but there are steps you can take to protect yourself.
• Use the proper sports equipment, including personal protective equipment. For equipment to protect you, it must be:
- The right equipment for the game, position, or activity
- Worn correctly and the correct size and fit
- Used every time you play or practice
• Follow your coach’s rules for safety and the rules of the sport
• Practice good sportsmanship at all times

IT IS BETTER TO MISS ONE GAME THAN A WHOLE SEASON – SEE SOMETHING – SAY SOMETHING!!!

SDHSAA CONCUSSION FACT SHEET FOR PARENTS

What is a concussion?
A concussion is a brain injury. A bump or blow causes concussions or jolts to the head or body. Even or what seems to be a mild bump or blow to the head can be serious.

What are the signs and symptoms?
You can’t see a concussion, Signs and symptoms of concussion can show up right after the injury or may not appear or be noticed until days after the injury. If your teen reports, one or more symptoms of concussion listed below, or if you notice the symptoms yourself, keep your teen out of play and seek medical attention right away.

Signs Observed By Parents or Guardians
• Appears dazed or stunned
• Is confused about assignment or position
• Forgets an instruction
• Is unsure of the game, score, or opponent
• Moves clumsily
• Answers questions slowly
• Loses consciousness (even briefly)
• Shows mood, behavior, or personality changes
• Can’t recall events prior to hit or fall
• Can’t recall events after hit or fall

Symptoms Reported by Athlete
• Headache or “pressure” in head
• Nausea or vomiting
• Balance problems or dizziness
• Double or blurry vision
• Sensitivity to light or noise
• Feeling sluggish, hazy, foggy, or groggy
• Concentration or memory problems
• Confusion
• Just not “feeling right” or is “feeling down”

How can you help your teen prevent a concussion?
Every sport is different, but there are steps your teens can take to protect themselves from concussions and other injuries.
• Make sure they wear the right protective equipment for their activity. It should fit properly, be well maintained, and be worn consistently and correctly.
• Ensure that they follow their coaches’ rules for safety and the rules of the sport
• Encourage them to practice good sportsmanship at all times.

What should you do if you think your child has a concussion?
1. Keep your child out of play. If your child has a concussion, her/his brain needs time to heal. Don’t let your child return to play the day of the injury until a health care professional, experienced in evaluating for concussion, says
your child is symptom-free and it’s OK to return to play. A repeat concussion that occurs before the brain recovers from the first – usually within a short time (hours, days, or weeks) – can slow recovery or increase the likelihood of having long-term problems. In rare cases, repeat concussions can result in edema (brain swelling), permanent brain damage, and even death.
2. Seek medical attention right away. A healthcare professional experienced in evaluating for concussions will be able to decide how serious the concussion is and when it is safe for your child to return to sports.
3. Teach your child that it’s not smart to play with a concussion. Rest is key after a concussion. Sometimes athletes wrongly believe that it shows strength and courage to play injured. Discourage others from pressuring injured athletes to play. Don’t let your child convince you that s/he’s “just fine”.
4. Tell all of your child’s coaches and the student’s school nurse about ANY concussion. Coaches, school nurses, and other school staff should know if your child has ever had a concussion. Your child may need to limit activities while
s/he is recovering from a concussion. Things such as studying, driving, working on a computer, playing video games, or exercising may cause concussion symptoms to reappear or get worse. Talk to your healthcare professional, as well as your child’s coaches, school nurse, and teachers. If needed, they can help adjust your child’s school activities during her/his recovery.

Baltic High School Concussion Policy

 If an athlete is exhibiting signs and/or symptoms of a concussion, they must follow the South Dakota High School Activities Association (SDHSAA) concussion return to play protocol. The use of an Against Medical Advice form or physician note will be prohibited to allow an athlete to bypass this protocol. The SDHSAA concussion return to play protocol must be completed with or under the supervision of the athletic trainer prior to return to sport.

 The return to play protocol is as follows:

Note: Each step should be completed with no concussion symptoms before proceeding to the next step.

1. No activity, complete rest with no symptoms.

2. Light exercises: walking or stationary cycling with no symptoms.

3. Sport specific activity without body contact and no symptoms.

4. Practice without body contact and no symptoms. Resume resistance training.

5. Practice with body contact and no symptoms.

6. Return to game play with no symptoms. 

Baltic School is a Closed Campus.  All students shall remain on the school campus during the hours that school is in session unless released by the building principal or the building principal's designee with a confirmation from a student's guardian. However, there are incentive exceptions for Seniors to earn open-campus privileges. (See student handbook for details.) Written parental permission is required for an individual who is rewarded an incentive open campus period for that student to be able to leave the campus during that time.  Parents and guardians, be aware that buses will operate at their normal times, and your child(ren) must provide their own transportation home if they have a privilege-earned open period before the buses leave for the day.  I understand that by signing below, I'm permitting my student(s) to leave the school during a privilege-earned open period they have scheduled during the day.

Children need healthy meals to learn. Baltic School District offers healthy meals every school day. Breakfast costs $1.75 for all students.  Lunch costs are $3.30 (PK-5), $3.40 (6-12).  Reduced-price is $.30 for breakfast and $.40 for lunch. Menus, application for free or reduced-priced meals, special diet forms are all available on the Baltic School website under Nutritional Services.

 Your children may qualify for free meals or for reduced-price meals:

 ·       All children in households receiving benefits from SNAP, the Food Distribution Program on Indian Reservations (FDPIR), or TANF are eligible for free meals

·       Foster children who are under the legal responsibility of a foster care agency or court are eligible for free meals

·       Children participating in their school’s Head Start program are eligible for free meals

·       Children who meet the definition of homeless, runaway, or migrant are eligible for free meals

·       Children may receive free or reduced-price meals if your household’s income is within the limits on the Federal Income Eligibility Guidelines; your children may qualify for free or reduced-price meals if your household income falls at or below the limits on this chart

 FEDERAL ELIGIBILITY INCOME CHART (Gross Income) School Year 2025-2026

The Baltic School District is asking families who desire school bus transportation for the school year to complete the applicable information below.  For out-of-town families in most situations, the bus will make individual stops.  For out-of-town housing developments or grouped housing, pick-up and drop-off points may be established.

For in-town families, pick-up and drop-off points will be established depending upon the location of families requesting transportation.  There will be no pick-up or drop-off points within 3 blocks of the school.  It will most likely be necessary for in-town students to walk 1-2 blocks to the pick-up and/or drop-off point. 

Because of overcrowding on in-town buses, it has become necessary to restrict the age of students who may access in-town busing.  Please be advised that in-town busing is limited to PK-5th grades, with students in grades 6-12 not eligible to ride in-town buses.  It is very important that in-town families requesting bus service complete this form so that pick-up and drop-off points can be established.

There will be fees associated with in-town busing.  Students in JK - 3rd grades, busing will be provided free of charge. Students in grades 4 - 5 may ride the bus but will be charged $75 per student, per semester. This fee will be waived for students who submit an application for free or reduced school lunches and qualify.

Pre-school students may ride the bus in the morning or at the end of the school day free of charge.  In the middle of the day, pre-school students may be transported to and from in-town daycares for a fee of $20 per month

Buses will be free for all students residing within 5 miles of the school but outside the city limits.

Transportation fees may be paid in the parent portal or the elementary office.

Please complete the form below by August 1st.  Approximately one week before the first day of school, out-of-town families will be informed of approximate pick-up and drop-off times, and in-town families will be notified of the location of pick-up and drop-off points with approximate pick-up and drop-off times.