Forms
2022 Program Forms
Daruma no Gakko Code of Conduct and Family Pledge (click to review PDF)
Administration of Medication
Please bring corresponding medications on the first day of program, and pick up any unused medication on the last day. Remember, we cannot give any medications without the below forms.
PDF that can be completed on the computer and then printed (preferred)
PDF that must be printed and filled out by hand (if fillable PDF is not compatible)
2022 Additional Forms
Applications
Family Forms
Student, Staff and Aide Health Screener Please complete this weekly health screener AND take a COVID-19 antigen test within 24 hours before attending program on Monday, June 20th and Monday, June 27th.
Volunteer Health Screener Please complete within 24 hours before volunteering on site.
Bento Orders Orders are due by Friday, June 17th. Prepared by Musashi, and distributed at Undokai Community Day, June 25th, at Live Oak Park in Berkeley.