Student Registration Form
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New Student
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Student Personal Information:
First Name *
Last Name *
Other Name
Date of Birth *
dd/mm/yyyy (e.g. for Apr 5, 2001 you enter 05/04/2001), accepted age is between 5-12 years.
Gender *
Grade/Level *
Parent/Guardian(s) information:
Father/Guardian First Name *
Father/Guardian Last Name *
Father/Guardian Email *
Mother First Name *
Mother Last Name *
Mother Email
Mailing Address:
Address *
City *
Province *
Postal Code *
Contact Information:
Home *
Work
Cell
Home Language
Emergency Contact Information:
First Name *
Last Name *
Home
Work
Cell
Email
Student Medical Report:
It is very important that we are made aware of any medical conditions your child may have and what needs to be done in the event of an emergency (other than a call to 911).
Health Card
Remedy (eg. Epi-Pen)
Allergy/Medical Concerns *
Doctor’s Name
Doctor’s Phone
Student Photo Release Report:
Photos, videos, films or interviews will only be done with the prior knowledge and consent of the school principal or designate and will not be used for commercial gain. I/we hereby consent to the inclusion of photographs of my/our child in the following:
• class pictures, yearbook, special events/awards, videos and films
• photographers, films, or interviews taken by media as part of a school-related activity
• school board publications produced by the Communications Department
• photographs for use on school Internet pages and our public web sites
I/We hereby consent to the inclusion of any photographs of my/our child
*
Required
Comment *
Charity Tool School System www.charitytool.com
Charity Tool School System www.charitytool.com
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