Head Start LC & Grade 9 Orientation
August 26, 27, 28
8:30 am to 2:30 pm
LCVI, 153 Van Order Drive, Kingston K7M 1B9
Contact us at (613) 546-5575 or rileyjk@limestone.on.ca
LCVI: Grit, Growth, Gratitude
Student's Name: First, Last (include preferred name if different) *
Your answer
Date of Birth: Month, Day, Year *
MM
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DD
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YYYY
English as a Second Language? *
School Attended in Grade 8? *
Your answer
Home Address: *
Your answer
Health Concerns (allergies, medications etc) or Dietary Needs: *
Your answer
Learning Needs or Exceptionalities: *
Your answer
Parent/Guardian Name: *
Your answer
Relationship to Student: *
Your answer
Home Phone:
Your answer
Cell Phone:
Your answer
Work Phone:
Your answer
Emergency Contact: *
Your answer
Relationship to Student: *
Your answer
Phone Number of Emergency Contact: *
Your answer
Parent/Guardian Consent: I support my child’s registration in the Limestone District Head Start Math at LCVI, Summer Numeracy Program for students transitioning into grade 9 at LCVI. *
Required
Student Consent: I agree to attend the Limestone District School Board’s Head Start Math at LCVI, Summer Numeracy Program. I will show respect for the instructors, the materials, and the facility while I am in attendance. I understand that I am expected to remain at the school site from 8:30 am to 2:30 pm each day. *
Required
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