Chinook’s Edge School Division No. 73 Student Registration ... Dec 15 CESD... · Chinook’s Edge…

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  • Chinooks Edge School Division No. 73

    Student Registration Form This registration form is a legal document. All information will be treated confidentially. It is the responsibility of parents/guardians to notify the school of any changes to the following information. Registration is pending until Principal approval.

    School History Name of Previous School Attended City/Town Province

    Has the student ever registered in a Chinooks

    Edge School before? Yes No Previous Chinooks Edge School Division School School Year

    Student Information School Program of Choice

    English French Immersion

    Alberta Student Number (ASN) Grade Enrolling In Preferred Start Date

    Preferred Name (AKA Name)

    Surname First Name Middle Name

    Legal Name of Student

    Surname First Name Middle Name

    Gender:

    Male Female Date of Birth Student Age at Registration

    Month Day Year Years Months Mailing Address

    Address City Province Postal Code Street (Town) or 911 (Rural) Address Legal Land Description (e.g. SE-30-35-08-W4)

    Student Home Phone (with area code)

    ( )

    Student Cell Phone (with area code)

    ( )

    You must present the students birth certificate at the time of registration in Chinooks Edge School Division No. 73.

    Citizenship Status What is the citizenship or immigrant status of the student?

    Canadian Citizen Lawfully admitted to Canada for permanent residence (student) *Child of an individual lawfully admitted to Canada for permanent or temporary residence

    Child of a Canadian citizen *Step-child of a Canadian or Temporary Foreign Worker * Temporary Resident: Expiry Date Required International Students Only _________________ Year/Month/Day *Supporting documentation required

    Section 23 Francophone Rights Do you claim entitlement to a francophone education under the terms of the School Act? Eligible Ineligible

    According to the School Act and section 23 of the Canadian Charter of Rights and Freedoms, a parent or legal guardian who is a Canadian citizen has the right to have his/her children receive school instruction in French. This applies if the parent/guardian is a resident of Alberta and: French was the first language learned, and is still understood, by at least one parent; or, one or more of the parents, or one or more of their children have received, or are receiving instruction in a French first language program or school in Canada (this does not include a French Immersion Program). If eligible, the provincial Student Record Regulation requires Chinooks Edge School Division to release demographic information about the student and parent to the local Francophone Education Board upon written request from that school jurisdiction.

    Aboriginal Self-Identification (for those with Status Rights only) If you wish to declare the student is Aboriginal, please select one: First Nations (Status) First Nations (Non-Status) Mtis Inuit For further information, please refer to https://education.alberta.ca/system-supports/results-reporting/ or contact Alberta Education at 780-427-8501. If you have questions regarding the collection of student information by Chinooks Edge School Division No. 73, please contact the Superintendent at 403-227-7070 or toll free at 1-800-561-9229.

    Independent Student Status Is the student living independently under the definition of the School Act? Yes No *Supporting documentation required The definition of an Independent Student is a student who is (i) 18 years of age or older, or (ii) 16 years of age or older and (A) who is living independently, or (B) who is a party to an agreement under section 57.2 of the Child and Youth and Family Enhancement Act. (Section 1(m) of the School Act).

    English as a Second Language (ESL) A student may be eligible for ESL support when the primary language spoken at home is a language other than English. Is English the students first language: Yes No What language is spoken at home? _______________________

    https://education.alberta.ca/system-supports/results-reporting/

  • Individual Program Plan Does your child currently have an Individual Program Plan (IPP)? Yes No Please provide a copy if possible.

    Student Resides With Both Parents (same residence) Both Parents (separate residences) Mother Father Acting Guardian Mother and Step Father Father and Step Mother Living Independently Other _____________________________________

    Parents/Guardians Primary Contacts

    Co

    nta

    ct 1

    Name Relationship to student Resides with student

    Yes No Surname First Name Day Phone ( )

    Home Phone ( )

    Cell Phone ( )

    Email

    Co

    nta

    ct 2

    Name Relationship to student Resides with student

    Yes No Surname First Name Day Phone ( )

    Home Phone ( )

    Cell Phone ( )

    Email

    Additional Parent/Guardian 2nd Residence (if applicable)

    Par

    ent/

    Gu

    ard

    ian

    Name Relationship to student Send Copy of Reports

    Yes No Surname First Name Mailing Address

    Address City Province Postal Code Physical Address (if different)

    Address City Province Postal Code Day Phone ( )

    Home Phone ( )

    Cell Phone ( )

    Email

    Child Access Court Orders Physical Access - A guardian or parent may have their right to visit a student removed by a legal process. Please indicate if a legal document exists which restricts visitation with the student: Yes No If you have answered yes, the school will collect the most recent documentation which will be retained on the students record. Court Orders Access to Information (Disclosure Restrictions) A guardian or parent may have their right to access information about a student removed by a legal process. Please indicate if a legal document exists which restricts access to information about this student: Yes No If you have answered yes, the school will collect the most recent documentation which will be retained on the students record. Custody A student may be impacted by court order under the Child, Youth and Family Enhancement Act, Family Law Act, Divorce Act or Youth Criminal Justice Act. Indicate if the school should be aware of any such order pertaining to your child. Is there a court order regarding custody and access to your child? Yes No If you have answered yes, the school will collect the most recent documentation which will be retained on the students record.

    Local Emergency Contact Information (Grandparents, Relatives, Friends, Neighbours, etc.)

    1

    Name Relationship to student

    Surname First Name Day Phone ( )

    Home Phone ( )

    Cell Phone ( )

    2

    Name Relationship to student

    Surname First Name Day Phone ( )

    Home Phone ( )

    Cell Phone ( )

    3

    Name Relationship to student

    Surname First Name Day Phone ( )

    Home Phone ( )

    Cell Phone ( )

    Medical Information If your child has a serious or life threatening medical condition, please indicate below:

    Diabetes Asthma Allergies (Anaphylactic) Epilepsy Heart Condition Hemophilia Other _________________________

    Description

    Medication

  • Names of Other Students Living at the Same Address Attending a Chinooks Edge School

    Student School Student School

    Student School Student School

    Student School Student School

    Transportation Urban Students If you live in an area where urban transportation is available and wish to request busing for your child, please complete the Urban Student Transportation Form, available either on our website www.cesd73.ca under Transportation, or at your school office, and fax it to the Transportation Department at the number listed on the form. Please note if there is a fee, payment must accompany the registration form.

    Rural Students Please check the box below if you wish to have rural busing for your child. This request will take 24-48 hours to process and you will be contacted by the driver. If you are unsure about your designated school based on your legal land description, please contact the Transportation Department at 403-227-7072, 1-800-266-9573 or fax 403-227-7217. I wish to request rural busing for my child.

    Freedom of Information and Protection of Privacy (FOIP) Provisions Schools play an important role in the education and socialization of our children. In this process, personal information often collected and used for authorized programs and activities that are a vital part of a healthy and functioning school. The purpose of this notice is to inform you about the collection and use of student information by our school and Division under the FOIP Act. The personal information collected on this form is part of the Division registration process and is authorized under the provisions of the School Act and its regulations of the FOIP Act. The personal information will be used to provide an educational program and ensure a safe and secure school environment. Information acquired through this form is kept secure and access is restricted. Once the information is collected and compiled, Chinooks Edge School Division No. 73 believes the uses listed below are part of a vital, healthy, and functioning school and participation of all students is important and encouraged. Here are activities where the information may be used: the use of student names, photos and comments in the school

    calendar, newsletter, yearbook, video yearbook, graduation books, other school publications including school social media sites, library cards and other secure CESD online environments.

    the taking of individual, class, team, video or club photos for school purposes.

    the use of student names on artwork or other creative work or material of students displayed at school or school Division sites or at a school or school Division sponsored display in the community.

    the use of student names in honour rolls, graduation ceremonies, scholarships or other awards within the Division.

    the use of student names and academic information necessary for determining eligibility or suitability for provincial, federal or other types of awards such as athletic programs or scholarships in the event the Division applies on a students behalf.

    the use of student names, addresses, phone number and special medical conditions for the purpose of arranging transportation and providing information to contracted school bus carriers.

    the use of student names, related contact information and telephone numbers for absenteeism checks.

    the taking of photos/video of classroom or other school activities where the material will be used within the school or in the Division promotional materials.

    the use of students names for school sponsored activities such as fine arts, productions, fairs, clubs, presentations, celebrations, sports activities.

    If you have any questions or concerns regarding the collection and the intended purpose, please contact the principal of the school your child attends.

    Technology Responsible Use Terms and Conditions I have reviewed and agree with the Technology Responsible Use Terms and Conditions document.

    Declaration By Parent, Guardian Or Independent Student I hereby certify the above information to be true, correct and complete. I have identified all guardians for this student.

    Date: _______________________________ Signature: __________________________________________________________________

    For Office Use Only Check Only Those That Apply

    Registration Approved on: _____ /_____ /_____ Month Day Year

    Staff Initial: _________

    Notes: _________________________________________ _______________________________________________ _______________________________________________

    Date Entered in SIS: ______________________________

    Birth Certificate Cumulative File Request Form

    Media Consent Form Custody Papers

    Immigration Papers Adoption Order

    Student Study Permit IPP

    Emergency Medical Plan Out of Area Request Form

    Court Orders Change of Name Form

    Parent Alert Letter

    Updated: 2017 March

    http://www.cesd73.ca/

  • Chinooks Edge School Division No. 73

    Media Consent Form

    Dear Parent or Guardian Chinooks Edge School Division No. 3 enjoys a strong relationship with media, as they frequently photograph, videotape or interview students about t...

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