1. Form 300-1 Updated: 2018-10-01


Form 300-1 Updated:   2018-10-01


November 2009

HOLY FAMILY CATHOLIC REGIONAL DIVISION NO. 37

STUDENT REGISTRATION FORM


This is a legal document, please ensure all areas are completed, mark “n/a” if area is not applicable.

Provincial ID Number: ___________________________ Date of Registration:  
 
1Glenmary 1 Good Shepherd 1 Holy Family 1 Rosary 1 St. Andrew’s 1 St. Stephen’s 1 Providence 1 Cyberhigh
 
For New Registration to Holy Family C.R.D. No. 37 please provide proof of legal name:

1Birth Certificate 1 Adoption Order 1 Canadian Citizenship 1 Permanent/Landed Immigrant
 

SECTION A – STUDENT INFORMATION
 
_____________________ ______________________ _________________    
Legal Surname                                 Legal First Name                                           Legal Middle Name                            Preferred Full Name – also known as
 
Gender: _____________ Date of Birth: ___/___/___ Grade Attending: ____ 1 English 1 French Immersion
                                                                Year/Month/Day
 
________________________ _______ _____________________ _____________    
Street Address Box Number Town Postal Code Phone Number
 
Student’s Email Address: _______________________________________________________________________________________________________________
 
Legal Land Description (Rural Students):
Quarter ________ Section __________ Township __________ Range __________ Meridian  
 
Please Provide 911 Address (Civic Address): __________________________________________________
 
Name, phone number and address of school last attended:  
 
  Grade:  
 
Name and Grade of other Children in your family:
____________________________________________  
Name and Grade   Name and Grade
____________________________________________  
Name and Grade   Name and Grade
 
Medical Information and Support Services
Alberta Health Care Number: _________________________________________
 
Please indicate all allergies, medication and serious health problems:  
 
 
Family Physician: ________________________________________ Phone Number:  
 
Child has received services: 1   Speech/Language Therapist 1 Psychologist   1 Behavior Specialist 1 Occupational/Physical Therapist 1 Glenrose Hospital/Others 1 Received school-based Special Education Services
 
** Please provide a copy of specialists’ report or medical reports that require close attention.

 


 
SECTION B – PARENT INFORMATION
 
Mother’s/Legal Guardian’s Name and Address:  
  Home Telephone  
 
_________________________ _______________________    
Cell Phone Work Telephone Email Address
Father’s/Legal Guardian’s Name and Address:  
 
  Home Telephone  
 
_________________________ _______________________    
Cell Phone Work Telephone Email Address
Emergency Contact Name:   Telephone:  
 
Work Telephone:   Cell Phone:  
 
Language Spoken at Home: _________________________________________   
 
The Student lives with 1 Father & Mother 1 Mother Only 1 Father Only 1 Independent
1 Mother & Step-Father 1 Father & Step-Mother 1 Other/Guardian 1 Grandparent(s)
 
Who has legal custody of the child? 1 Parents 1 Mother 1 Father 1 Guardian 1 Grandparent
 
If legal custody is not the mother or father of the child, please provide legal documentation of appointment of guardianship. Is there anything we should know about the custody? Please provide legal documentation.
 
 
 
If Student requires busing:
Does your child ride the bus? 1 Yes 1 No If Yes, Bus number (if known): _____ Route Number: ______
 
 
SECTION C – CATHOLIC SCHOOL DECLARATION
 
I wish to have my child registered and I support the philosophy and objectives of the Holy Family Catholic Regional Division No. 37 and those of its schools. Pursuant to the School Act, religion of parents/guardians is required.

 
Father/Legal Guardian: Are you of the Catholic Faith 1 Yes 1 No
 
Print Name: _______________________________________ Signature:  
 
Mother/Legal Guardian: Are you of the Catholic Faith 1 Yes 1 No
 

Print Name: _______________________________________ Signature:  

Do you live in an area where a Catholic School District exists? 1 Yes 1 No 1 Don’t Know

We encourage you to declare your support for Separate Schools on your Property Assessment and Tax Notice.

 

 


 
SECTION D – NOTICE TO PARENT OR GUARDIAN OF RELIGIOUS PERMEATION
 
The Alberta Human Rights Act requires a school board to give notice to a parent/guardian when courses of study, education programs, institutional materials, instruction or exercises include subject matter that deals primary and explicitly with religion.

All of the schools in this district are Catholic Separate Schools, the essential purpose of which is to fully permeate Catholic theology, philosophy, practices and beliefs, the principles of the Gospel and teachings of the Catholic Church, in all aspects of school life, including in the curriculum of every subject taught, both in and outside of formal religion classes, celebrations and exercises.

Every course of study and educational program, all institutional materials, instruction and exercises will at all times include subject matter that deals primarily and explicitly with religion.

Sacramental Preparation

In partial fulfillment of the right, responsibility and duty of Catholic separate schools to fully permeate Catholic theology, philosophy, practices and beliefs, the principle of the Gospel and teachings of the Catholic Church in all aspects of school life, this school is actively involved in sacramental preparation of students. To assist in sacramental preparation, please advise whether your child has received any of the following sacraments:

0 Baptism (please provide a copy of Baptismal Certificate)

0 Reconciliation

0 First Communion

0 Confirmation

 

 
SECTION E – ABORIGINAL SELF- IDENTIFICATION
 
If you wish to declare the student is Aboriginal, please select one:

 

First Nation (status) ___ First Nation (non-status) ___ Métis ___ Inuit ___

 

For further information, please refer to: https://education.alberta.ca/system-support/results-report or contact Alberta Education at 780.427.8501.
 
If you have any questions regarding the collection of student information by the school board, please contact the School Board Superintendent at 780.624.3956.
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
 
Does the student have treaty status? 1 Yes 1 No Does the student reside on reserve? 1 Yes 1 No
 
On which reserve does he/she reside?  
 
Does the student have Métis status? 1 Yes 1 No Does the student reside on a settlement? 1 Yes 1 No
 
On which settlement does he/she reside?  
 
Parent/Legal Guardian Name (Please Print):   
 

Parent/Legal Guardian Signature:  

 

 

 

 
SECTION F – FRANCOPHONE EDUCATION ELIGIBILITY DECLARATION
 
Pursuant to Section 23 of the Canadian Charter of Rights and Freedoms:
Citizens of Canada

·   Whose first language learned and still understood is French; or
·   Who have received their primary school instruction in Canada in French have the right to have their children receive primary and secondary instruction in French; or
·   Of whom any child has received or is receiving primary or secondary school instruction in French in Canada, have the right to have all their children receive primary and secondary school instruction in the same language.

In Alberta, parents can only exercise this right by enrolling their child in a French first language (Francophone) program offered by a Francophone Regional Authority.

According to the criteria above as set out in the Canadian Charter of Rights and Freedoms , are you eligible to have your child receive a French first language (Francophone) education? Please check one.

1 Yes 1 No 1 Do not know

If yes, do you wish to exercise your right to have your child receive a French first language (Francophone) education?

1 Yes 1 No

To exercise your Section 23 rights, you must enroll your child with the Northwest Francophone Education Region No. 1 – St. Isidore (780-624-8855).

Name of parent/legal guardian:
 
_________________________________ ___________________________  
Please Print Signature Date
 

 
SECTION G – FREEDOM OF INFORMATION AND PROTECTION OF PRIVACY ACT
 
The personal information requested on this form is being collected for the school registration process pursuant to the provisions of the School Act and its regulations (e.g. for the establishment of a student record, determination of student residency) and under the authority of the Freedom of Information and Protection of Privacy Act (FOIP) Act. If you have any questions or concerns regarding the collection and the intended purposes, please contact the Secretary-Treasurer for the Holy Family C.R.D. No. 37 at 10307 – 99 Street, Peace River, AB T8S 1R5 – 780-624-3956.
 
Declaration of Parent/Legal Guardian
I hereby certify the foregoing information to be true, correct and complete.
 
________________________________________________________  
Parent/Legal Guardian Signature Date
 
 
SECTION H – ANTI-SPAM LEGISLATION
 
In accordance with new anti-spam legislation, I give consent to receive Commercial Electronic Messages from Holy Family Catholic Regional Division No. 37. From time to time emergent and important school or Division information/news will be communicated to parent(s)/guardian(s) via mail/email and/or telephone.
 
 
       
                   Yes
           

 

 
FOR SCHOOL OFFICE USE ONLY – ACCEPTANCE OF REGISTRATION
 
Resident Student: Registration accepted.
 
_____________________________________________________  
Principal’s Signature Date
 
Non-Resident Student: Registration Accepted if room and resources available.

1 room and resources available (Principal’s Initials)

1 provisions have been made with Resident Board for Special Education Funding. (Principal’s Initials)
 
_____________________________________________________  
Principal’s Signature Date
 

 

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