student registration form - … · the school must have the following documentation in order to...

Adopted: January 14, 2004

Amended: Nov.12,2014 of 2

Mamquam Elementary School 2018-2019 Box 160, 40266 Government Rd. Garibaldi Highlands, V0N 1T0 Ph. 604-898-3601 Fax: 604-898-4092

The school must have the following documentation in order to register your child:• Child's Birth Certificate• Child's Care Card• Proof of Street Address (Parent's driver license or utility bill with parent name and street address

Legal Surnane: ________________________________Legal First Name: _______________________________Legal Middle Name: ________________________________

Usual Surname: Same As Legal __________________________________

Usual First Name: Same As Legal _________________________________

Birth Date (DD-MM-YYYY):________________Gender: Female Male Copy of Birth Certificate Provided

Present Grade: ______ If completing form for next school year: Grade in September: _______

Property Address

Street Number: ________________ Street Name: __________________________________________________

Apartment: ____________ Municipality: _______________________________________ Province:BC ______

Postal Code: ___________________ Comp: ________ Lot/Site: _______ Phone:

_____________________________

Mailing Address

Same As Property,

or:

_____________________________________________________________________________________________

Demographic Information

Aboriginal Ancestry: Yes No

If Yes, Status: Status On Reserve Status Off Reserve Metis Inuit Non Status

Band of Residence (if On Reserve): _________________________________

Language at Home: English Other _________________________________________

Immigration Status: Canadian Citizen Permanent Resident/Landed Immigrant International

Citizenship: Canadian Citizen Other __________________________________

Country of Birth: Canada Other ______________________________________

Parents

Student Living With: Both Mother Father Guardian Other:

___________________________________________

Custody: Joint Other _______________________________________________ Court order in effect

1 - Parent Type: Mother Father Guardian Other: __________________________________

Surname: ___________________________________ First Name:

Business Ph.: ________________________________Ext.:

Home Ph.: __________________________________Cell Ph.:

Email: _____________________________________Work Place:

Mailing Address: Same as Student Or:

_____________________________________________________________________________________________

STUDENT REGISTRATION FORM

Adopted: January 14, 2004

Amended: Nov.12, 2014 of 2

2 - Parent Type: Mother Father Guardian Other: __________________________________

Surname: ___________________________________ First Name:

Business Ph.: ________________________________Ext.:

Home Ph.: __________________________________Cell Ph.:

Email: _____________________________________Work Place:

Mailing Address: Same as Student Or:

_____________________________________________________________________________________________

Emergency Contacts In the event your child is ill or there is an emergency, we will attempt to contact you prior to calling emergency

contacts listed below. Please DO NOT list yourself as an emergency contact, but rather provide us with the

names of other friends or family who can pick up your child in the event of an emergency or illness.

1. Surname: __________________________________First Name:

Relationship: _______________________________Home Ph.:

Work Ph.: __________________________________Cell Ph.:



Work Ph.: _________________________________Cell Ph.:



Work Ph.: _________________________________Cell Ph.:

(If possible, please make contact 4 out of district)

4: Surname: _________________________________First Name:

Relationship: ________________________________Home Ph.:

Work Ph.: ___________________________________Cell Ph.:

Medical

Doctor: _____________________________________ Phone: ______________________

Dentist: ____________________________________Phone: ______________________

Care Card Number: ________________________________________________________

Allergies and Health Conditions: ________________Life Threatening? Yes No

_____________________________________________________________________________________________

Indicate any special/extra classes or support that your child is currently

receiving: ___________________________________

I certify that the information I have provided on this form is correct.

Parent Signature: ________________________________________ Date: ___________________________________

For

Office

Use

Only:

Previous School’s Records Requested Copy of Birth Cert. on

File

Copy of Freedom of Information

Release on File

Pen # Local I.D. # Local ID # reported to Librarian

Demographics Printed/Added to Student

Information Binder In Office

Local ID # & class info

reported to Comp Tech

Printed Name Tag For Classroom

Emergency Kit

AP604.3

Information and Communications Technology Acceptable Use Agreement Form for Students

August 22, 2014 AP604. 3 ICT Form 1

I have read, understand, and agree to these expectations before using the School District’s Information and Communication Technology.

1. School District No. 48 provides access to ICT for the purposes of supporting theeducation of students and to conduct District business.

2. All District ICT shall only be used by current staff and enrolled students. Exceptions mustbe approved by the District Network Manager or Director of Instruction.

3. All users of District ICT are expected to conduct themselves in a legal, appropriate,respectful, ethical, and responsible manner, as they would in any other environmentwhere their behaviour impacts others and reflects upon School District No. 48.

4. All users of District ICT are expected to follow copyright laws and Freedom ofInformation and Protection of Privacy (FOIPPA) requirements, cite sources and attributematerial to its proper owner when conducting research.

5. All users of District ICT are responsible for all of the activity in their accounts, forprotecting their passwords, and for logging off when away from their District devices.

6. All users of District ICT are expected to protect the integrity of the ICT and inform theappropriate person or authority immediately if aware of any threat or security risk.

7. All users of District ICT are expected to avoid activities during instructional time thatplace a heavy load on the system, and stay within the limits of their server allotments.

8. All users of District ICT do so with the understanding that the School District will not beresponsible for loss of personal information resulting from system failure.

9. All District ICT accounts and systems are the property of the School District, and thecontents may be inspected at any time.

10. All of the expectations above apply regardless of where the District ICT user is accessingthe system.

By signing below I am indicating that I have read, understood, and agreed to the expectations in this form. I acknowledge that if I violate this agreement my privilege to use the ICT may be revoked and disciplinary action may be taken against me.

Student’s Name: _____________________________________________________________

Student’s Signature: ________________________ Date: (mm/dd/yy) ____/_____/____

Page 1 of 1

AP604.3

Information and Communications Technology Acceptable Use

Permission for Student Access to

District Information and Communication Technology

August 22, 2014 AP604.3 ICT Form 2

NAME OF CHILD: _____________________________________________________

School District 48 provides access to Information and Communication Technology (ICT) for

educational purposes only. It is impossible for School District 48 to prevent access to materials

that may be controversial. All parents of students under age 18 must provide permission for

their child to access district ICT.

(_______) Yes - I give permission for my child to access the District ICT and I will not hold School

District 48 responsible for information or materials that my child may acquire through the use

of technology.

(_______) No - I do not give permission for my child to access the District ICT.

Signature: ________________________________Date: (mm/dd/yy) ____/____/______

Page 1 of 1

Page 1 of 1

School District No. 48 (Sea to Sky)

Consent for Access from Outside Media

August 22, 2014 Page 1 of 2 Media Consent- Form 3

For parents* and high school students: Please complete, sign, and return to your school.

Student’s Name: (Last) ______________________________ (First) ______________________________ (please print)

School:

Media (including radio, television, newspapers, and other print and online media) are sometimes permitted or invited to come to the school or to school activities and allowed to take photos or video or conduct interviews with students, for the purposes of promoting public understanding of school programs, building public support for public education, and encouraging student achievement.

If you do not want your child to be involved in such activities, you need to:

Tell your child to avoid these situations,

Tell your child’s teacher of your wishes,

Complete and return the form on the back of this page to ask the school and school district to takereasonable steps to avoid this type of publication of your child’s name, image, or personal informationby outside media.

Note that school and district staff cannot control news media access, photos/videos taken by the media or others in public locations (such as field trips or off school grounds) or school events open to the public, such as sports events, student performances, school board meetings, etc.

For Parents: I acknowledge receipt of this Notice. If I have questions I will contact the School District Information and Privacy Officer.

__________________________ Parent’s signature

For Students: I acknowledge that I am primarily responsible for protection of my personal privacy while at school and at school activities and will take appropriate steps to do so.

__________________________ Student’s signature

*For parents who have court orders describing their parental rights, this form should be signed by the parent who has the right to exercise the student’s privacy protection rights.

August 22, 2014 Page 2 of 2 Media Consent- Form 3

School District No. 48 (Sea to Sky) Consent for Access from Outside Media

NOTE: To be completed only if you wish to register an objection to publication of your child’s personal information by outside media at school events.

I do not want my child’s image or name being published by outside media. I have told my child’s teacher of my wishes. I REQUEST that the school district and its staff take all reasonable steps to avoid having my child’s image or name collected or published by outside media when they are present in school or at school activities at the invitation of the school or school district. I CONSENT to disclosure by the school district or its staff of the personal information that is necessary to give effect to this request. I MAY choose to override this Notice by giving my consent in a specific circumstance. This request applies during the current school year unless I expressly revoke it.

Date: ____________________

Parent’s Name: (Last) ______________________________ (First) _______________________________ (please print)

Parent/Guardian* Signature: ____________________________________________________________

Parent/Guardian Contact Information (for contacts related to this notice)

Telephone No.: _________________________ Email: _________________________________

For Students:

I am aware of my parent’s wishes as expressed above. I understand that I am primarily responsible for the protection of my own privacy at school and at school activities and will take appropriate steps to do so.

Student Signature:_____________________________________________________________________

*For parents who have court orders describing their parental rights, this form should be signed by a parent who has the right to exercisethe student’s privacy protection rights.

If you have questions about this notice or about the collection of student personal information, you may contact:

School District Information and Privacy Officer

Peter Jory Director of Instruction (Technology and Innovation) School District No. 48 Sea to Sky [email protected]

Phone: 604-892-5228 Fax: 604-892-1038

August 22, 2014 Page 1 of 2 Personal Information Consent


Personal Information Consent

For parents* and high school students: Please complete, sign, and return to your school.

Student’s Name: (Last) ______________________________ (First) ______________________________ (please print)

School:

Collection, use, and sharing of student personal information

Schools and Districts are authorized to collect, use, and share student personal information that is directly related to and necessary for their educational functions. For other school or education-related purposes, parental or student consent is required.

The Board of Education of School District No. 48 is seeking your consent to collect, keep, use and share photographs, videos, images, and/or names of students in a variety of publications and on the school or District’s website(s) for education related purposes, such as recognizing and encouraging student achievement, building the school community, and informing others about school and District programs and activities.

For example, student names, and/or images may be used or shared in

school and District communications, such as newsletters, brochures, and reports in limited orpublic circulation;

school and District websites, social media sites (e.g. Facebook), and online video (e.g. YouTube),with limited or public access;

videos, CDs, and DVDs designed for educational use only.

Please check A OR B (not both)

A. _____ I GIVE MY CONSENT for the school or District to collect, use, and share my child’s nameand/or image for purposes consistent with the above. I understand that images and informationposted on the internet may be stored and accessed outside of Canada.

This consent may be withdrawn at any time in writing but withdrawal of consent does not requirethe school or District to take any steps to withdraw from publication any previously publishedmaterial. Unless withdrawn, this consent is effective immediately and lasts until September 30 ofthe next school year.

B. _____ I DO NOT CONSENT to the use and disclosure of my child’s name and/or image for the abovepurposes for this school year.

Date: ____________________

of 2


Personal Information Consent

Parent’s Name: (Last) ______________________________ (First) ______________________________ (please print)


Parent/Guardian Contact Information (for contacts related to this notice)

Telephone No.: _________________________ Email: __________________________________

For Students:

I consent to the school and District collecting, keeping, using, and sharing my image and name for educational purposes such as recognizing and encouraging student achievement, building school community, and informing others about the school and District, its programs, and activities.

Student Signature: ____________________________________________________________________

*For parents who have court orders describing their parental rights, this form should be signed by aparent who has the right to exercise the student’s privacy protection rights.

If you have questions about this consent or about the collection of student personal information, you may contact:

School District Information and Privacy Officer

Peter Jory Director of Instruction (Technology and Innovation) School District No. 48 Sea to Sky [email protected]

Phone: 604-892-5228 Fax: 604-892-1038

School District No. 48 (Sea to Sky) Freedom of Information and Privacy Protection

(FIPPA) Consent for Web 2.0 Tools

Dear Parent/Guardian --

An important part of our class work this year will involve using Internet-based tools to create and share our learning -- to continue building a lifelong digital portfolio. Many tools may require your child to create a personal account, using his/her email account. Please note that your child will use Internet-based tools for both classroom activities and homework assignments, and will continue to hold accounts after our coursework is completed.

Your written consent to your child’s use of Internet-based tools is required by British Columbia’s Freedom of Information and Protection of Privacy Act (FOIPPA).

If you choose not to provide your consent to your child’s use of Internet-based tools, your child will not be penalized in any way and alternate activities will be provided, as appropriate.

It is important to be aware that the majority of the Internet-based tools noted below are online services hosted outside of British Columbia and possibly Canada. While stored outside the country, information in your child’s accounts may be subject to the laws of foreign jurisdictions, including, in the United States, the USA Patriot Act.

As a general safe practice, when interacting with any online service, students should take care and avoid posting personal information or personal location that could be used to identify themselves or other persons.

To explain and document their learning, students may be using Prezi, Showme, Kidsblog, Edublog, Voicethread, Wordpress, and Flickr. We may also use: __________________________________.

To communicate with other learners, students may be using Twitter, Wordpress, Kidsblog, Blogger, Skype, or wikispaces. We may also use: __________________________________.

To store and manage assignments and other information, students may be using Dropbox, Youtube, Evernote, or Google Drive. We may also use: __________________________________.

Kindly return a copy of this letter to the school office, signed and dated before [date]______________. If you have any questions or concerns, please feel free to contact me at [school email address] or at school [school phone number] _______________.

Consent: I understand that the information my child may create and store could be stored in or accessed from a location outside of Canada, and I hereby consent, on behalf of me and my child, to

Page 1 of 2

School District No. 48 (Sea to Sky) Freedom of Information and Privacy Protection

(FIPPA) Consent for Web 2.0 Tools

my child’s information identified above being stored in, or accessed from, a location outside of Canada.

This permission to use the tools indicated above is granted for the duration of my child’s time in School District No. 48 (Sea to Sky).

__________________________________ ______________________________________ Signature of Parent or Guardian Signature of Student (if over 13)

__________________________________ _______________________________________ Print Name Print Student Name and Grade

__________________________________ _______________________________________ Date Date

If you have questions about this notice or about the collection of student personal information, you may contact:

School District Information and Privacy Officer Peter Jory Director of Instruction (Technology and Innovation) School District No. 48 Sea to Sky [email protected] Phone: 604-892-5228 Fax: 604-892-1038

Page 2 of 2

SD48 (Sea to Sky) Consent for Electronic Messages for Canadian Anti-Spam Legislation (CASL)

Page 1 of 1

Parents and guardians: Please complete, sign, and return to your school.

Student’s Name: (Last) (First) (please print)

Canada's Anti-Spam Legislation (CASL) has come into effect as of July 1, 2014. As a result, our school must now obtain your specific consent to be able to

send you newsletters, announcements, and other electronic messages which may contain advertising or promotions including requests for field trips,

fundraising, yearbooks, student pictures, dance tickets, or other similar events and offers.

I give (Please print school name)

and School District No. 48 (Sea to Sky) permission to contact me using electronic messages which may include information as described above.

Parent’s Name: (Last) (First) (please print)


Preferred Email Address Other Approved Addresses or Numbers

Signature Date

I also give the school Parent Advisory Council and the District Advisory Council

permission to contact me using electronic messages which may include commercial information as described above.

Signature Date

You may also subscribe or unsubscribe from this communication list by contacting the school.

Reviewed: July 14, 2016

student registration form - … · the school must have the following documentation in order to...

Documents