Notice to Parent or Guardian of Religious Permeation The Alberta Human Rights Act requires a school board to give notice to a parent or guardian when courses of study, educational programs, institutional materials, instruction or exercises include subject matter that deals primarily and explicitly with religion. All of the schools in this Division 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 the 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.

Student Information

Legal Surname:	Legal Given Name:	Legal Middle Name:
Also Known as Surname (if different than above)	Also Known as Given Name:	Phone Number (Home):
Gender: Male    Female	Date of Birth: (click on box)	Grade Entering:	Requested Start Date: (click on box)
Street Address:	City:	Province:	Postal Code:
Subdivision:	Legal Land Description (for rural residents):
Has your child attended ECS in a prior year? Yes    No
Program Requested: ECS/AM    ECS/PM    ECS/Full Day M/W    ECS/Full Day T/T    None			Boundary School: Archbishop Jordan High School Ecole Our Lady of Perpetual Help School Father Kenneth Kearns School Holy Redeemer Catholic School Holy Spirit Catholic School Jean Vanier Catholic School John Paul II High School Madonna Catholic School Our Lady of Mount Pleasant School Our Lady of The Angels School Pope John XXIII School St. Luke Catholic School St. Martin's School St. Mary's School St. Patrick's School St. Theresa School School Requested: Archbishop Jordan High School Ecole Our Lady of Perpetual Help School Father Kenneth Kearns School Holy Redeemer Catholic School Holy Spirit Catholic School Jean Vanier Catholic School John Paul II High School Madonna Catholic School Our Lady of Mount Pleasant School Our Lady of The Angels School Pope John XXIII School St. Luke Catholic School St. Martin's School St. Mary's School St. Patrick's School St. Theresa School View boundary map
English    Ukrainian Bilingual    French Immersion
Do you require bus service? Yes    No If yes please fill out a busing request form. (*RURAL STUDENTS ONLY– Form required if busing is NOT to and from home address)

Parent (Guardian) Information

Student Lives With: Both Parents Mother Only Father Only Guardian Foster Home Independently Shared Custody Other If other please explain:
Mother (Guardian) Surname:	Mother (Guardian) Given Name:	Catholic: Yes    No
Mother (Guardian) Home Phone:	Mother (Guardian) Work Phone:	Mother (Guardian) Cell Phone:
Mother (Guardian) Email Address:
Father (Guardian) Surname:	Father (Guardian) Given Name:	Catholic: Yes    No
Father (Guardian) Home Phone:	Father (Guardian) Work Phone:	Father (Guardian) Cell Phone:
Father (Guardian) Email Address:

Custody Information

Does a guardianship order exist for this student? Yes    No If yes, then which type? Temporary     Permanent     Other     (If you selected "other" please explain)

In rare instances, a child may be designated as “Protected” if a court has issued a restraining order under the Child Welfare Act, the Domestic Relations Act, the Divorce Act, the Corrections Act, the Corrections and Conditional Release Act (Canada), the Youth Justice Act or the Youth Criminal Justice Act (Canada). Is a Court Order for the protection of your child in place? Yes    No If “yes”, please make arrangements to discuss this situation with the school administration. Legal documentation will be required.

Sacramental Information
This information will be used in conjunction with the Division’s Religious Education Programs in cooperation with the Catholic Parish.

Religion of Student: Roman Catholic     Ukrainian Catholic     Non-Catholic

Sacraments Celebrated: (Please check all that apply) Baptism     First Communion     First Reconciliation (Confession)     Confirmation If your child has been baptized in the Catholic Church, please provide a copy of the Baptismal Certificate to the school.

Medical Information

Does your child have any medical conditions the school should be made aware of? Yes    No If yes, please specify:

Is your child a member of Medic Alert®?Yes     No      If yes, Medic Alert Number®:

Emergency Contact Information

#1 Emergency Contact Person (If parent is unavailable)	Name:	Relationship to Student:
Home Phone:	Work Phone:	Cell Phone:
#2 Emergency Contact Person (If parent is unavailable)	Name:	Relationship to Student:
Home Phone:	Work Phone:	Cell Phone:

Special Needs Information

Does your child have any physical, intellectual, behavioral or emotional needs which would impact our ability to provide an appropriate educational program? Yes    No If yes, please describe in the space below:

Previous School(s) Attended

Name of School (Most Recent):		Dates Attended:	From:
City and Province	Postal Code		To:
Name of School:		Dates Attended:	From
City and Province	Postal Code		To:

Citizenship of Student

Citizenship of Student: Canadian    Permanent Resident/Landed Immigrant    Student Study Permit    Child of Canadian Citizen Child of Individual Lawfully Admitted to Canada for Permanent or Temporary Residence    Unknown
Entry into Canada (MM/DD/YYYY):	Student Study Permit Expiry Date:

Aboriginal Declaration

If you wish to declare that your child is an Aboriginal person, please specify: Non-Aboriginal      Status Indian/First Nations      Non-status Indian/First Nations      Metis      Inuit Alberta Education is collecting this personal information pursuant to section 33(c) of the Freedom of Information and Protection of Privacy (FOIP) Act as the information relates directly to and is necessary to meet its mandate and responsibilities to measure system effectiveness over time and develop policies, programs and services to improve Aboriginal learner success. Alberta school boards are also collecting this information pursuant to the same section in conjunction with section 2(1)(t) of the Student Record Regulation and for the same purposes. This information will also be used to determine the provincial First Nations, Metis and Inuit Funding Allocation provided to school authorities. For further information or if you have questions regarding the collection activity, please contact the office of the Director, Aboriginal Policy, Strategic Services Division, Alberta Education, 10155-102 Street, Edmonton AB, T5J 4L5, (780) 427-8501. If you have questions regarding the collection activity by the Elk Island Catholic Separate School Board, please contact Mr. Robert Simonowits, Assistant Superintendent - Student Services, at Elk Island Catholic Separate School Board (780) 467-8896.

Francophone Rights

According to Section10 of the School Act and Section 23 of the Canadian Charter of Rights and Freedoms the following applies: Citizens of Canada whose first language learned and still understood is French, or who have received their primary school instruction in Canada in French or of whom any child has received or is receiving primary or secondary instruction in French in Canada have a right to have their children receive primary and secondary instruction in French. 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 this 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? Yes      No      Do Not Know

If yes, do you wish to exercise your right to have your child receive a French first language (Francophone) education? Yes      No      Do Not Know Signature Date

Consent to Disclose Personal Information....School Council

The school has a School Council that represents the parents and engages in activities of the school. The school will normally make the parent/guardian name, phone number and mailing address as well as the student's name and grade level available to the School Council for contact purposes. I give permission for the release of the above information to the School Council. This consent will remain in effect for the years that the student attends EICS unless otherwise notified by the parent/guardian or student (if 18 years of age or independent). Signature Date

Copyright Permission

I hereby grant permission to Elk Island Catholic Schools, on behalf of the student being registered to: (Please check all appropriate boxes) Video/Audio/Photograph my child      Display any of my child’s work      Reproduce any of my child's work This work will be produced for non-profit, educational purposes during the student's attendance at EICS. I understand the production(s)/work(s) may be shown at educational displays during Board sponsored open houses, inservice sessions, other school related activities at school or school board sites, or in a school publication. This consent will remain in effect for the years that the student attends EICS unless otherwise notified by the parent/guardian or student (if 18 years of age or independent). Signature Date

The information collected on this registration form is required to allow the Division, through its administrators, to make such decisions as are necessary in order to fulfill its obligation to provide students with an appropriate Catholic education program that meets their needs, to provide a safe and secure environment, to protect the student's rights and to determine eligibility and/or suitability for provincial or federal programs and the funding available both under the School Act and the Regulations and through the Charter of Rights and Freedoms. The information will be made available to employees of Elk Island Catholic Schools, its authorized agents, and the Board of Trustees, within the scope of their roles and responsibilities, and to individuals working with the children or students in schools and to Alberta Education on a "need to know" basis. Please read the information contained on the attached FOIP Notification Form which describes particular uses to which personal information may be put. The information will be used for authorized programs and activities that are part of normal school life, and will be governed by the Freedom of Information and Protection of Privacy Act. We realize that there may be occasion where you have concerns relating to the safety of your child with respect to any of the uses of this information. In this case, please contact the school where your child attends. If you have questions regarding the use or disclosure of this information, please contact the school principal or Mr. Joe Weleschuk, Assistant Superintendent - Human Resources, EICSRD No. 41, at (780) 467-8896.

DECLARATION BY PARENT, LEGAL GUARDIAN, OR STUDENT (IF STUDENT LIVING INDEPENDENTLY)

I hereby affirm that I have read the EICS FOIP Notice form and the Notice of Religious Permeation. I affirm that the information provided on this registration form is complete and correct. Signature Date

This registration form is not an official document and does not guarantee enrollment. You will be contacted by the school or EICS Division staff for confirmation of application including ensuring all proper signatures and documents are on file.

I agree to the terms and conditions stated on this form