Registration

Student Information

Student Citizenship or Immigrant Status

Phone Numbers

Siblings

Address/Location

School History

Medical Information

Although we understand that providing this information is optional, it could be crucial for the well-being of the child.

Parent/Guardian Information

Please identify each of the legal guardian(s) for the child being enrolled. The legal guardian is the parent or person legally appointed as guardian as defined in the Family Law Act, Corrections Act, Corrections and Conditional Release Act, Young Offenders Act, or Child, Youth, and Family Enhancement Act.

First Legal Parent/Guardian

Second Legal Guardian

Emergency Contact

An emergency contact person is someone who resides in the vicinity of the school, other than the student’s parent or guardian, who can be called upon to quickly respond to an emergency situation if the parent or guardian is unavailable.

Guardianship Rights and Student Protection

Guardians of the student must be identified to ensure each party’s rights are respected. If an order does exist affecting guardianship rights or custody or access rights, a copy of the order will be required to be placed in the student record. The court seal must be evident on the order. In rare instances, a child may be designated as “protected” if a court issues a restraining order under the Child Welfare Act, the Divorce Act, the Young Offenders Act or similar legislation.

Family Circumstances

Independent Student Status

The Education Act defines an independent student as someone who is (i) 18 years of age or older, or (ii) 16 years of age or older and (a) living independently in accordance with section 6, or (b) who is party to an agreement under Section 57.2 of the Child, Youth, and Family Enhancement Act.

Francophone Rights

According to Section 14 of the Education 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/are receiving instruction in a French First Language Program or school in Canada (this does not include a French Immersion program).

Aboriginal Self-Declaration

For further information, please refer to https://open.alberta.ca/dataset/eccd5aa5-b46a-44f3-97dd-486043973cd3/resource/3616dff5-e30d-4b72-8ce0-760d4b993b6a/download/edc-aboriginalstudent-self-id-info-parents-guardians-2020.pdf or contact Alberta Education at 780-427-8501.

If you have questions regarding the collection of student information by the school board, please contact the School Board Superintendent at 780-624-2060 or 800-362-1360

If yes, please provide the following information

Digital Citizenship and Technology Use

As a condition of using Northland School Division network resources, I understand that access to division information resources, including access to internet and cloud-based resources, is a privilege and agree to abide by Administrative Procedure 140 – Use of Technology and the regulations identified in the Northland School Division Form 140-1 Technology User Agreement.

Using and Disclosing Personal Information

Northland School Division recognizes that all procedures for the collection and storing of information by Division staff in the course of affairs and procedures regulating the release of information to other parties must follow provisions of the Freedom of Information and Protection of Privacy Act (FOIP).

Access to information is guided by Administrative Procedure 180 -
Freedom of Information and Protection of Privacy. Further details can be found in Form 180-1 FOIP and Media Consent.

Media Participation

While under the supervision of Northland School Division, I hereby give Northland School Division and outside organizations permission to photograph, video tape, audio tape, and/or interview my child. I understand that this means that a photograph(s), video(s), audio tape(s), interview(s), or likeness of my child may be collected, used, reproduced, and broadcast within NSD and by the outside organization for displays, publications (including yearbooks), websites, social media, other electronic media, and advertising or promotional materials.

I hereby give Northland School Division permission to use, publish, display, and copyright any work, written material, or creative work created or authored by my child through school activities. I understand that artwork, written material, or creative work may be used by Northland School Division in division or school displays, publications (including yearbooks), websites, social media, other electronic media, and advertising or promotional materials. I understand that Northland School Division may make minor edits as deemed appropriate.

I understand that consent can be revoked at any time by written notification provided to my child’s school. Further details can be found in Form 180-1 FOIP and Media Consent.

Consent to Post Personal Information

Northland School Division requests consent to post personal information (including but not limited to first name, last name, grade, photographs, video, audio, award recognition, and school related activities) to external websites, social media, media publications (including yearbooks), and promotional materials. I understand that my signature below indicates my consent.

I understand that once provided, consent, in whole or in part (e.g. last name or photo, etc.), can be revoked at any time by written notification provided to my child’s school, acknowledging that although photos/videos will be removed from websites and social media accounts, it may not be possible to remove all traces of personal information from the Internet.

Further details can be found in Form 180-1 FOIP and Media Consent.

Policies and Regulations

If the hyperlinked documents are unavailable for any reason, information related to the sections above is available at your school in paper format. Please ask your school secretary
or principal.

Collection and Use of Personal Information Disclaimer

The information requested on this form is being collected pursuant to the Education Act, Section 56 and the FOIPP Act, Sections 33(c), 39(1)(b), and 40(1)(c). Information acquired through this form is kept secure and access is restricted. In accordance with the Student Record Regulation, this form will be placed in the student’s record file.

If you have any questions regarding this request for individual student information and about our use or disclosure of student information, please contact the school or the Northland School Division No. 61 FOIPP Coordinator at P.O. Bag 1400, 9809 – 77th Avenue, Peace River AB T8S 1V2, 780-624-2060 or 1-800-262-8674, fax 780-624-5914.

Declaration

I am the legal guardian or the independent student referred to in this registration form. I have read and understand the information regarding guardianship and I have identified all guardians for this student. I hereby certify the foregoing information to be true, correct, and complete.