Kindergarten Registration : Ottawa Adventist® School Ottawa ON

Student's Information

Student's Name

Home Address

Alternate Address If Applicable

Date of Birth

School Year*

Grade Entering*

Student Email

Father's Information

Father's Name

Occupation

Work Phone and Extension

Home Phone

Mobile Phone

Father's Email

Mother's Information

Mohter's Name

Mother's Occupation

Mother's Address

Work Phone and Extension

Home Phone

Mobile Phone

Mother's Email

Guardian Information If Applicable

Guardian Name

Guardian Occupation

Guardian's Address

Work Phone and Extension

Home Phone

Mobile Phone

Guardian's Email

Emergency Contact Information

Name

Relationship

Work Phone and Extension

Home Phone

Mobile Phone

Emergency Contact Email

Registration Fees

Non-refundable Fee of $140.00 paid once per year upon submission of Registration

A. Constituency Member

Tuition

B. Non-constituency Member

Tuition

Choose Payment Frequency

Agree to the following by selecting the check boxes I/We understand and accept this financial contract as binding between myself/us and the School Board of the Ottawa Adventist School. Any breach of this contract must be settled immediately with the School Board Treasurer.

Medical Consent

Medical Insurance Number

Doctor's Name

Doctor's Phone Number

Medical Information Existing Medical Conditions Allergies Medications

Additional Information (if needed)

Evacuation Consent

Instructions given to my child/children are as follows: (Please select ONE)

1. My child may go home by public transit. My child has access to the house if I am not at home.

Additonal Insructions:

2. When informed of the emergency, I will arrange for transportation. I will inform school staff, should a designated adult pick up my child on my behalf.

Additional Instructions:

3. My child may be released to any responsible adult who offers transportation. Responsible adult may include: another parent, Pastor, Teacher, church Board member

Additional Instructions:

4. Teaching staff may be discretionary in any such emergency.

Additional Instructions:

Field Trip Consent

Field Trips I/we hereby give permission for my/our child/children, to participate in the schools off campus field trips. These include, trips to the library, skating, museums, swimming, and other educational or seasonal programs the staff deem to be advantageous. I/we understand that such trips will be preceded by a note to parent(s) and / or guardian(s)

Media Usage

Media Usage I/we hereby give permission for the Ottawa Adventist School and the Ontario Conference of Seventh-day Adventist, Office of Education, to use photos or video footage of my child/children in newsletters and other promotional material.

Please download, sign, date and forward to the Ottawa Adventist School the signature sheet below:

Signature Sheet

Notes:

1. All plans require post dated cheques

2. Non sufficient funds (N.S. F.) marked cheques will be subjected to an additional fee of 25$.

3. Stop payment(s) made on post dated cheques must be reported to school staff and / or Board Treasurer a minimum of five (5) business days prior to the date on cheque. Neglect to do so, will be subjected to an additional $25.00 fee.

Ottawa Adventist^® School