Apply to enroll - Best private school in Brampton, ON

Student Name *

First

Middle

Last

Date of birth *

Gender *

Transportation *

School year *

Grade *

Address *

Phone number *

Present school

Student Lives With *

Personal Information is collected under the authority of the Education Act and will be used for the establishment and maintenance of the Ontario Student Record in accordance with the (OSR) Guideline 2000. Access to the OSR Records may be obtained by contacting the Principal.

Father's Name *

First

Last

Father's Occupation *

Father's Cellphone *

Father's Email *

Mother's Occupation *

Mother's Cellphone *

Signature (1) *

Medical Information

Ontario Health Card *

Expiry Date *

Doctor's Name *

Doctor's Phone *

Dietary Restrictions

List all foods the student should not eat for dietary (incl. allergies) or religious reasons.

Has the student been diagnosed with allergies? *

Does the student require an EPI-PEN? *

Has the student been diagnosed with asthma? *

Does the student require an inhaler for asthma? *

Could your child be given headache medication without your consent *

Does the student take any medication regularly? *

Please specify any medical, social, or emotional problems the school should be aware of

EMERGENCY CONTACT AND RELEASE AUTHORIZATION:

The school is authorized to release the student to the individuals listed below. Those individuals can also be contacted in case of emergency should the school not be able to contact the parent(s) or guardian(s).

Emergency Contact Name *

First

Last

Emergency Contact Relationship to Student *

Cell Phone *

Home Phone

Work Phone

Signature (2) *

Internet Usage Policy *

I have read and agree with the Internet Usage Policy

We are pleased to offer students of the Queens Gate Academy access to the computer network for the Internet. It is our intent to make Internet access available to further educational goals and objectives. Queens Gate Academy is dedicated to enabling learners to lead productive and fulfilling lives. We do this through effective, systematic, and innovative use of technology in an environment that:

Values people

Fosters collaboration and positive relations

Encourages lifelong growth and development

Promotes the exchange of ideas and information anytime, anywhere

Extends the frontiers of the learning environment

Makes creative use of technology

Results in a more efficient and productive use of resource

Even with safeguards in place, they are not all inclusive and students may find ways to access other materials as well. We believe that the benefits to students from access to the Internet, in the form of information resources and opportunities for collaboration, comes with more benefits but it also comes with some disadvantages. Therefore, it is important that students and parents are aware of the ethical use of the Internet. Queens Gate Academy support and respect each family’s right to decide whether to apply for access.

Use of Queens Gate Academy connections to the Internet shall be for the exchange of information to support the user’s education and research.
As outlined in School policy and procedures on student rights and responsibilities, the following are not permitted:

Sharing confidential information about others

Sending or displaying offensive messages or pictures

Using obscene language

Harassing, insulting or attacking others

Engaging in practices that threaten the network (e.g., loading files that may introduce a virus)

The use of unauthorized software

Violating copyright laws

Using other’s passwords

Trespassing in others’ folders, documents, or files

Intentionally wasting limited resources

Violating regulations prescribed by the Internet provider

Any malicious attempt to harm or destroy data of any person, computer, or network

Promoting, supporting or celebrating religion or religious institutions

Using network resources to play internet games or other non-educational entertainment

Damaging computers, computer systems or computer networks

Using Chat Rooms

Other

Queens Gate Academy will provide Internet activity for educational purposes ONLY. Users may not use this access to advertise or take money. The school makes no warranties of any kind, whether expressed or implied, for the service it is providing. The school will not be responsible for any damages a user incurs. Use of information from the Internet is at a student’s own risk.
Failure to observe these rules will result in loss of computer privileges and/or other consequences consistent with the school code of behaviour.

Guidelines for Internet Use

Use equipment for educational purposes ONLY
Keep passwords CONFIDENTIAL
Show RESPECT for people and organizations
Use ONLY authorized software
Be POLITE and WELL MANNERED when using e-mail
Do NOT break copyright laws
Do NOT access or post offensive material
Do NOT harm or destroy data of a person, computer or network
RESPECT other people’s time – keep messages brief
LOGOFF as soon as you have completed your task

Violations may result in a loss of access as well as other disciplinary or legal action.
The attached form must be signed by the student, parent/guardian and the advisor.

Signature (3) *

Media Release Form *

I have read and agree with the Media Release Terms

We are seeking parental permission for a number of school-based activities. By signing the consent form below, you are giving permission to:

Post your child's schoolwork in the school's front foyer and/or hallways. Please note that only your child's first name will appear next to the piece

Include your child's full name and grade on awards/trophies that will be kept in the school's front foyer and/or hallways

Mention your child's achievements in our school newsletter, website and social media accounts. Only your child's first name will be used. The grade level may also be mentioned

Post your child's schoolwork in our school's newsletter, website and social media accounts. Your child's first name and grade level may be referred to. Grades or marks will not be posted

Include your child’s full name in school programs or student awards (graduation programs, school plays and musical productions, school brochures), and school yearbook

Use photos and/or videos of your child in our school’s newsletter, yearbook, website and social media accounts, as well as the board’s website, social media accounts and internal publications. Photos will be taken of groups of students and will not identify any individual student (e.g. a photo of a group of students playing basketball in the gym)

Have your child recorded or photographed by a staff member, volunteer or student teacher as part of the learning program. These photos and videos may be used within the school or board and may appear on school/board websites and/or social media accounts, including but not limited to Twitter, Facebook, Instagram and YouTube

Have your child recorded, photographed and/or interviewed for media stories throughout the school year. This does not include photographs taken for political purposes (e.g. for politician’s newsletters). The images and/or audio may be used in local, national or international news stories about school programs, initiatives, awards and/or events. Your child's full name and image may accompany the story

In providing this consent, I acknowledge that any photos/videos posted on the school’s and/or board’s website or social media accounts may be widely circulated to the public and may be viewed by anyone with access to the Internet

If I provide consent, and then later revoke my consent, I acknowledge that although the photos/videos will be removed from the board’s websites and social media accounts, it may not be possible to remove all traces of personal information from the Internet

This consent will be effective during the current school year. Consent may be revoked at any time by contacting the school office

Signature (4)

Status

New Student or Returning

Child#

If you have multiple children attending the school, please indicate which child you have registered

Payment Plan

Payment Method

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Medical Information

EMERGENCY CONTACT AND RELEASE AUTHORIZATION:

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