ALAQSITE’W GITPU SCHOOL
REGISTRATION FORM
2006/2007
Student’s Name _______________________________________________________________
Medicare Number __________________________________ Band Number _______________
Age ________________ Date of Birth (month) _________ (day) _________ (year) _________
Mother’s Name ___________________________________
Father’s Name ___________________________________
Guardian (If Applicable) ___________________________________________
Telephone (home) _________________________ Telephone (work) __________________________
Email ___________________________
Address:
P.O. Box _________________________________________
Street ___________________________________________
City/Town ________________________________________
Province _____________ Postal Code _________________
Does your child have any medical problems or allergies, if so please indicate:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Person(s) to contact when parent(s) cannot be reached:
1.________________________________________
Telephone _____________________________
2. ________________________________________
Telephone _____________________________
Person(s) not authorized to pick up child __________________________________________________
____________________________________ ______________________________________
Date Parent Signature
ALAQSITE’W GITPU SCHOOL AUTHORIZATION FORM 2006/2007
Permission to transport student to hospital in the event of an accident or serious illness.
The Alaqsite’w Gitpu School prides itself on having an active safety program to prevent accidents. However prepared we are, an accident may happen or serious illness may occur. We request that you sign this form giving the Alaqsite’w Gitpu School permission to transport your son/daughter to the hospital either by ambulance or by private car as the circumstances indicate. Should such occur, every effort shall be made to contact you immediately and inform you of the circumstances. Permission shall be for as long as your son/daughter shall be enrolled in the Alaqsite’w Gitpu School, or until we are otherwise instructed by you.
__________________________________________ Student’s Name
__________________________________________ Parent Signature
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WE'RE GOING ON A FIELD TRIP
Where: ____________________________
____________________________
When: _____________________________
_____________________________
Why: ______________________________
______________________________
How: ______________________________
Please
Bring: _________________________________________________________________
Please sign the permission slip and have your child return it
by: _______________________________
Your child will not be allowed to go on the trip without the permission slip .
Thank You,
__________________________
Teacher
.....................................................................................................................................................
My child _________________________________ has my permission to participate on
the field trip to _______________________________.
________________________________
Parent or Guardian Signature
