application checklist date received (office use only...

Application ChecklistOnline High School - Grades 10 - 12

2017 - 2018

Christ the Redeemer Catholic Schools

Email to: [email protected]

Yes No

Applying for Grade (2017-18):Student Name:

Are you planning to obtain an Alberta High School Diploma?Yes NoWill you be attending another school while taking courses with us?

If so, please provide name of School and list course(s):

Your application package will NOT be PROCESSED if the REQUIRED documentsare missing.

1. Application Checklist

ReturningStudent

Required

NewStudent

RequiredParent

ChecklistOffice

Use

2. Application Form (must be signed by BOTH Parent(s)/Legal Guardian(s)

4. Course Selection, CTS and High School Planning Sheets

6. Student Cumulative/Confidential Records Release Form

7. Copy of Psychoeducational or Specialized Assessment if one exists (most recent)

8. Copy of Individual Program Plan (IPP) if one exists, from last school attended

9. Copy of most current progress report/assessment/report card

10. Copy of student Birth Certificate. (Must accompany application for NEW Student)

12. Guardianship/Custody documents MUST accompany application, if applicable

OFFICE USE ONLY:Intake(FM)

Student Services / RegistrarPS

Records

53721482

FM # # Students in Family:

Mailing Address: Box 137, Okotoks, AB T1S 1A4

Street Address: 200, 109 Southbank Blvd, Okotoks, AB T1S 0G1

Ph: (403)938-4119 or 1-800-659-1945 ~ Fax: (403)938-8563

100, 10634-178 Street NW, Edmonton, AB T5S 1H4

Ph: (403)938-4119 or 1-800-659-1945 ~ Fax: (403)938-8563

03/03/16 Application Checklist Online HS

/

11. Citizenship Documents: If student is not a Canadian citizen, a copy of a validvisa or other document by which the student is lawfully admitted to Canadafor permanent or temporary residence MUST accompany the BirthCertificate

3. Questionnaire

CTRNewReturning

Online High SchoolBlended ProgamHome Education

Email completed application to: [email protected]

You can e-mail or fax these documents to our office. If you wish to scan and e-mail these documents to us, please ensure lowresolution and file size is not more than 5 megabytes. A Student Services coordinator will provide follow-up contact once yourapplication has been processsed.

5. Diploma Course Contract

Date Received (Office Use Only)

13. Collection of Personal Information and Media Consent Form

1. Does your child have special learning needs and/or an Individualized Program Plan (IPP) and/or a Psychoeducational Assessment?2. Does your child have any medical challenges that would impact his/her schooling? If yes, please provide details.

According to Section 10 of the School Act and Section 23 of the Canadian Charter of Rights and Freedoms, a student is eligible to receive instruction in French if:- Either parent’s mother tongue is French (French was the first language learned & understood by one of the parents)- Either parent was educated in French in Canada- One or more children in the family have received primary or secondary school instruction in French in Canada

Is the child eligible to receive French language education?If so, do you wish to exercise this right?If you are an Aboriginal person, please specify:(Alberta Education is collecting this personal information pursuant to Section 33(c) of the F.O.I.P.P. Act as the information relates directly to and is necessary to meet itsmandate and responsibilities to measure system effectiveness over time and develop policies, programs and services to improve Aboriginal learner success. For furtherinformation or if you have questions regarding the collection activity, please contact the office of the Director, Aboriginal Policy, Alberta Education, 10155-102 Street,Edmonton AB, T5J 4L5 (780)427-8501.)

Student Legal Last Name Legal First & Middle Name(s) BirthdateGender Grade (2017/18)

Preferred Last Name Preferred First Name

Mother/Legal Guardian (last name) First Name Home phone Work Phone

Primary Parent/Guardian E-mail address Alberta Education I.D. #

Name of Resident Board (2016-17)


Application FormOnline - Grades 10-12

2017-2018

Name of school attended in 2016-17

CitizenshipCatholic? Yes No

Student resides with:Mother Father Legal Guardian Independent Student

Other (specify)

Student’s Address for mailing textbooks City/Town

Student’s Physical residence address

Postal CodeProvince

Postal Code

I hereby certify that:1. The above information is correct to the best of my knowledge and the student is a resident of Alberta;2. I have read and understood the “School Division Use of Personal Information” section in this registration package; and3. I will comply with the technology requirements.

The information requested on this form is being collected pursuant to the School Act, the Student Records Regulation AR 71/99 and pursuant to Section 33(c) of theF.O.I.P.P. Act for the establishment of a student record as the collection is related directly to and is necessary to a school board’s obligation to provide a schoolenvironment (e.g., program placement, determination of eligibility and/or suitability for provincial or federal funding). Personal information may also be provided to theMinister of Education for the purpose of carrying out programs, activities, or policies under his administration (e.g., research, statistical analysis). If you have anyquestions or concerns, please contact the F.O.I.P.P. coordinator at Box 1318, 1 McRae Street, Okotoks, AB T1S 1B3 or telephone (403)938-2659/1-800-737-9383.

03/03/16 Application Full Time Online Grades 10-12

Signature of Mother/Legal Guardian(Independent Student, if applicable)

Approved by The Centre for Learning@HOME Principal

Date

Date

Cell Phone

Father/Legal Guardian (last name) First Name Home phone Work PhoneCell Phone

Home phone

City or Legal Land Description and Rural(911) Address

Yes NoYes No

Status Indian/First Nations Non-Status Indian/First Nations Metis Inuit

� ��

� � ��

Yes No� �Yes No� �



Ph: (403)938-4119 or 1-800-659-1945 ~ Fax: (403)938-8563


Ph: (403)938-4119 or 1-800-659-1945 ~ Fax: (403)938-8563

Both Parents

Mailing address of parent if different than student City/Town Postal CodeProvince

Signature of Father/Legal Guardian

Note: BOTHparent(s)/LegalGuardian(s)must sign thisapplication.

Shared Custody

Student Cell PhoneYes No

Parent permissionto request studentcell number

Initials

PLEASE PRINT

HS Online Questionnaire

2017-2018 NEW APPLICANT ONLY

In order to serve your family and meet the educational needs of your child, please complete this questionnaire.

STUDENT NAME:________________________________________ GRADE:__________ (2017/2018)

1. Why have you selected The Centre for Learning@HOME?

2. What was your child’s schooling program for 2016-2017 (home education, blended, online, distance education or traditional school)?

3. Was the last program you followed successful?Why or why not?

4. Are you planning to be away from your permanent address for any extended period of time? If yes, please explain.

5. What are your child’s interests and hobbies?

6. Who is the parent/guardian primarily responsible for the child’s program? Does this person work outside of the home?If so, please explain the supervision in place.

7. What are your career goals and post-secondary plans?

8. If your child attended a traditional school in 2016-2017, please check the box that best describes your child’s attendance:Missed between 5-10 days of school Missed between 11-20 days of schoolMissed over 20 days of school, please explain circumstances

9. Has your child ever had the following? If yes, please attach any relevant documentation.

Psychoeducational or Specialized Assessment Learning Support Participation Medical challenge

AB Special Education Code IPP

10. If your child is intending to be employed during the school year, please indicate how many hours per week. ______

11. If your child has not been attending a school program this past year, please explain the circumstances.

04/2017 Questionnaire - NEW Online Students 2017-2018

Physical Address: 100, 10634-178 Street NW, Edmonton, AB T5S 1H4

Mailing Address: Box 137, Okotoks, AB T1S 1A4 Physical Address: 200,109 Southbank Blvd. Okotoks, AB T1S 0B2 Phone: (403) 938-4119 or 1-800-659-1945 ~ Fax: (403) 938-8563

Phone: (403) 938-4119 or 1-800-659-1945 ~ Fax: (403) 938-8563


Diploma Course Contract2017-2018

PLEASE PRINT

This form must be completed by any student planning to take a diploma level (30 Level) course in 2017-18.

Agreement to the terms and conditions of this contract forms part of your registration withThe Centre for Learning@HOME. Students will not be enrolled in a diploma course

if this form is not completed and verified by the Principal.

04/03/17 Diploma Contract

Student Signature Date

Terms of registration and enrollment in these courses:

1. A student accepts the general guidelines and conditions as set out for registration in The Centre for Learning@HOME HighSchool Handbook.

2. A student enrolled in diploma courses will demonstrate a consistent effort in each course by completing all assignments,quizzes, projects, tests, etc. as assigned by the teacher.

3. Students will ensure all work assigned by the teacher is completed by the assigned due dates in order to be in good standing inthe course; otherwise, they may be removed from the course.

4. If the student is not demonstrating the required effort to pass the course, they will be removed from the specific course inquestion (in essence, if the student is failing the course because the student is not doing all of the required work, the schoolreserves the right to withdraw them from the course).

5. All students who have a mark below 65% in a Diploma-level course must attend the Learning Strategies live class(es).

Please check ( ) the diploma courses you plan on taking for the 2017/18 school year:

Biology 30�

Chemistry 30�

Physics 30�

Science 30�

English 30-1�

English 30-2�

Math 30-1�

Math 30-2�

Social Studies 30-1�

Social Studies 30-2�

Legal Guardian Signature Date

The Centre for Learning@HOME Principal Signature Date

I, ___________________________________ , have read and understand the standards established by The Centre for Learning@HOME in regards to diploma courses.



Ph: (403)938-4119 or 1-800-659-1945 ~ Fax: (403)938-8563


Ph: (403)938-4119 or 1-800-659-1945 ~ Fax: (403)938-8563

GRADE 10 Crdts SEM GRADE 11 Crdts SEM GRADE 12 Crdts SEM

English 10-1 5 1, 2 English 20-1 5 1, 2 English 30-1 5 1, 2

English 30-1 Learning Strategies 3 1, 2

English 10-2 5 L English 20-2 5 L English 30-2 5 1, 2

English 30-2 Learning Strategies 3 1, 2

Social Studies 10-1 5 1, 2 Social Studies 20-1 5 1, 2 Social Studies 30-1 5 1, 2

Social Studies 30-1 Learning Strats 3 1, 2

Social Studies 10-2 5 1, 2 Social Studies 20-2 5 1, 2 Social Studies 30-2 5 1, 2

Social Studies 30-2 Learning Strats 3 1, 2

Math 10-C 5 1, 2 Math 20-1 5 1, 2 Math 30-1 5 1, 2

Math 30-1 Learning Strategies 3 1, 2

Math 20-2 5 1, 2 Math 30-2 5 1, 2

Math 30-2 Learning Strategies 3 1, 2

Math 10-3 5 L Math 20-3 5 L Math 30-3 5 L

Math 31 5 2

Math 10 Foundations 3 1

Science 10 5 1, 2 Science 20 5 1, 2 Science 30 5 2

Science 30 Learning Strategies 3 2

Biology 20 5 1. 2 Biology 30 5 1, 2

Biology 30 Learning Strategies 3 1, 2

Chemistry 20 5 1, 2 Chemistry 30 5 1, 2

Chemistry 30 Learning Strategies 3 1, 2Physics 20 Math 20-1 Requirement

5 1, 2 Physics 30 Math 20-1 Requirement

5 1, 2

Physics 30 Learning Strategies 3 1, 2

Science 14 5 1 Science 24 5 2Notes: Two Learning Strategies courses can be combined for 5 credits.

The Centre for Learning@HOME Course Selection Sheet Please use this tentative course selection sheet to identify which courses you are interested in completing. Your Student Services Coordinator will call to review and confirm your choices to finalize your application. If you are uncertain of which courses to select, please use your best judgement to indicate your interest. During peak times, please note this process

may take up to two weeks to complete.

1=Semester 1 2=Semester 2 L=Linear/Full Year CORE COURSES- ENGLISH

CORE COURSES- MATHEMATICS

CORE COURSES- SCIENCES

CORE COURSES- SOCIAL STUDIES

Student Name: __________________________________________ Grade in 2017-18: _________________ Credits: ________ PROGRAM - 4yr___ 3yr___ 2yr___

GRADE 10 Crdts SEM GRADE 11 Crdts SEM GRADE 12 Crdts SEM

*CALM (Career and Life Management) 3 1,2

*Physical Education 10 5 L Physical Education 20 5 L Physical Education 30 5 L

Art 10 5 L Art 20 5 L Art 30 5 LGreen Certificate AGR3000 and Work Experience Mandatory

Varies L Green Certificate AGR3000 and Work Experience Mandatory

Varies L Green Certificate AGR3000 and Work Experience Mandatory

Varies L

French 10 - 3Y 5 1 French 20 - 3Y 5 1, 2 French 30 - 3Y 5 2

Performing Arts 15 5 L Performing Arts 25 5 L Performing Arts 35 5 L

TENTATIVE- General Music 10 5 L TENTATIVE - General Music 20 5 L TENTATIVE - General Music 30 5 L

Religion 15 3 1,2 Religion 25 3 1, 2 Religion 35 3 1, 2

Spanish 10 - 3Y 5 1 Spanish 20 - 3Y 5 1, 2 Spanish 30 - 3Y 5 2

Special Projects 10 5 L Special Projects 20 5 L Special Projects 30 5 LWork Experience 15 HCS3000

Mandatory PrerequisiteUp to 10 L Work Experience 25 HCS3000

Mandatory PrerequisiteUp to 10 L Work Experience 35 HCS3000

Mandatory PrerequisiteUp to 10 L

Personal and General Psychology 6 2 Experimental Psychology 30 3 1RAP (Registered Apprenticeship Program)Work Experience Mandatory

Varies L RAP (Registered Apprenticeship Program)Work Experience Mandatory

Varies L

Creative Writing and Publishing 15 5 L Creative Writing and Publishing 25 5 L

Avid Readers 25 5 L World Geograpy 30 3 L

Micro Economics 30 3 1

Macro Economics 30 3 2

Forensic Science 25 3 1 Forensic Science 35 3 2

Philosophy of Man 30 3 1

Study Strategies 15 3 L

Notes:

COMPLEMENTARY COURSES

1=Semester 1 2=Semester 2 L=Linear/Full Year

Student Name: __________________________________________ Grade in 2017-18: _________________ Credits: ________ PROGRAM - 4yr___ 3yr___ 2yr___

*CALM and PE10 are mandatory courses required to obtain an Alberta High School Diploma.

The Centre for Learning@HOME Course Selection SheetPlease use this tentative course selection sheet to identify which courses you are interested in completing. Your Student Services Coordinator will call to review and confirm your choices to finalize your application. If you are uncertain of which courses to select, please use your best judgement to indicate your interest. During peak times, please note this process

may take up to two weeks to complete.

GRADE 10 P GRADE 11 P GRADE 12 P

Agriculture Cosmetology Human & Social Services

AGR1040 - Animal Basics COS1010 - Prsnl. & Professional Practices HSS1010 - Health Services Foundations

AGR2020 - Animal Husbandry & Welfare AGR1040 & AGR3000 Pre-Req

HSS1020 - Nutrition & Wellness

AGR3000 - Agriculture SafetyFashion Studies

*FAS1030 is a pre-req for all Fashion Studies courses unless otherwise

specified

HSS3050 - Becoming a Mentee

FAS1030 - Sewing Fundamentals HSS3060 - Extending the Mentoring Relat. HSS2050

Pre-Req

Career Transitions FAS1080 - Knitwear HSS1050 - Introduction to Mentorship

CTR1010 - Job Prep FAS2110 - Creating Home Décor HSS1080 - Leadership Fundamentals 1

CTR2010 - Job Maintenance CTR1010

Pre-ReqHSS2040 - Family Foundations

CTR2310 - Career Directions Financial Management HSS2050 - Becoming a Mentor HSS1050

Pre-Req

CTR3010 - Preparing for Change CTR1010

Pre-ReqFIN1010 - Personal Financial Info. HSS2080 - Leadership Fundamentals 2

HSS1080 Pre-Req

CTR3310 - Career Direction Transitions FIN1015 - Accounting Prep

FIN1020 - Accounting Cycle 1 FIN1015

Pre-ReqElectro-Technologies

Communication Technology *COM1005

is a pre-req for all ComTech courses unless otherwise specified

FIN1030 - Accounting Cycle 2 FIN1020 Pre-Req

ELT1130 - Robotics 1

COM1005 - Visual Composition FIN2020 - Retail Accounting 1 FIN1030 Pre-Req

ELT2140 - Robotics 2 ELT1130 Pre-

Req

COM1025 - Typography FIN2030 - Retail Accounting 2 FIN2020 Pre-Req

COM1035 - Graphic Tools Information Processing

COM1205- Photography Intro Foods *FOD1010 is a

pre-req for all foods modules INF1030 - Word Processing 1

COM1215 - Photography Exposure FOD1010 - Food Basics INF1050 - Database 1

COM1255 - E-Learning & Learn. Mgmt. FOD1020 - Contemporary Baking INF1060 - Spreadsheet 1

COM1275 - Photo. Digital Processing FOD1030 - Snacks & Appetizers INF1070 - Digital Presentation

COM2025 - Electronic Layout & Pub. 1 FOD1040 - Meal Planning 1 INF2020 - Keyboarding

**COM2035 - Raster Graphics 1 COM1035

Pre-ReqFOD1060 - Canadian Heritage Foods INF2050 - Word Processing 2

**COM3035 - Raster Graphics 2 COM2035

Pre-ReqFOD2030 - Food Decisions and Health INF2070 - Database 2

COM2045 - Vector Graphics 1 COM1035

Pre-ReqFOD2040 - Cake and Pastry INF2080 - Spreadsheet 2

COM3025 - Electronic Layout & Pub. 2 COM2025 Pre-Req

FOD2090 - Creative Cold Foods INF2090 - Correspondence

COM3045 - Vector Graphics 2 COM2045 Pre-

ReqFOD2150 - Food Safety and Sanitation INF2100 - Reports

FOD2180 - Vegetables & Fruits INF2910 - Project B

Community Care Services FOD3020 - Nutrition & Digestion INF3010 - Hardware/Software Analysis

CCS1080 - Community Volunteerism 1 FOD3030 - Creative Baking INF3060 - Word Processing 3 INF2050 Pre-Req

CCS2080 - Community Volunteerism 2 CCS1080 Pre-Req

FOD3060 - Food Presentation INF3080 - Project Management Tools

CCS3080 - Community Enhancement CCS2080 &

HSS2080 Pre-Req FOD3100 - Entertaining with Food INF3910 - Project D

CCS3110 - Early Learning & Child Care 1 FOD3160 - Regional Cuisine

CCS3120 - Early Learning & Child Care 2 CCS3110

Pre-Req


Pre-ReqHealth Care Services


Pre-Req

HCS1050 - Musculoskeletal System HSS1010 Pre-Req


Pre-Req

HCS1080 - Cardiovascular System HSS1010 Pre-Req

HCS2020 - First Aid/CPR with AED

Computing Science *CSE1010

and CSE1110 courses

have been combined into one course for 2 credits*

HCS3000 - Workplace Safety Systems

CSE1010 - Computer Science 1 HCS3010 - Workplace Safety Practices HCS3000 Pre-Req

CSE1110 - Structured Programming 1 HCS3040 - Child Care First Aid

Career and Technology Courses Tentative Course Selection Planning Sheet

Student Name: ___________________________________________ Grade 2017-18: _________________ Credits: ___________________________


Legal Studies Marketing and Management Tourism *TOU1010 is a pre-req for all Tourism modules unless otherwise specified

LGS1010 - Private Law MAM1010 - Marketing and Management TOU1010 - The Tourism Sector

LGS1020 - Public Law MAM1020 - Quality Customer Service TOU1120 - Adventure & Ecotourism 1

LGS1030 - Relationship Law MAM1030 - Communications Strategies 1 TOU3000 - Tourism Essentials

LGS2010 - Family Law TOU3040 - Accommodations Operations

LGS2020 - Employment Law Recreation Leadership TOU3060 - Destination Management

LGS2050 - Law & the Traveller REC1020 - Injury Management 1 TOU3080 - Air Transportation

LGS3010 - Property Law REC1030 - Tech. Found. For Injury Mgmt. HCS1050

Pre-ReqTOU3090 - Surface Transportation

LGS3020 - Dispute Resolution REC1040 - Foundations for Training 1

LGS3040 - Negligence REC1050 - Sport Psychology 1 Wildlife

LGS3070 - Landmark Decisions REC2010 - Nutrition for Rec. Act.&Sport WLD1010 - Introduction to Wildlife

LGS3080 - Criminal Law REC2040 - Foundations for Training 2 REC1040

Pre-ReqWLD1020 - Wildlife Diversity

REC2060 - Leadership in Rec. & Sport WLD1070 - Hunting & Game Management

REC2120 - Coaching 1 WLD1075 - Bowhunting Education

REC3010 - Human Movement HCS1050 Pre-Req

WLD1080 - Angling & Fish Management

WLD1090 - Boating Safety

WLD2910 - Project B

Each CTS course is worth 1 high school credit.

Each course is designed to be completed within 4-

6 weeks. The courses are self-paced and students

may start at any time throughout the year.

Pre-Req = Pre-Requisite

*A pre-requisite course must be completed before

this course can be accessed.

Course numbers distinguish the course level:

introductory courses begin with a 1, intermediate

courses begin with a 2, and advanced courses

begin with a 3.

**Raster Graphics 1 and 2 must be taken together

for 2 credits

For a description of the courses please refer to this

Alberta Education website

http://education.alberta.ca/teachers/program/ct

s/program-of-studies.aspx

Career and Technology Tentative Course Selection Planning Sheet cont.

Year 1: Semester 1 Year 1: Semester 2 Summer School- Optional Courses Crdts Courses Crdts Crdts

Total Credits Total Credits Total Credits

This worksheet is for preliminary planning purposes only. We will make every effort to accommodate your course requests, pending availability of courses. Your Student Services Coordinator will assist you in selecting the appropriate courses and pathways, and in making sure you have the correct credits to graduate. It is recommended that students take an average of 35-40 credits per year, although some years may be lower or higher, depending on the program you are planning to pursue. A minimum of 100 credits are required to graduate with an Alberta High School Diploma. *You can select up to 50 credits per school year if you are applying for the '2-Year Accelerated Program'. Your Student Services Coordinator can discuss this option with you.

You may choose: a) two option courses b) one core course c) one option and one core course.

1 Year High School Planning Worksheet

Year 1: Semester 1 Year 1: Semester 2 Year 1: Semester 1 Year 1: Semester 2Courses Crdts Courses Crdts Courses Crdts Courses Crdts

Total Credits Total Credits

Courses Crdts Courses Crdts

Total Credits Total Credits



Total Credits Total Credits Total Credits Total Credits

This worksheet is for preliminary planning purposes only. We will make every effort to accommodate your course requests, pending availability of courses. Your Student Services Coordinator will assist you in selecting the appropriate courses and pathways, and in making sure you have the correct credits to graduate. It is recommended that students take an average of 35-40 credits per year, although some years may be lower or higher, depending on the program you are planning to pursue. A minimum of 100 credits are required to graduate with an Alberta High School Diploma. *You can select up to 50 credits per school year if you are applying for the '2-Year Accelerated Program'. Your Student Services Coordinator can discuss this option with you.

High School Completion Path: 3 Year

Year 2: Semester 1 Year 2: Semester 2

High School Planning Worksheet


High School Completion Path: 2 Year


Student Cumulative/Confidential Records

Release Form

2017-2018

PLEASE PRINT


Physical Address: 200, 109 Southbank Blvd. Okotoks, AB T1S 0G1 Phone: (403) 938-4119 or 1-800-659-1945 ~ Fax: (403) 938-8563

03-2017 Cume File Release 2017-2018

Physical Address: 100, 10634-178 Street NW, Edmonton, AB T5S 1H4

Phone: (403) 938-4119 or 1-800-659-1945 ~ Fax: (403) 938-8563


Student Information (to be filled out by Parent or Legal Guardian)

___________________________________________________ _____________________________________________________________

School/Home School Attended in 2016-2017 City/Town

______________________________________________________________ ___________________________________________________

School Phone Number (include area code) School Fax Number

Student Name: Grade Birthdate:

2016-2017 (y/m/d)

Student Name: Grade Birthdate: 2016-2017 (y/m/d)


2016-2017 (y/m/d)


2016-2017 (y/m/d)


2016-2017 (y/m/d)

NOTICE TO PREVIOUS SCHOOL

Please forward the cumulative record for the above-named student(s), to include academic history, any grant coding, assessment

information, and any other pertinent information about the student(s) such as health information necessary to provide appropriate

programming.

Note that Section 2(1) of the Student Record Regulation for the Province of Alberta stipulates the information required to be included

on the student’s record. Section 2(6)(b) further permits the release of personal information related to the student where inclusion of the

information would “be necessary to ensure the safety of students and staff.”

Section 6(1) of the Student Record Regulation provides for the transfer of student records, specifically, “the board from which the

student transfers shall, on receipt of a written request from that school, send the student record...” If you have any questions

regarding this request, please direct them to the undersigned.

Please send files for the student(s) listed above to:

The Centre for Learning@HOME


Fax: (403) 938-2657

Attn: Student Records

_______________________________________________ Signature/Approval of Parent/Legal Guardian

________________________________________________ Signature/Approval of Principal

The Centre for Learning@HOME


Collection of Personal Information & Media Consent2017-2018

The information collected in this form contains personal information covered by the Freedom of Information and Protection ofPrivacy (FOIP) Act. This information is required by Christ The Redeemer Catholic Schools and is necessary to fulfill the school board’sobligation to provide each student with an educational program that meets his or her needs. Once this information is collected andcompiled, Christ The Redeemer Catholic Schools believes the uses listed below are part of a vital, healthy and functioning school,and participation of all students is important and encouraged.

There may be occasions where there are concerns relating to the safety of your child with respect to the use of this information. Inthat case, please contact the school principal or Christ The Redeemer Catholic School's FOIP Coordinator at 403.938.2659.

I hereby declare that I have read, understand and consent to the use of my student’s personal information as stated in the “SchoolDivision Use of Personal Information” section.

Media Consent

Throughout the year photographs and videos of students are produced by the school or school board. When photographs or videosare taken of students where individual students can be identified, the Freedom of Information and Protection of Privacy Act requiresus to obtain your consent where the photographs or videos may be used for purposes outside of the school or at public functions.Such purposes may include brochures, the school or school board website, electronic presentations, social media and otherpublications illustrating school activities.Additionally, your child’s work or photograph may also be used in district publications to illustrate the programs at our schools. Forexample: artwork displays, newsletters, school division promotional publications, brochures, etc.

I grant permission for my child to appear in positive media coverage (including social media) of school events, programs or activitiesand grant permission for their name, photograph, video/audio footage and/or work to be used in school and division publications. Ifyou choose to answer no, then every effort from the school and school board will be used to ensure your child’s photograph andvideo is not used in school related or school board related events or on social media. However, we cannot restrict the use of thismaterial during a public event.

Yes No


DateSignature of Father/Legal Guardian

Yes No


DateSignature of Father/Legal Guardian

Student Name:

Collection of Personal Information & Media ConsentThe information collected in this form contains personal information covered by the Freedom of Information and Protection of Privacy (FOIP) Act. Thisinformation is required by Christ The Redeemer Catholic Schools and is necessary to fulfill the school board’s obligation to provide each student withan educational program that meets his or her needs. Once this information is collected and compiled, Christ The Redeemer Catholic Schools believes theuses listed below are part of a vital, healthy and functioning school, and participation of all students is important and encouraged.

There may be occasions where there are concerns relating to the safety of your child with respect to the use of this information. In that case, pleasecontact the school principal or Christ The Redeemer Catholic School's FOIP Coordinator at 403.938.2659.

Below are some examples of activities where personal information may be used within the school and school board. This list does not include all theactivities or programs that take place within a school. School personnel will contact parents/guardians for written consent if activities occur that areinconsistent with those listed below.

The use of a student’s name, school, grade, birthdate, photograph, health information, academic information and/or written material and artwork maybe used for:

· a school newsletter, yearbook or other school and/or school board publication· class, team, group or club photographs and the display of these photographs for recognition purposes in the school and/or school board office· identification purposes in a school or school-related activity· creative displays, bulletin boards at the school and/or school board office.· honor rolls, graduation ceremonies and other recognition awards at the school or school board office· determining eligibility or suitability for awards or scholarships or for school board sponsored athletics· the provision of transportation services· absenteeism verification, emergency fan-outs, field trips and other school sponsored activities by assigned classroom volunteers· athletic events, fine arts productions, celebrations and other school sponsored activities at the school or school board sites· responding to emergency health situations or to assist students who have severe or life-threatening medical or other conditions by authorized

individuals*Please note:

· Schools will take every precaution to ensure that e-mail addresses are not used in a fashion that would make them available for public use.· Selected Christ The Redeemer Catholic schools may require the use of e-mail addresses to pass on to class/club representatives for school use

only.

Media ConsentThroughout the year photographs and videos of students are produced by the school or school board. When photographs or videos are taken of studentswhere individual students can be identified, the Freedom of Information and Protection of Privacy Act requires us to obtain your consent where thephotographs or videos may be used for purposes outside of the school or at public functions. Such purposes may include brochures, the school or schoolboard website, electronic presentations, social media and other publications illustrating school activities.

Additionally, your child’s work or photograph may also be used in district publications to illustrate the programs at our schools. For example: artworkdisplays, newsletters, school division promotional publications, brochures, etc.

By agreeing to this consent form below you are granting permission to the Christ the Redeemer Catholic School Division to photograph, record and/orvideotape your children, display your child’s academic and creative work and/or reproduce your child’s work for the purposes of promotional material.

By agreeing, you confirm that you understand your child’s photograph and/or academic and creative work may be used for, but not limited to, thefollowing:· Education displays during school sponsored open houses, in-service sessions and other school related activities at school sites· At school related activities at school sites· At school sponsored displays in the community or at school board office· School or school board publications and promotional material· School or school board’s websites· School and school board social media sites (Facebook, Twitter, Instagram, etc.)

In addition, from time to time, schools are visited by members of the media to cover positive events and stories. Their coverage may includephotographs, video footage or audio for radio, of students. This coverage may also include interviews with students about a school event, program oractivity. These school visits are supervised by school administration and/or a member of the school board’s Communications Department and are alwayspre-arranged.

*Please note: Photos/videos of school activities (e.g. athletic events, concerts, graduation or other ceremonies) that are open to the general public maybe taken and used for purposes within and outside the school. The school is not able to restrict such activity at public events.

Parents: Please retain this addenum for your information