Fillable AAD Grade7 2020 2021

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AAD Grade7 2020 2021

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The AAD Grade7 2020 2021 form is 16 pages long and contains:

  • 1 signature
  • 105 check-boxes
  • 114 other fields

Country of origin: CANADA
File type: PDF

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STUDENT REGISTRATION CHECKLIST
COMING FROM AN EDMONTON PUBLIC SCHOOL
SCHOOL REGISTRATION FORM (4 PAGES) HONORS APPLICATION – OPTIONAL (JUNIOR HIGH ONLY)
CURRENT PROGRESS REPORT CURRENT IPP (IF ONE EXISTS)
FOIP & MEDIA FORM (MANDATORY) PROGRAM FORMS (AAD, DANCE & ELITE)
BEHAVIOUR POLICY (MANDATORY)
OPTION SELECTION SHEET (JUNIOR HIGH ONLY)
COURSE SELECTION SHEET (HIGH SCHOOL ONLY)
STUDENT REGISTRATION CHECKLIST
COMING FROM AN OUT OF DISTRICT SCHOOL (NOT EDMONTON PUBLIC)
SCHOOL REGISTRATION FORM (4 PAGES) HONORS APPLICATION – OPTIONAL (JUNIOR HIGH ONLY)
CURRENT PROGRESS REPORT CURRENT IPP (IF ONE EXISTS)
FOIP & MEDIA FORM (MANDATORY) PROGRAM FORMS (AAD, DANCE & ELITE)
BEHAVIOUR POLICY (MANDATORY) BIRTH CERTIFICATE or TRAVEL PASSPORT COPY (MANDATORY)
OPTION SELECTION SHEET (JUNIOR HIGH ONLY) PARENT/GUARDIAN ADDRESS VERIFICATION (MANDATORY)
COURSE SELECTION SHEET (HIGH SCHOOL ONLY)
Office use only: Current School: ____________________
Current District: Edmonton Public
Other
Reference check completed by:___________________________________________
Special Needs or IPP required: No: Yes: ______
This student requires: _________________________________________________
STUDENT NAME: ________________________________________________________
GRADE in 2020-21: ______________________________________________________
PROGRAM: _____________________________________________________________
£
Child of a Canadian citizen
£
*
Child of an individual lawfully admitted to
Canada for permanent or temporary residence
£
*
Step-child of a Canadian or Temporary
Foreign Worker
Student’s Legal Last Name
Student’s Legal First Name Desired Program (Regular, French Immersion, etc.)
Student’s Legal Middle Name Date of Birth
Month Day Year
£
Male
£
Female
Preferred First Name Preferred Last Name
Student’s Residence
Address City Province Postal Code
Mailing Address (if different than Student’s Residence – mail-outs from school will be sent to this address)
Address City Province Postal Code
DISCLOSURE RESTRICTIONS
A parent/legal guardian may have their right to access information about a student removed by a legal process.
Please indicate if a legal document exists which restricts access to information about this student:
£
Yes
£
No
If you have answered yes, the school will collect the required documentation which will be retained on the student’s record.
If you have answered no, the information collected on this registration form and documents collected under the Student Record Regulation
may be disclosed as permitted under the regulation.
STUDENT REGISTRATION
PLEASE READ THIS INFORMATION BEFORE COMPLETING THE REGISTRATION FORM
This registration form is a legal document. Before a student can be registered by a school, this form must be completed in its entirety and signed by
the parent or legal guardian, or by the student (if living independently). This form is used to enrol a student who is new to Edmonton Public Schools,
or who is returning to the District.
Office Use Only
EPS # ASN # Program
School Grade Room First Day of School
Print the student’s legal surname (last name) and given names below. These are the
names on the student’s birth certificate or adoption papers. If the student uses a
different first or last name, there is a space at the end of this section for preferred name.
1 of 4
C19 Updated January 28, 2019
Month Day Year
CITIZENSHIP STATUS
What is the citizenship or
immigrant status of the student?
* Supporting documentation required;
see page 4 for Citizenship Information.
£
Canadian citizen
£
Lawfully admitted to Canada for
permanent residence (student)
£
Temporary Resident:
Expiry Date Required
(International Students only):
FRANCOPHONE RIGHTS – SECTION 23 (Optional)
According to the School 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/legal 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, or are receiving instruction in a French first language program or school in Canada (this does not
include a French immersion program).
Do you claim entitlement to a francophone education under the terms of the School Act?
£
Eligible
£
Ineligible
If eligible, provincial Student Record Regulation requires Edmonton Public Schools to release demographic information about the student
and parent to the local Francophone Education Board upon written request from that school jurisdiction.
Month Day Year
Primary Phone (with area code) Student Cell Phone - Optional (with area code)
SCHOOL HISTORY Has the student ever registered at an Edmonton Public School?
£
Yes
£
No
IF NO - Previous Non-District School: City: Province/Country:
STUDENT INFORMATION
IF YES - Previous EPSB School: Edmonton Public Schools ID number (if applicable):
Parent/Legal GuardianParent/Legal Guardian
PARENT/LEGAL GUARDIAN INFORMATION
2 of 4
If there are two parents or guardians, it is important to fill in both sections below, whether or not the parents or guardians are living together.
A guardian is defined in section 20 of the Family Law Act, or a guardian appointed under Part 5 of the Child Welfare Act, Part 1, Division 5 of the
Child, Youth and Family Enhancement Act or section 23 of the Family Law Act.
*NOTE: It is very important that you indicate whether or not each parent/guardian or independent student is Roman Catholic or not Roman Catholic.
Under the terms of the School Act, the residency status of a student is based on religion and where the parent(s) or legal guardian(s) live. A student is
a resident of Edmonton Public Schools if at least one of the parents or guardians live in Edmonton and is not Roman Catholic.
Relationship to Student (select one)
£
biological or adoptive mother
£
biological or adoptive father
£
legal guardian
Last Name
First Name Mr., Mrs., Ms., Dr., etc.
Address
(if different from student’s) Does the student reside with this individual?
£
Yes
£
No
Address City Province Postal Code
Primary Phone (with area code) Secondary Phone (with area code)
Other Phone (with area code) Email
Religious Declaration (check one) *See note above
£
Not Roman Catholic
£
Roman Catholic
Relationship to Student (select one)
£
step-father
£
step-mother
£
other: __________________________________________________________
Last Name
First Name Mr., Mrs., Ms., Dr., etc.
Address (if different from student’s) Does the student reside with this individual?
£
Yes
£
No
Address City Province Postal Code
Primary Phone (with area code) Secondary Phone (with area code)
Other Phone (with area code) Email
Relationship to Student (select one)
£
biological or adoptive father
£
biological or adoptive mother
£
legal guardian
Last Name
First Name Mr., Mrs., Ms., Dr., etc.
Address (if different from student’s) Does the student reside with this individual?
£
Yes
£
No
Address City Province Postal Code
Primary Phone (with area code) Secondary Phone (with area code)
Other Phone (with area code) Email
Religious Declaration
(check one) *See note above
£
Not Roman Catholic
£
Roman Catholic
First Parent/Guardian
OPTIONAL - Other Relevant Adult
Second Parent/Guardian
PARENT/GUARDIAN INFORMATION
3 of 4
FREEDOM OF INFORMATION AND PROTECTION OF PRIVACY ACT (FOIP)
The personal information collected on this form is part of the District registration process and is authorized under the provisions of the School Act and
its regulations and also under Section 33(c) of the FOIP Act. All personal information collected during the registration process and during the course of
the school year will be used to provide an educational program and ensure a safe and secure school environment. If you have any questions or concerns
regarding the collection or intended use of this information please contact the school principal or visit the following link:
http://www.epsb.ca/media/epsb/schools/registerforschool/EPSB_CollectionUseOfPersonalInfo.pdf.
FAMILY CIRCUMSTANCES Are there any family circumstances about which you wish the school to be aware?
MEDICAL INFORMATION (Optional)
You do not have to provide information on medical concerns, but the information could be crucial to the well-being of the student.
Are there any serious medical conditions about which you wish the school to be aware? Please indicate below:
£
Diabetes
£
Epilepsy
£
Allergies (please specify)
£
Haemophilia
£
Heart Condition
£
Asthma
£
Other (please specify)
Medical Notes:
Student’s Alberta Health Care Number: ______________________________________________________________________________________________
OPTIONAL - Other Relevant Adult
Relationship to Student (select one)
£
step-father
£
step-mother
£
other: __________________________________________________________
Last Name
First Name Mr., Mrs., Ms., Dr., etc.
Address
(if different from student’s) Does the student reside with this individual?
£
Yes
£
No
Address City Province Postal Code
Primary Phone (with area code) Secondary Phone (with area code)
Other Phone (with area code) Email
EMERGENCY/MEDICAL INFORMATION
EMERGENCY CONTACTS (NOT STUDENT’S PARENT/LEGAL GUARDIAN)
Emergency Contact #1
Primary Phone of Emergency Contact #1 (with area code) Other Phone (with area code)
Emergency Contact #2
Primary Phone of Emergency Contact #2
(with area code) Other Phone (with area code)
An emergency contact is someone who may be contacted
if the student’s parent/legal guardian is unavailable.
4 of 4
DECLARATION BY PARENT, LEGAL GUARDIAN, OR INDEPENDENT STUDENT
The information provided in this document is true, correct and complete. I have identified all parents and legal guardians for this student.
The individuals identified in the “parent/legal guardian” section have the right to view student information and make educational decisions
for this child, unless otherwise indicated here and supported with legal documentation.
___________________________________________________________________________________________________________________________________
Further, I recognize that it is my responsibility to notify my child’s school should the above information change.
Date: ___________________________________________ Signature: _______________________________________________________________________
ABORIGINAL SELF-IDENTIFICATION (Optional)
If you wish to identify yourself as an Aboriginal person, please specify:
£
Status Indian/First Nations
£
Non-Status Indian/First Nations
£
Métis
£
Inuit
For further information, please refer to http://education.alberta.ca/system-supports/results-reporting or contact Alberta Education
at 780-427-8501. If you have questions regarding the collection of student information by the school board, please contact Edmonton Public
School’s First Nations, Métis, and Inuit Education unit at 780-429-8580.
ADDITIONAL ENROLMENT INFORMATION
Birth country, if not Canada
The following questions are asked to assist in program placement
and to assist in communication in an emergency.
Is English the student’s first language?
£
Yes
£
No
What language is mainly spoken at home?
CITIZENSHIP DOCUMENTATION
Office Use Only
CHILD DOCUMENTS
Alberta Adoption Order
Alberta Birth Certificate
Canadian Birth Certificate outside Alberta
Canadian Citizenship Certificate
Canadian Permanent Resident Card
Confirmation of Permanent Residency
(if not expired)
Canadian Passport (if not expired)
For Canadian citizens – Registration Form
(with Temporary Declaration)
ADDRESS VERIFICATION
More than one document may
be required. Select applicable
documentation(s):
Operator’s License
Utility Bill
Lease Agreement
Property Tax Bill
Other:
Address verification
documents are NOT part
of the student record.
Do not retain at the school.
A copy of any student identification documentation should be placed in the Student Record.
Bolded documents will be accepted in the event of an enrolment audit. If a child’s document does not
prove right of access to education in Alberta, a parent document is required as well.
LEGAL STUDENT IDENTIFICATION VERIFICATION DOCUMENT
Select applicable documentation(s):
INDEPENDENT STUDENT STATUS
The School 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) who is living independently, or, (b) who is a party to an agreement under section 57.2 of the Child, Youth and Family Enhancement Act.
Are you claiming status as an Independent Student under the definition of the School Act?
£
Yes
£
No
Religious Declaration
(check one) *See note on page 2
£
Not Roman Catholic
£
Roman Catholic
Citizenship Documentation: Expiry Date (if applicable):
Parent Work Visa/Permit
Parent Study Visa/Permit
Confirmation of Permanent Residency
Permanent Residency (Card)
Temporary Residency
Citizenship Card
Month Day Year
Month Day Year
Month Day Year
STUDENT PROTECTION
An individual may be forbidden contact with the student by way of a legal process.
Please indicate if a legal document exists which forbids an individual from having contact with this student:
£
Yes
£
No
If you have answered yes, the school will collect the required documentation which will be retained on the student’s record.
PARENT DOCUMENTS
A parent document is ONLY required if the child
document does not prove right of access to education
in Alberta.
Canadian Birth Certificate
Study Permit
(if not expired)
Canadian Temporary Resident Work Visa
(if not expired)
Canadian Passport (if not expired)
Canadian Permanent Resident Card
Confirmation of Permanent Residency
(if not expired)
CONSENT TO POST OR PUBLISH STUDENT INFORMATION
FOIP CONSENT
PLEASE READ THIS INFORMATION BEFORE COMPLETING THE FORM
Edmonton Public Schools is requesting your permission to use your child’s personal information (i.e., image,
grade and/or name, etc.) in public venues or on the Internet where the general public may have access to the
information in order to communicate with parents, the community and the general public.
By signing this form, you are agreeing that your child’s personal
information may be used in the following ways by the school
and school district. Examples include, but are not limited to:
• video recordings
• displays
• posting pictures, videos, podcasts or presentations online
• brochures, program booklets, newsletters or publications
• accessing and posting information to public websites or
social media applications (i.e., Facebook
®
,Instagram
®
,
YouTube®, Twitter® and other emerging technologies).
Classroom lessons may also be digitally recorded to provide
material for staff development or to demonstrate good
professional practices. These recordings may be shared
with other educational organizations.
Some websites may require students to login and provide
information such as their name, school and email address
when they are sharing digital images, videos and presentations
across the school district or on public websites.
To make sure that you know and understand how your child’s
information may be used, the school administration and/or
your child’s teacher will continue to communicate with you and
provide you with additional information on events and projects
that your child may be participating in.
Consent is voluntary and you may withdraw your consent and
request that your child’s personal information be removed
from sites that are administered by Edmonton Public Schools
by notifying the school principal in writing.
Please note that once photographs, student names and
other identifying information is released in any public forum,
Edmonton Public Schools cannot control or prevent the
further distribution or use of the material by those who
access the information.
For more details on how personal information is used in
Edmonton Public Schools, visit www.epsb.ca/media/epsb/schools/
registerforschool/EPSB_CollectionUseOfPersonalInfo.pdf.
Updated January 25, 2019 – C19
£
YES – I consent to my child’s information being used for the
above stated purposes.
£
NO – I do not consent to my child’s information being used
for the above stated purposes.
Student’s Name
Print Parent/Guardian/Independent Student Name(s)
Parent/Guardian/Independent Student Signature(s) Date
Freedom of Information and Protection Of Privacy Act (FOIP)
In accordance with the Freedom of Information and Protection of Privacy Act (FOIP), Edmonton Public Schools is authorized and required under
the provisions of the School Act and its regulations to collect, use and disclose personal information that is necessary to provide educational
programming and ensure a safe and secure school environment for students.
EPS #
Office Use Only
Edmonton Public Schools collects the personal information of students and
parents for educational purposes and to protect the safety of students and
staff. Consent is not required to gather and share this information.
Below are some examples of how and where personal information may be used. This list is not intended to be
all-inclusive:
Collection and use of personal information
by Edmonton Public Schools
• use of student’s name and related contact
information for absenteeism verification;
• use of student’s name or image in articles, photos or
videos in the school calendar, newsletter, yearbook or
an internal website such as SchoolZone;
• the taking and use of individual, class, team, club or
school videos and photos within the school for
internal school purposes;
• use of student’s name on artwork or other material
to be displayed at the school or another Edmonton
Public Schools’ site;
• use of student’s name on lists such as honour rolls,
scholarships or other awards within the school or
school district;
• managing and validating school passwords and
email accounts;
• sharing information with Alberta Education.
epsb.ca
In accordance with the Freedom of Information and Protection of Privacy (FOIP) Act, Edmonton Public Schools
is authorized and required under the provisions of the School Act and its regulations to collect, use and
disclose personal information necessary to provide an educational program and ensure a safe and secure school
environment for students.
Edmonton Public Schools uses Google Apps for Education allowing all students and staff to communicate and
collaborate. Any emails, documents, presentations or files created in Google Apps for Education is stored on
servers located outside of Canada and subject to foreign laws.
Please note: photos or videos of students attending or participating in school activities (e.g., sports events,
concerts, cultural programs, clubs, field trips, graduation or other ceremonies) that are open to the general public
may be taken by the public-at-large, including the media, without consent. Edmonton Public Schools cannot
control or prevent the further distribution or use of these photos, videos, images or other personal information.
When student information is used by the school or the school district for purposes beyond educational
programming and student safety, the FOIP Consent Form must be signed and returned to the school.
Please contact the school principal if you have any questions or concerns regarding the collection or
intended uses of this information.
STUDENT AGREEMENT CODE OF CONDUCT
In order to achieve maximum success at Vimy Ridge Academy, students must be familiar with the following
expectations for student learning and student behavior. Section 12 of the School Act states that students will conduct
themselves so as to reasonably comply with the following Code of Conduct:
Code of Conduct:
be diligent in pursuing the student’s studies;
attend school regularly and punctually;
co-operate fully with everyone authorized by the
Board to provide education programs and other
services;
comply with rules of the school;
account to their teachers for their conduct
respect the rights of others;
ensure the student’s conduct contributes to a
welcoming, caring, respectful and safe learning
environment that respects diversity and fosters a
sense of belonging;
refrain from, report and not tolerate bullying or
bullying behaviour directed toward others in the
school, whether or not it occurs within the school
building, during the school day or by electronic
means;
positively contribute to the student’s school and
community.
carry school I.D. card at all times
hats are not permitted inside the school
resolve conflict or seek assistance to resolve
conflict in a peaceful, safe, and non-threatening
manner that is conducive to learning and growth.
Strategies for addressing conflict between
students may include counselling, mediation, or
forms of restorative practice;
use school and personal technology appropriately
and ethically; and
ensure that they conduct themselves with
academic integrity and refrain from and report all
incidents of academic misconduct including, but
not limited to, cheating and plagiarizing.
Unacceptable Behaviours
behaviours that interfere with the learning of
others and/or the school environment
behaviours that create unsafe conditions
acts of bullying, harassment, threats, or
intimidations whether it be in person, indirectly,
or by electronic means
physical violence
retribution against any person who has
intervened to prevent or report bullying or any
other incident or safety concern
possession, use or distribution of substances
restricted by federal, provincial, municipal,
District or school authorities
any illegal activity such as:
o possession, use or distribution of illegal
substances
o possession of a weapon or use of a
weapon (or replica) to threaten,
intimidate or harm others
o possession, use, display, or distribution
of offensive messages, videos or images
o theft or possession of stolen property
any breach of rules and expectations established
by District administrative regulations or a
school-based code of conduct
failure to comply with Section 12 of the School
Act.
I understand and agree to the above conditions.
Student Name printed: _________________________________ Grade: ________________
Student Signature: ____________________________________ Date: __________________
Parent Signature: _____________________________________ Date: __________________
GRADE 7 COURSE SELECTION FORM (2020-2021)
PLEASE PRINT AND FILL IN THE FOLLOWING INFORMATION:
LEGAL SURNAME: ___________________________ GIVEN NAME: _______________________
Does your child have an I.P.P. or special academic accommodations in place? YES NO
If your child has an IPP, please provide a copy of the latest IPP.
Physical Education Program of choice:
AAD BASEBALL EDMONTON SCHOOL OF BALLET
AAD BJJ GREEN AND GOLD ATHLETE ACADEMY
AAD HOCKEY GREEN AND GOLD SOCCER
AAD LACROSSE OKANAGAN HOCKEY ACADEMY
AAD PURSUITS VIMY ELITE
AAD RINGETTE
AAD SPORT FIT
OPTION SELECTION 3OHDVHUDQNWKHIROORZLQJRSWLRQVIURP
,QIRUPDWLRQ3URFHVVLQJLVDPDQGDWRU\RSWLRQDQGZLOOEHUDQNHG
Each student will complete of the chosen options inZHHNURWDWLRQV7KHUHDUHIHHVDWWDFKHGWRHDFK
course) Please note: if a course does not have enoughVWXGHQWUHTXHVWVLWZLOOQRWEHRIIHUHG
_____ Art _____ Construction  _____ Digital Photography _____ Drama
_____ Food Studies  ,QIRUPDWLRQ3URFHVVLQJ B____ /HDGHUVKLSBBBBB0XVLF
Please indicate your current second language course in grade 6:
French as a Second Language Spanish Language & Culture None
French Immersion Spanish Bilingual
SECOND LANGUAGE CHOICE (Mandatory): Please check one of the following:
French 7 (JHS 7351) Spanish 7 (JHS 7037)
Parent Name: _____________________________________
Parent E-Mail Address: ____________________________
Parent Signature: ___________________________________
ACKNOWLEDGEMENT, WAIVER OF RIGHTS, RELEASE OF LIABILITY
AND INDEMNITY AGREEMENT
The undersigned, , (the “Participant”) and their parent or
lawful guardian, for themselves, their heirs, executors, administrators, successors and assigns, acknowledge
that the Academic & Athletic Development Institute of Edmonton (“AAD”) is a non-profit, limited liability
society incorporated under the laws of the Province of Alberta, and that the activities of the said society will
include athletic and recreational programs, and related events and activities, in which the risk of loss or damage
to property and serious injury, including, but not limited to: death or permanent paralysis is significant.
The undersigned agree that, in consideration of being allowed to participate in the activities of AAD, they
knowingly and freely assume all risks and perils in relation to any and all of the activities of AAD, and that
AAD, its officers, directors, servants, agents, volunteers and/or any other parties contracting with it (including
without limiting the generality of the foregoing, professional advisers, school boards and other boards and
agencies, sponsors, advertisers, owners and occupants of any premises used for activities and their respective
officers, directors, servants, agents and/or any other parties contracting with them) as well as other participants
in the activities of AAD, shall not be held responsible for and are hereby remised, released and forever
discharged and held harmless and indemnified in respect of any and all liability whatsoever connected with or
resulting from any death, injury, loss or damage to the undersigned, or any other person, or property resulting
from participation in, or presence at, or use of equipment and/or premises in relation to, the activities of AAD
whosesoever and whatsoever.
The undersigned agree that AAD or its officers, directors, servants, agents, volunteers and/or any other parties
contracting with it (including without limiting the generality of the foregoing, professional advisers, school
boards and other boards and agencies, sponsors, advertisers, owners and occupants of any premises used for
activities and their respective officers, directors, servants, agents and/or any other parties contracting with
them) as well as other participants in the activities of AAD, are not held responsible for any items that may
become lost or stolen.
The undersigned hereby give consent for medical and/or dental treatment and admission to any facilities for
those purposes in the event of accident or injury to any person.
The undersigned hereby grants AAD complete access to all personal information collected for programming
purposes. Some uses of this personal information by AAD include:
● use of the participant’s name, photo, or comments in AAD newsletter, website or other publications
● use of individual or group photos for promotional purposes
● use and disclosure to the public of participant’s names in regard to awards or achievements related
to the activities of the program
The undersigned acknowledges that they can have access to facilities not part of the training program
based upon scheduled availability.
The undersigned have read and understand this agreement and confirm that it is signed freely and
voluntarily and without any compulsion or inducement. The undersigned agree that signatures on this
document delivered electronically shall be fully effective and enforceable as if signed and delivered in
original (wet) form.
Dated at the City of Edmonton, in the Province of Alberta, this _____ day of ___________, 20 __ .
__________________________________ _______________________________________
Print name of Participant Participant’s Signature
I, as parent or legal guardian of the above named minor Participant, for myself and on behalf of the said
Participant, do consent and agree to the above terms and conditions.
__________________________________ _______________________________________
Print name of Parent or Legal Guardian Parent or Legal Guardian’s Signature
(For participants under 18 years of age) (For participants under 18 years of age)
A.A.D. FOIP AND MEDIA CONSENT
Academic Athletic Development (A.A.D.) may be contacted by the media agencies (newspaper, radio, television) for
access to student athletes for quotes or interviews. These audio and video images may be published or aired in a variety of
locations, including television, radio, newspapers and websites or used for publications.
In addition, A.A.D. may wish to include a student athlete’s pictures and/or quote in A.A.D.’s publications (brochures,
program booklets or newsletters) that will be shared with the general public. A.A.D. might also include a student’s picture
on the program’s websitesocial media, posters or brochures. A.A.D. may wish to publish the names of students who are
recipients of awards or scholarships on websites or other promotional media. Names, pictures, audio and/or quotes may
be used in subsequent years after student athletes are no longer enrolled in A.A.D. for promotional use or alumni lists both
on websites and in A.A.D. publications.
A.A.D. may work in collaboration with Edmonton Public Schools in promotional activities and student athlete’s picture
and/or quote maybe used in these joint activities. A.A.D. will not share any information with other organizations without
prior consent of a parent or guardian.
Please indicate by checking off the following items to indicate
your consent for your child to be:
WebsiteVDQG6RFLDO0HGLD
❏ Photographed for the A.A.D.’s websitesDQGVRFLDOPHGLDSODWIRUPV
❏ Student athletes’ name and grade posted on A.A.D. websitesDQGVRFLDOPHGLDSODWIRUPV
❏ Photographed, interviewed or quoted for A.A.D. publications, advertisements and promotional materials
Media
❏ Audio taped and identified for radio
❏ Videotaped and identified for television or film
❏ Quoted, photographed and identified in newspapers, newsletters or promotional media
__________________________________________________________________________________________
❏ I do not want my child’s information used
Students name: ____________________________________________________ (please print)
Parent/Guardian signature: _______________________________ Date: ______________________________
This consent maybe revoked at anytime by written letter. Please contact WKHA.A.D. Executive Director for further
information
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AAD Grade7 2020 2021

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Completed 7 January 2021

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