Revised January 2020 Research & Strategy Page 1 | 8
Resident / Non-Resident of The Calgary Board of Education (CBE)
Under the Education Act, a student is considered to be a resident of The Calgary Board of Education if the legal guardians / parents
with day-to-day care of the student reside in the City of Calgary and at least one of them is NOT of the Roman Catholic faith.
By signing below, I declare that (check one):
all legal guardians / parents with day-to-day care of the student identified on this form, are of the Roman Catholic faith
at least one of the legal guardians / parents with day-to-day care of the student identified on this form, is not of the
Roman Catholic faith
Print Legal Guardian / Parent Name
Signature Legal Guardian / Parent Name
Date (MM/DD/YYYY)
Student Name and Citizen Information
For acceptable identification refer to Proof of Age and Legal Name at the end of this document.
Preferred Last Name:
Preferred First Name:
Legal Middle Name:
Preferred Middle Name:
Student Email Address:
Birth Date:
Gender:
Female Male Undisclosed Unspecified
MM
DD
YYYY
Student Home Phone:
Student Mobile Phone:
Birth Country:
Home Language:
Student is a Canadian Citizen:
Yes No
If Canadian Citizen, name of Canadian document (e.g., birth certificate, passport, Canadian Citizenship Certificate):
If not Canadian Citizen:
Name of document (e.g., Permanent Resident, Landed Immigrant, Refugee Claimant, Temporary Resident, Child
of Canadian Citizen, Child of a lawfully admitted permanent or temporary resident, Stepchild of a Canadian or
Temporary Foreign Worker):
Expiry Date of Document:
MM
DD
YYYY
Office Use Only
CBE #:
ASN #:
Resident CBE:
Yes No
Name of School:
Program:
Lottery:
Yes No
Expected Start Date:
Grade Entering:
Full Day Kindergarten:
Yes No
MM
DD
YYYY
Entered by:
Date Entered (MM/DD/YYYY):
Address Verified:
Yes No
Student Registration Form
Dependent Student
This form is a legal document. It must be completed in its entirety by the legal guardian / parent for students registering in a school
(K-12) in The Calgary Board of Education. The information for each legal guardian (including custodial parents) must be included on
this form. Please print.
Revised January 2020 Research & Strategy Page 2 | 8
Student Address
Provide a home address. If the mailing address is the same, check the box and do not complete the mailing address:
Same
Home Address: Apt / Suite #:
Street:
City:
Province:
Postal Code:
Home Community (in Calgary):
Mailing Address: Apt / Suite #:
Street:
City:
Province:
Postal Code:
Student Medical Information
If the student’s attendance at school may be affected by an existing medical or physical condition, it is your responsibility to complete
and submit the Student Health Plan form to the school.
Does the student have any medical or physical conditions that may affect their attendance at school?
Yes No
If yes, give a brief description:
Has the Student Health Plan form been completed and submitted to school?
Yes No
Self-Identify as Indigenous
If you wish to declare the student as Indigenous, select one:
First Nation (status) First Nation (non-status) Métis Inuit
For further information, refer to https://www.alberta.ca/first-nations-metis-or-inuit-student-self-identification.aspx or contact Alberta
Education at 780-427-8501.
Francophone Eligibility
The exercise of Francophone eligibility rights refers to instruction in a Francophone school, NOT a French Immersion school.
According to the Education Act and Section 23 of the Canadian Charter of Rights and Freedoms, a student is eligible for instruction
in a Francophone school if at least one parent is a Canadian citizen and one of the following three conditions exists:
either parent’s first language learned and still understood is French;
either parent has received their primary school instruction in Canada in French; or
one or more of the parent’s children has received or is receiving primary or secondary instruction in French in Canada.
Does your child have Francophone eligibility?
Yes No
If yes, and you wish to exercise your right, please contact the Conseil Scolaire FrancoSud at 403-686-6998.
The Alberta Student Records Regulations requires that, if requested, The Calgary Board of Education provide the name,
address, date of birth and gender of Section 23 eligible students to the Francophone School District as well as the name,
address and telephone number of the student’s parent.
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Previous School Information
Has the student ever registered in a school in The Calgary Board of Education (CBE)?
Yes No
If yes, provide:
Name of CBE School:
CBE Student ID Number:
Grade Completed:
Withdrawal Date (MM/DD/YYY):
Has the student attended school elsewhere?
Yes No
If yes, provide:
Name of the Last School Attended:
Alberta Education ID Number (if applicable):
Grade Completed:
Withdrawal Date (MM/DD/YYY):
Reason for Leaving:
Was the student suspended or expelled?
Yes No
Address of School:
School Phone:
School Fax:
Student Learning Needs
Has the student ever had an Individual Program / Education Plan (IPP/IEP)?
Yes No
If yes, what is/are the Alberta Education special education code(s)?
If yes and from outside Alberta, provide the special education code(s) and their description(s).
Has the student ever been in a special education program/class or unique setting in CBE or elsewhere?
Yes No
If yes, what was the name of the program/class or setting, and if not from CBE, provide a description.
Are there any other unique learning needs (including language needs) we should know in order to support the student’s learning?
Legal Guardians / Parents / Others
If there is more than one Legal Guardian, include the information for each guardian on this form whether the guardians live together or not.
A legal guardian may be a parent or other person who is legally responsible for the well-being of the child and makes important decisions
for the child. Legal guardian is defined in section 1(2) of the Education Act and in the Alberta Government website.
For more information refer to the Relationship and Custody and Guardianship Documents at the end of this document.
Please provide a minimum of TWO emergency contacts.
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Legal Guardian
First Name:
Last Name:
Relationship to Student:
Emergency Protection Order:
Yes No
Emergency Contact:
Yes No
Contact Order (assign a priority level):
1
st
2
nd
3
rd
4
th
Legal Guardians Live Together:
Yes No
Do you need help with interpretation?
Yes No
Custody:
Sole Custody / Parenting Shared Custody / Parenting Delegation of Authority Decision Making
If a court order is in place, a copy must be provided for the student record. Copy of court order:
Yes No
If there are no court documents, a brief written summary of the current family status is required:
Email Address:
Lives with Student:
Yes No
Same Address as Student:
Yes No
Home Phone:
Call Order (preference):
1 2 3
Mobile Phone:
Call Order (preference):
1 2 3
Work Phone:
Ext:
Call Order (preference):
1 2 3
Provide an address if different than the students. If the mailing address is the same as the guardian’s home address, write “Same”.
Home Address: Apt / Suite #:
Mailing Address: Apt / Suite #:
Street:
City:
Street:
City:
Province:
Postal Code:
Province:
Postal Code:
Home Community (in Calgary):
Legal Guardian
First Name:
Last Name:
Relationship to Student:
Emergency Protection Order:
Yes No
Emergency Contact:
Yes No
Contact Order (assign a priority level):
1
st
2
nd
3
rd
4
th
Legal Guardians Live Together:
Yes No
Do you need help with interpretation?
Yes No
Custody:
Sole Custody / Parenting Shared Custody / Parenting Delegation of Authority Decision Making
If a court order is in place, a copy must be provided for the student record. Copy of court order:
Yes No
If there are no court documents, a brief written summary of the current family status is required:
Email Address:
Lives with Student:
Yes No
Same Address as Student:
Yes No
Home Phone:
Call Order (preference):
1 2 3
Mobile Phone:
Call Order (preference):
1 2 3
Work Phone:
Ext:
Call Order (preference):
1 2 3
Provide an address if different than the students. If the mailing address is the same as the guardian’s home address, write “Same”.
Home Address: Apt / Suite #:
Mailing Address: Apt / Suite #:
Street:
City:
Street:
City:
Province:
Postal Code:
Province:
Postal Code:
Home Community (in Calgary):
Revised January 2020 Research & Strategy Page 5 | 8
Legal Guardian
First Name:
Last Name:
Relationship to Student:
Emergency Protection Order:
Yes No
Emergency Contact:
Yes No
Contact Order (assign a priority level):
1
st
2
nd
3
rd
4
th
Legal Guardians Live Together:
Yes No
Do you need help with interpretation?
Yes No
Custody:
Sole Custody / Parenting Shared Custody / Parenting Delegation of Authority Decision Making
If a court order is in place, a copy must be provided for the student record. Copy of court order:
Yes No
If there are no court documents, a brief written summary of the current family status is required:
Email Address:
Lives with Student:
Yes No
Same Address as Student:
Yes No
Home Phone:
Call Order (preference):
1 2 3
Mobile Phone:
Call Order (preference):
1 2 3
Work Phone:
Ext:
Call Order (preference):
1 2 3
Provide an address if different than the students. If the mailing address is the same as the guardian’s home address, write “Same”.
Home Address: Apt / Suite #:
Mailing Address: Apt / Suite #:
Street:
City:
Street:
City:
Province:
Postal Code:
Province:
Postal Code:
Home Community (in Calgary):
NOT Legal Guardian (Other)
First Name:
Last Name:
Relationship to Student:
Emergency Contact:
Yes No
Contact Order (assign a priority level):
1
st
2
nd
3
rd
4
th
Permission to Pick Up Student from School:
Yes No
Release of Information Form Attached:
Yes No
Email Address:
Permission to Receive Mail:
Yes No
Home Phone:
Call Order (preference):
1 2 3
Mobile Phone:
Call Order (preference):
1 2 3
Work Phone:
Ext:
Call Order (preference):
1 2 3
Provide a mailing address if different than the students.
Apt / Suite #:
Province:
Street:
Postal Code:
City:
Community (in Calgary):
Revised January 2020 Research & Strategy Page 6 | 8
NOT Legal Guardian (Other)
First Name:
Last Name:
Relationship to Student:
Emergency Contact:
Yes No
Contact Order (assign a priority level):
1
st
2
nd
3
rd
4
th
Permission to Pick Up Student from School:
Yes No
Release of Information Form Attached:
Yes No
Email Address:
Permission to Receive Mail:
Yes No
Home Phone:
Call Order (preference):
1 2 3
Mobile Phone:
Call Order (preference):
1 2 3
Work Phone:
Ext:
Call Order (preference):
1 2 3
Provide a mailing address if different than the students.
Apt / Suite #:
Province:
Street:
Postal Code:
City:
Community (in Calgary):
NOT Legal Guardian (Other)
First Name:
Last Name:
Relationship to Student:
Emergency Contact:
Yes No
Contact Order (assign a priority level):
1
st
2
nd
3
rd
4
th
Permission to Pick Up Student from School:
Yes No
Release of Information Form Attached:
Yes No
Email Address:
Permission to Receive Mail:
Yes No
Home Phone:
Call Order (preference):
1 2 3
Mobile Phone:
Call Order (preference):
1 2 3
Work Phone:
Ext:
Call Order (preference):
1 2 3
Provide a mailing address if different than the students.
Apt / Suite #:
Province:
Street:
Postal Code:
City:
Community (in Calgary):
Sibling Information (Optional)
Do you have other children attending CBE schools?
Yes No If yes, specify below.
Name:
CBE School:
Grade:
Name:
CBE School:
Grade:
Name:
CBE School:
Grade:
Name:
CBE School:
Grade:
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Declaration
I, the undersigned, hereby represent that I have the legal authority to register the student identified on this form. I have identified
all legal guardians / parents for the student. I declare the information that I have provided on this form is complete and accurate.
I will immediately notify the school of any changes to the information on this form.
Print Legal Guardian / Parent Name
Signature Legal Guardian / Parent Name
Date of Signature (MM/DD/YYYY)
Freedom of Information and Protection of Privacy
The personal information requested on this form is collected under the authority of Alberta’s Freedom of Information and Protection of
Privacy Act (FOIP), the Education Act and its regulations, and the Canadian Charter of Rights and Freedoms, Section 23. This information
will be used for the maintenance of the student’s record, for a school board’s obligation to provide students with an education program that
meets their needs, to provide a safe and secure school environment and other purposes that relate directly to and are necessary for an
operating program or activity, including program placement, determination of eligibility and/or suitability for provincial or federal funding,
contact and health related information in the event of problems or emergencies. Personal information may also be provided to the Minister
of Education for the purpose of carrying out programs, activities, or policies under their administration (e.g., research, statistical analysis).
This information will be treated in accordance with the privacy protection provisions of the FOIP Act.
If you have any questions about this form please contact the school.
Revised January 2020 Research & Strategy Page 8 | 8
Proof of Age and Legal Name
The original document must be provided to the school. The school will make the copy.
The legal guardian / parent must produce the student’s birth certificate at the time of registration. If a birth certificate is not available, the
principal may accept a:
passport;
Canadian citizenship certificate;
Canadian federal government Permanent Residency Card, Permanent Resident Record or Confirmation of Permanent Residency;
Canadian federal government Record of Landing;
Canadian provincial government Notice of a Live Birth;
Indigenous Status card; or
court order that states the age and legal name of the child.
Note | Students who are not Canadian citizens must register at the Admissions and Assessment Office located at the Kingsland Centre.
Exception Students in Shelters
If the legal guardian / parent does not have one of the documents listed above, they will provide a written summary of current family status
until documentation can be provided. If applicable, the legal guardian / parent will provide the Restraining Order (RO) or Emergency
Protection Order (EPO).
Relationship
The following are the options for relationships:
Agency Representative
Babysitter
Cousin
Custodian
DLSA - CBE Diversity & Learning Support Advisor
Family Friend
Father
Foster Parent
Grandparent
Group Home Case Worker
Home Stay Parent
Interpreter
Legal Guardian
Mother
Other
Outside School Care
Parent
Partner
Physician
Probation Officer
Psychologist
Relative
Sibling
Social Worker
Sponsor
Spouse
Stepfather
Stepmother
Stepparent
Stepsibling
System AP, Global Learning
Unspecified
Custody and Guardianship Documents
The original custody document must be provided to the school. The school will make the copy.
Decision Making legal authority for making day-to-day decisions affecting the child. Similar to joint custody, can be court
ordered. If not addressed in an Order, the guardians usually both have rights and responsibilities for this.
Delegation of Powers and Duties to a Child Caregiver - implicit sub-allocation of powers and duties by the Director of Child and
Family Services, or their delegate (i.e., the social worker), under the Child, Youth and Family Enhancement Act. Done by the
social worker for a child in protective custody either Temporary Guardianship Order (TGO) or Permanent Guardianship Order
(PGO).
Shared Custody / Parenting more than one guardian may exercise the powers, responsibilities and entitlements of guardianship,
unless the court orders otherwise; shall use best efforts to co-operate with one another in exercising their powers, responsibilities
and entitlements of guardianship. Can be court ordered, or presumed if the parents were married and are now separated but
have not been to court.
Sole Custody / Parenting allocation, generally or specifically, of the powers, responsibilities and entitlements of guardianship
exclusive to one individual. Usually court ordered.
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