Summer School Student Registration Form
CARLETON VILLAGE JS SPORTS AND WELLNESS ACADEMY
Dates: Wednesday, July5th to Friday July 28th 2017 / Class Time: 9:00 am – 12 :00 pm
Student Information (Please Print)
Student OEN Number:
Home School:
Last Name: ______/ First Name: ______
Student Date of Birth: / Year: / Month: / Day: / Male: / Female
Home Phone: / ______/ Present Grade (Feb. 2017): ______
Medical/Emergency Information
Health Card Number:
Does your child have
any medical conditions? / Yes / No / If yes, please give additional information:
______
Does your child have
any allergies? / Yes / No / If yes, what are they allergic to? (i.e. peanut, bees, etc.)
______
Emergency contact / Name: ______Phone: ______
I hereby approve that my son/daughter attend this summer program and that his/her Report Card be shared with the appropriate summer school administrators and teachers. Note: Parent signature confirms that the information on this form is correct from the registration date. It is the responsibility of the parent to inform the school of any changes to this information. Any false or misleading information may be grounds for dismissal from this program.
Parent/Guardian Name (Please Print): ______Phone: ______
Parent/Guardian Signature: ______Date: ______
The information below is to be completed by the School
** A copy of the student's February 2017 Provincial report card must be attached to the registration form **
Indicate appropriate student support/needs: (School use only - to be completed by teacher)*Attach IEP if applicable
______
Principal/Designate Signature: ______Date: ______
(Please note that the Principal’s signature is required. Unsigned registrations will be returned.)
This information you have provided is collected under the legal authority of the Education Act, R.S.O.1980, chapter 129, as amended, and will be used as necessary for administrative purposes and program placement. If you have any questions, please contact: Lorelei Eccleston Principal (416) 393-1600

Information for Students and Parents

Program Description / Students inour summer literacy/numeracy classeswill be engaged in a consistent and comprehensive literacy and numeracy program to develop their reading, writing and mathematics skills while building interest and self-confidence in preparation for school in September.

Dates

/ Classes begin: Wednesday, July5th, 2017
Classes end:Friday, July 28th, 2017

Class Times

/ 9:00 am to 12:00 pm

Class Size

/
  • Class size will be a maximum of 20 students per teacher.
  • Additional classroom support will not be available.

Busing /
  • Please note that busing is provided only from specific school locations.
  • Details regarding busing will be included with the confirmation letter to be sent to parents in
    early June 2017.

Student Eligibility /
  • All students are eligible for the summer program.
  • All registration forms must be signed by your child’s Principal and a copy of the February 2017 Provincial report card must be attached to the registration form.

Student Attendance /
  • In order to be successful, your child is expected to attend summer school each day for the entire length of the summer school program.
  • If a student is absent for 3 consecutive days, he/she may be removed from the program.

Student Registration Form /
  • A parent or guardian must complete and sign the registration form.
  • The registration form must be returned to your child’sregular school (teacher or school office) to be signed by your child’s Principal before Friday, March 31, 2017. Unsigned and incomplete registration forms will be returned.

Registration Deadlines /
  • Friday, March 31, 2017 - all student registration forms are to be returned to your child’s school teacher and/or school office by this date.

Confirmation Letter / A confirmation letter and bus information form for students accepted to the program will be sent to the classroom teacher for distribution early June.