Parent InformationParent name(Required) First Last Parent email(Required) IMPORTANT: Please check the PDF documents that were emailed to you, and make all corrections below, if necessary. If no correction is necessary in a certain field, leave the field blank and we will keep the information we have on file.Mailing AddressAny changes to this section?(Required) Yes No Civic NumberStreet (incl. apartment)CityPostal codeFather phone #E-mail (father) Mother phone #E-mail (mother) Employer InformationAny changes to this section?(Required) Yes No FATHER INFORMATIONOccupationEmployerEducationAddressOffice #Mobile #MOTHER INFORMATIONOccupationEmployerEducationAddressOffice #Mobile #Car Model (for security)Any changes to this section?(Required) Yes No Father carLicense plate #ColorMother carLicense plate #ColorIn case of emergency, the school may callAny changes in this section?(Required) Yes No Name #1TelephoneCellRelationshipName #2TelephoneCellRelationshipDoctorTelephoneHEALTH INFORMATION: It is your responsibility as a parent to inform Hebrew Academy of your child's allergies and medical conditions (e.g. asthma, diabetes, etc.) andto submit an Emergency Action Plan for each allergy and/or condition.Student Re-registrationHow many children are you re-registering?(Required)-- Please choose --123456Student #1Student Name(Required) First Last Grade entering (2025-2026)(Required)-- Choose one --Grade 1Grade 2Grade 3Grade 4Grade 5Grade 6Secondary ISecondary IISecondary IIISecondary IVSecondary VMedicare Expiry Date (yyyy-mm)Leave blank if unchanged.Parental Status Living together Living apart Parental AuthorityAre there any changes to the medical situation of your child?(Required) Yes No Please specify(Required)Eligibility Fee Price: Registration Fee Price: Subtotal for this student $ 0.00 CAD Student #2Student Name(Required) First Last Grade entering (2024-2025)(Required)-- Choose one --Grade 1Grade 2Grade 3Grade 4Grade 5Grade 6Secondary ISecondary IISecondary IIISecondary IVSecondary VMedicare Expiry Date (yyyy-mm)Leave blank if unchanged.Parental Status Living together Living apart Parental AuthorityAre there any changes to the medical situation of your child?(Required) Yes No Please specify(Required)Eligibility Fee Price: Registration Fee Price: Subtotal for this student $ 0.00 CAD Student #3Student Name(Required) First Last Grade entering (2024-2025)(Required)-- Choose one --Grade 1Grade 2Grade 3Grade 4Grade 5Grade 6Secondary ISecondary IISecondary IIISecondary IVSecondary VMedicare Expiry Date (yyyy-mm)Leave blank if unchanged.Parental Status Living together Living apart Parental AuthorityAre there any changes to the medical situation of your child?(Required) Yes No Please specify(Required)Eligibility Fee Price: Registration Fee Price: Subtotal for this student $ 0.00 CAD Student #4Student Name(Required) First Last Grade entering (2024-2025)(Required)-- Choose one --Grade 1Grade 2Grade 3Grade 4Grade 5Grade 6Secondary ISecondary IISecondary IIISecondary IVSecondary VMedicare Expiry Date (yyyy-mm)Leave blank if unchanged.Parental Status Living together Living apart Parental AuthorityAre there any changes to the medical situation of your child?(Required) Yes No Please specify(Required)Eligibility Fee Price: Registration Fee Price: Subtotal for this student $ 0.00 CAD Student #5Student Name(Required) First Last Grade entering (2024-2025)(Required)-- Choose one --Grade 1Grade 2Grade 3Grade 4Grade 5Grade 6Secondary ISecondary IISecondary IIISecondary IVSecondary VMedicare Expiry Date (yyyy-mm)Leave blank if unchanged.Parental Status Living together Living apart Parental AuthorityAre there any changes to the medical situation of your child?(Required) Yes No Please specify(Required)Eligibility Fee Price: Registration Fee Price: Subtotal for this student $ 0.00 CAD Student #6Student Name(Required) First Last Grade entering (2023-2024)(Required)-- Choose one --Grade 1Grade 2Grade 3Grade 4Grade 5Grade 6Secondary ISecondary IISecondary IIISecondary IVSecondary VMedicare Expiry Date (yyyy-mm)Leave blank if unchanged.Parental Status Living together Living apart Parental AuthorityAre there any changes to the medical situation of your child?(Required) Yes No Please specify(Required)Eligibility Fee Price: Registration fee Price: Subtotal for this student $ 0.00 CAD Consent & TotalConsent(Required) I agree with the collection and usage of my personal data for managing, administering, and communicating all aspects of school offerings, activities, protocols, and policies. Additionally, I understand that my information may be shared with external organizations when the circumstances necessitate such sharing.Signature(Required)By typing your name and submitting the form, you solemnly declare that all the information contained herein is true and accurate.Date(Required) DD slash MM slash YYYY Total
