Student Information Student & Contact InfoStudent Name* First Middle Last Student Grade & Section*Casa ACasa BCasa CCasa V1A1B1V2A2V3A3B3V4A4V5A5V6A6B6V7A7V8A8B/VHifdhHifdh VV = Virtual ClassHome Phone NumberFathers' Name* First Last Fathers' Email* Father's Contact Number*Mothers' Name* First Last Mothers' Email* Mothers' Contact Number*AddressPlease fill if you haven't already updated our record. Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Emergency Contact InfoContacts other than parentsEmergency Contact #1 Name* First Last Emergency Contact #1 Number*Emergency Contact #1 Relation*Emergency Contact #2 Name* First Last Emergency Contact #2 Number*Emergency Contact #2 Relation*Medical InfoDoes your child have a Medical Condition (ex: allergy, skin condition, health concern, etc)?*YesNoPlease specify details about the Medical Condition(s).*Medication Required at School*YesNoHave you submitted a letter from your doctor stating this medical condition for the new academic year, Sep 2020 - June 2021?*YesNoIf your child is on Epipen, please provide the valid Anaphylaxis Emergency Plan -(Click here for the Form) to the office at your earliest but no later than Monday, September 14th, 2020. Please note that: It is the parent's responsibility to provide 2 Epipens to school; 1 for the office and 1 for the classroom along with the Anaphylaxis Emergency Plan. Checking the expiration date on the Epipen is also the parent's responsibility. Please ensure that the Students name, grade and section are clearly labeled on both the Epipens provided. It is recommended that students on Epipen wear a MedicAlert wrist band to school at all times.