Capilano Little Ones School Registration

School Registration

Online registration form for Xwemélch’stn Etsímxwawtxw – Capilano Little Ones School. Complete the student, guardian, health, consent, and bus information for the upcoming school year.
Student Information
Entering School Year
Grade
Legal Name

First NameMiddle NameLast Name
Usual Name
Gender
Birthdate

MonthDayYear
Date
Band Name / Number
Home Address
Street Address
City
Postal Code
Previous School Information
Inclusive Education / Assessment Supports

Other
Additional Assessment Information (please specify and provide a copy with
registration): Developmental/ Psych Ed, Medical Diagnosis, OT/SLP/PT Reports
Report Upload

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Toilet Training for New Students Only (K4/New K5 Students)

*Please note: to be enrolled your child needs to be fully toilet trained*
If new, is your child fully toilet trained?
Did they attend anywhere before our school?
Prior Daycare / Preschool
Parent/Guardian & Emergency Contacts

Please note that it is very important to keep your child's records updated in case of emergency * If you need to update your information, please contact the school office at 604-985-1515
Student Lives With

Other
Legal documentation involving guardianship: separation, divorce, guardianship orders
Guardianship Documents

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Parent/Guardian 1 Name

First NameMiddle NameLast Name
Parent/Guardian 1 Relationship
Parent/Guardian 1 Address
Street Address
Parent/Guardian 1 Email
example@example.com
Parent/Guardian 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian 1 Work Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian 1 Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian 2 Name

First NameMiddle NameLast Name
Parent/Guardian 2 Relationship
Parent/Guardian 2 Address
Street Address
Parent/Guardian 2 Email
example@example.com
Parent/Guardian 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian 2 Work Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian 2 Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Contact Information

(if Parent/Guardian cannot be reached)
Contact 1 Name

First NameMiddle NameLast Name
Contact 1 Relationship to Student
Contact 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Contact 2 Name

First NameMiddle NameLast Name
Contact 2 Relationship to Student
Contact 2 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Health Information
In order to protect the health of your child and other children in the school, all the parents and guardians or children enrolled at Xwemélch'stn Etsimxwawtxw must provide a statement of the child's health status.

We are requesting a copy of your child's immunization record which indicates if they are protected against the following communicable diseases: Diphtheria, Pertussis, Tetanus, Poliomyelitis, Haemophiles, Inflluenza B and other determined by law.
Medical alerts

Other
Health notes
Any Allergies: *Please note that if any medication is to be administered a form needs to be filled out*
Doctor name

First NameLast Name
Doctor phone
Please enter a valid phone number.Format: (000) 000-0000.
Care card number
Parent/Guardian Consents
Student Attendance

Regular attendance is an essential part in a child's success at school. It is important that children arrive on time and attend each day. Children who attend regularly, learn to read, write, and solve problems with more ease. The School Principal or School teacher will ask to speak with the family if a child does not attend school for more than 5 days a month without any justifiable reason. We will offer to help with any other support systems within the community (Ayas Men Men), if your child is experiencing any challenges.
Parent/Guardian Signature
Permission for EMERGENCY Medical Aid In Case of Accident or Illness Consent Release.

I hereby give my permission to authorized staff of Xwemélch'stn Etsimxwawtxw School to call an ambulance or my family physician in case of accident or illness of my child when I cannot be immediately reached.
Consent Choice
Permission for Day School Field Trips:

I hereby give permission for my child to participate in school supervised day field trips.
Consent Choice
Permission for Photo/Video Taking

I hereby give permission for my child to participate in Xwemélch'stn Etsimxwawtxw School picture/video taking. Photos may be used on the school website or shared with external funding agencies, newspapers, TV networks the Ta7lneώás' - Education Employment & Training may be working with.
Consent Choice
Parent/Guardian Signature
Consent to Obtain and Release Information

Any information in Xwemélch'stn Etsimxwawtxw student files such as: registration documents or student assessments are strictly confidential. The sharing of these documents can only be released on the authority of the custodial parent/guardian.

Therefore, I give Xwemélch'stn Etsimxwawtxw School permission to share and discuss my child's progress using enclosed student documents, using written or verbal information.

* Note: Parents/guardians would be contacted before any therapy services are used with your child. We would not use therapy services without parent/guardian permission. *
I give my permission to share information with the following agencies: Xwemélch'stn Etsimxwawtxw School Based Team; Squamish Nation Education Department; FNESC; FNSA; Supported Child Care Development; Supported Child Care Development; Pediatricians or Family Doctors; Public School transferred from or to; Contracted Therapists (Speech & Language Pathologist/Occupational Therapist)
Parent/Guardian Name

First NameMiddle NameLast Name
Parent/Guardian Signature
Bus Contract
Consent to Obtain and Release Information

The bus service begins at 8:00am and drop-off begins at 3:00pm. Once you have a designated stop, this is the stop for the year, and it cannot be changed I will pick my child up at:
Locations
*Please note: due to enrollment numbers, the bus schedule is tight for time and number of seats*

It is important to arrive a few minutes before the bus arrives for AM and PM pick up times.

Should you not be available to drop off or pick up your child at their designated stop, it is important to have an authorized contact person, we will not release your child to persons who are not on the emergency/authorized contact list.

If for some reason there is no one authorized to pick up your child at their designated stop, your child will be brought back to the school grounds, to be picked up. Please call the school 604-985-1515 at this time and we can contact/locate the bus driver.

If for some reason there is repeated failure to pick up your child, you will receive a phone call, then a written warning and then temporary suspension of bus service.

* The bus driver will have a cell phone for emergency purposes only . If you need to make arrangements about your child's bus services, please contact the school at 604-985-1515. *

It is important for our young students to understand bus safety. Please discuss with your child the importance of staying seated at all times on their chair and in their seat belts.

If a child is acting in an unsafe manner on the bus and is posing a danger on themselves or others, the following procedure will happen:
- Student will be given a verbal warning and spoken to (bus driver will inform parent)
- If unsafe actions continue, the parent/guardian will receive a written warning, and we'll work together to help solve the problem.
- If unsafe actions continue further, bus service will be temporarily suspended
Authorized Pickup Contact

NameRelationship
Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Pickup Contact

NameRelationship
Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Special Instructions
Parent/Guardian Acknowledgment Signature
Should be Empty:

School Registration

Student Information

Toilet Training for New Students Only (K4/New K5 Students)

Parent/Guardian & Emergency Contacts

Alternate Contact Information

Health Information

Parent/Guardian Consents

Bus Contract