508 3rd Ave SE, Airdrie AB T4B 2C2 (403) 912-1133 (403) 912-1135 Email: [email protected]Web: atlaslearningacademy.com Address: Phone: Fax: Preschool Please include a copy of your child’s Birth Certificate with the registration package *Birth Certificate is For NEW students only* ☐ 5 Days (Mon-Fri) ☐ 4 Days (Mon-Thurs) ☐ 3 Days (Mon, Wed, Fri) ☐ 2 Days (Tue & Thurs) ☐ Airdrie Daycare Program ☐ ☐ AM (9-12) AM (9-12) ☐ PM (1-4) AM (9-12) AM (9-12) ☐ PM (1-4) Grade 1 ☐ Before school care (Starts at 6:30) ☐ After school care (Ends at 6pm Mon-Thurs & 5:30pm on Fri) ☐ Junior Kindergarten ☐ ☐ Grade 2 Grade 3 Grade 4 ☐ ☐Elementary (Mon-Thurs 8:40-3:40 & Fri 8:40-12:00) Fees:$480/mth (Sept-June) ☐ Kindergarten (Full Day) (Mon-Thurs 8:40-3:40 & Fri 8:40-12:00) Fees:$600/mth (Sept-June) ☐ Before school care (Starts at 6:30) ☐ After school care (Ends at 6pm Mon-Thurs & 5:30pm on Fri) Kinder A Kinder B ☐ ☐ (Not Guaranteed for Grade 1 Spot) Grade 5 ☐ Before school care (Starts at 6:30) ☐ After school care (Ends at 6pm Mon-Thurs & 5:30pm on Fri) Grade 6 Grade 7 Grade 8 ☐ ☐ Middle School (Mon-Thurs 8:40-3:40 & Fri 8:40-12:00) Fees:$500/mth (Sept-June) ☐ ☐ ☐ ☐ ☐ ☐ Junior Kindergarten (Full Day) (Mon-Thurs 8:40-3:40 & Fri 8:40-12:00) ☐ Fees:$600/mth (Sept-June) $425 $350 $275 $195 $950 Tuition Agreement Please read attatched. I / We _________________________________________________ have read, understand and agree to the terms and conditions of Atlas Learning Academy Tuition Agreement. My / Our signature on the Tuition Agreement recognizes that I / We agree to pay the Tuition Fees in accordance with the Agreement. Name of Parent/Legal Guardian: _____________________________ and ___________________________ [If two parents signing] Parent/Legal Guardian Signature: _______________________________ Date: ______________ Parent/Legal Guardian Signature: _______________________________ Date: _______________________ [If two parents signing]
☐ After school care (Ends at 6pm Mon-Thurs & 5:30pm on Fri)
Kinder A
Kinder B
☐
☐ (Not Guaranteed for Grade 1 Spot)
Grade 5☐ Before school care (Starts at 6:30)
☐ After school care (Ends at 6pm Mon-Thurs & 5:30pm on Fri)Grade 6
Grade 7
Grade 8
☐
☐ Middle School (Mon-Thurs 8:40-3:40 & Fri 8:40-12:00) Fees:$500/mth (Sept-June)
☐
☐
☐
☐☐
☐
Junior Kindergarten (Full Day)
(Mon-Thurs 8:40-3:40 & Fri 8:40-12:00)
☐
Fees:$600/mth (Sept-June)
$425
$350
$275
$195
$950
Tuition Agreement Please read attatched.
I / We _________________________________________________ have read, understand and agree to the terms and conditions of Atlas Learning Academy Tuition Agreement. My / Our signature on the Tuition Agreement recognizes that I / We agree to pay the Tuition Fees in accordance with the Agreement.
Name of Parent/Legal Guardian: _____________________________ and ___________________________ [If two parents signing]
Student Mobile Phone (For Off Campus Lunch - Grade 7 & 8):
Provide the address of the legal guardian / parent where the student lives full time. If the student lives with legal guardians that do not live together, the legal guardians must choose one address to use as the primary student residence.
Apt / Suite #:
Street:
Province:
Student InformationThis form is a legal document. It must be completed in its entirety by a legal guardian or parent for each Preschool to grade 8 student registering at Atlas Learning Academy. The information for each legal guardian, including custodial
parents, must be included on this form. The form must be signed for it to be considered complete.
Student Citizenship *New Atlas Students Only*
Birth Country: Primary Language Spoken at Home:
All Languages Spoken in the Home:
Student is a Canadian Citizen: ☐ Yes ☐ No
If Canadian Citizen, name of Canadian document and number (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):
Effective Date of Document: Expiry Date of Document: MM DD YYYY
If you wish to declare the student as Indigenous, select one:
☐ First Nations (status) ☐ First Nations (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 (dial 310-0000 first to be connected toll-free from anywhere in Alberta).
508 3rd Ave SE,
Airdrie AB T4B 2C2
Previous School Information
Student Learning Needs
Has the student ever had an Individual Program Plan (IPP), Individual Education Plan (IEP) or had a learning, medical or mental health assessment that has provided recommendations to support the student’s learning? ☐ Yes ☐ No
If yes, provide the school with the learning, medical or mental health assessment document (e.g., psycho-educational assessment, physician letter). You may bring a physical copy to the school or email it to [email protected].
Are there any language needs or other unique learning needs we should know in order to support the student’s learning?
No Contact Order (assign a priority level): ☐ 1st ☐ 2nd ☐ 3rd ☐ 4th ☐ 5th ☐ 6th
Legal Guardians / Parents Live Together: ☐ Yes ☐ No If yes, skip to Home Phone.
Custody: ☐ Sole Custody / Parenting ☐ Joint / Shared Custody / Parenting ☐ Delegation of Authority ☐ Decision Making
Court Order: ☐ Yes ☐ No If yes, a copy must be provided for the student record.
Emergency Protection Order: ☐ Yes ☐ No If yes, a copy must be provided for the student record.
If there are no court documents, a brief written summary of the current family status is required:
Home Phone: Call Order (preference): ☐ 1 ☐ 2 ☐ 3
Work Phone: Ext. Call Order (preference): ☐ 1 ☐ 2 ☐ 3
Mobile Phone: Call Order (preference): ☐ 1 ☐ 2 ☐ 3
Email Address:
City:
Postal Code:
Home Address: Apt / Suite #:
Street:
Province:
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.
Set the phone preferences using the ‘Call Order’. Select 1 for the preferred phone number.
Please provide a minimum of TWO emergency contacts. They may be legal guardians, non-legal guardians or a combination of both.
Emergency Contact: ☐ Yes ☐ No Contact Order (assign a priority level): ☐ 1st ☐ 2nd ☐ 3rd ☐ 4th ☐ 5th ☐ 6th
Legal Guardians / Parents Live Together: ☐ Yes ☐ No If yes, skip to Home Phone.
Custody: ☐ Sole Custody / Parenting ☐ Joint / Shared Custody / Parenting ☐ Delegation of Authority ☐ Decision Making
Court Order: ☐ Yes ☐ No If yes, a copy must be provided for the student record.
Emergency Protection Order: ☐ Yes ☐ No If yes, a copy must be provided for the student record.
If there are no court documents, a brief written summary of the current family status is required:
Ext.
Call Order (preference): ☐ 1 ☐ 2 ☐ 3
Call Order (preference): ☐ 1 ☐ 2 ☐ 3
Call Order (preference): ☐ 1 ☐ 2 ☐ 3
Home Phone:
Work Phone:
Mobile Phone:
Email Address:
City:
Postal Code:
Home Address: Apt / Suite #:
Street:
Province:
City:
Postal Code:
Mailing Address: Apt / Suite #:
Street:
Province:
(If different from home address)
Legal Guardian
Last Name:
Same Address as Student: ☐ Yes ☐ No
First Name:
Relationship to Student:
Lives with Student: ☐ Yes ☐ No
Emergency Contact: ☐ Yes ☐ No Contact Order (assign a priority level): ☐ 1st ☐ 2nd ☐ 3rd ☐ 4th ☐ 5th ☐ 6th
Legal Guardians / Parents Live Together: ☐ Yes ☐ No If yes, skip to Home Phone.
Custody: ☐ Sole Custody / Parenting ☐ Joint / Shared Custody / Parenting ☐ Delegation of Authority ☐ Decision Making
Court Order: ☐ Yes ☐ No If yes, a copy must be provided for the student record.
Emergency Protection Order: ☐ Yes ☐ No If yes, a copy must be provided for the student record.
If there are no court documents, a brief written summary of the current family status is required:
Ext.
Call Order (preference): ☐ 1 ☐ 2 ☐ 3
Call Order (preference): ☐ 1 ☐ 2 ☐ 3
Call Order (preference): ☐ 1 ☐ 2 ☐ 3
Home Phone:
Work Phone:
Mobile Phone:
Email Address:
City:
Postal Code:
Home Address: Apt / Suite #:
Street:
Province:
City:
Postal Code:
Mailing Address: Apt / Suite #:
Street:
Province:
(If different from home address)
508 3rd Ave SE,
Airdrie AB T4B 2C2
NOT Legal Guardian / Others (e.g., stepparent, babysitter, neighbour, family friend)
First Name: Last Name:
Relationship to Student: Lives with Student: ☐ Yes ☐ No
Permission to Pick Up Student from School: ☐ Yes ☐ No
Emergency Contact: ☐ Yes ☐ No Contact Order (assign a priority level): ☐ 1st ☐ 2nd ☐ 3rd ☐ 4th ☐ 5th ☐ 6th
Ext.
Home Phone:
Work Phone:
Mobile Phone:
Call Order (preference): ☐ 1 ☐ 2 ☐ 3
Call Order (preference): ☐ 1 ☐ 2 ☐ 3
Call Order (preference): ☐ 1 ☐ 2 ☐ 3
NOT Legal Guardian / Others (e.g., stepparent, babysitter,neighbour, family friend)
First Name: Last Name:
Relationship to Student: Lives with Student: ☐ Yes ☐ No
Permission to Pick Up Student from School: ☐ Yes ☐ No
Emergency Contact: ☐ Yes ☐ No Contact Order (assign a priority level): ☐ 1st ☐ 2nd ☐ 3rd ☐ 4th ☐ 5th ☐ 6th
Ext.
Home Phone:
Work Phone:
Mobile Phone:
Call Order (preference): ☐ 1 ☐ 2 ☐ 3
Call Order (preference): ☐ 1 ☐ 2 ☐ 3
Call Order (preference): ☐ 1 ☐ 2 ☐ 3
NOT Legal Guardian / Others (e.g., stepparent, babysitter, neighbour, family friend)
First Name: Last Name:
Relationship to Student: Lives with Student: ☐ Yes ☐ No
Permission to Pick Up Student from School: ☐ Yes ☐ No
Emergency Contact: ☐ Yes ☐ No Contact Order (assign a priority level): ☐ 1st ☐ 2nd ☐ 3rd ☐ 4th ☐ 5th ☐ 6th
Ext.
Home Phone:
Work Phone:
Mobile Phone:
Call Order (preference): ☐ 1 ☐ 2 ☐ 3
Call Order (preference): ☐ 1 ☐ 2 ☐ 3
Call Order (preference): ☐ 1 ☐ 2 ☐ 3
*Please List at Least One*
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 Print Administrator Name
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
Does the student have any life-threatening allergies? ☐ Yes ☐ No If yes to either of the above questions, give a brief description:
Has the Student Health Plan form been completed and submitted to the school? ☐ Yes ☐ No
Are Your Child’s Immunizations up to date: AHC#:
Allergies, food/medication restrictions:
Any on-going medications:
Doctor's Name:
Name of Clinic:
Doctor’s Address:
Doctor’s Phone Number:
I, __________________________, give Permission to qualified First Aid/CPR trained staff at Atlas Learning Academy that have a
current First Aid/CPR certificate, to administer First Aid to my child, ____________________________, if needed.
I, __________________________, give permission to the Atlas Learning Academy staff to seek any medical attention deemed
necessary in the event of an emergency for my child, ____________________________, while in their care at the school/facility. I
will be contacted as soon as possible to meet them at the specified location. (All EMS costs/charges will be the responsibility of the
parent/guardians.)
Emergency Release Consent
Parent/Guardian Signature: Date of Signature (MM/DD/YYYY)
1. I will shut off the chromebook/tablet when I am finished using it.2. I will use the INTERNET only for school purposes.3. I will not check email during school hours.4. I will not use any type of chat or instant messaging.5. I will not download anything without permission.6. I will only save school related work in my home directory.7. I will not visit any website or create any file that is inappropriate for school.8. I will not try to install any programs on any school computers.9. I will only use a computer if I have permission from a teacher to use it.10. I will not waste paper and ink by printing things I do not need for my schoolwork.11. I will not change any setting on any school computer without permission.12. I will not harm or destroy any equipment or information on purpose and I will be
financially responsible for any damages.
When students violate a point of this agreement it will be dealt with in the following manner:
1. A verbal warning plus a note home to be signed.2. A phone call home and restriction to privileges.3. Suspension of the technology privileges, time frame to be determined.
I have read this document and agree to adhere to these rules:
1. Parent/Guardian will provide a post-dated cheque in the amount of $300.00, dated 25 June 2021.Cheque will be cashed in the event the Chromebook is damaged while off school grounds. Damageincludes water damage, screen cracking, keys missing/malfunctioning, software issues.
2. Parent/Guardian will provide a sleeve/protector in which the Chromebook is to be transported to andfrom school. Measurements: 11”
3. The school will provide a large Ziplock bag into which the Chromebook must be placed, along with theprotective sleeve, before being placed in the student’s backpack. This is to prevent water damagefrom leaking water bottles. Parent/Guardian will ensure this is being used to and from school.
4. Parent/Guardian will ensure the Chromebook is kept safely and used responsibly while off schoolcampus.
5. Parent/Guardian understands that until a new Chromebook is purchased, this may impact thestudent’s ability to complete classwork in a timely manner. It is the student and parent/guardian’sresponsibility to ensure work is completed in the event of a lost or damaged Chromebook.
6. Parent/Guardian understands there is technology on each Chromebook that enables teachers’ accessto student activity while using the Chromebook. If the Chromebook is found to be used for activityoutside of school assignments, the Borrowing Agreement will be terminated.
Chromebook Borrowing Agreement
1. Parent/Guardian will provide a post-dated cheque in the amount of $300.00, dated June 25th 2021.Cheque will be cashed in the event the Chromebook is damaged while off school grounds. Damageincludes water damage, screen cracking, keys missing/malfunctioning, software issues.
2. Parent/Guardian will provide a sleeve/protector in which the Chromebook is to be transported to andfrom school. Measurements: 11”
3. The school will provide a large Ziplock bag into which the Chromebook must be placed, along with theprotective sleeve, before being placed in the student’s backpack. This is to prevent water damagefrom leaking water bottles. Parent/Guardian will ensure this is being used to and from school.
4. Parent/Guardian will ensure the Chromebook is kept safely and used responsibly while off schoolcampus.
5. Parent/Guardian understands that until a new Chromebook is purchased, this may impact thestudent’s ability to complete classwork in a timely manner. It is the student and parent/guardian’sresponsibility to ensure work is completed in the event of a lost or damaged Chromebook.
6. Parent/Guardian understands there is technology on each Chromebook that enables teachers’ accessto student activity while using the Chromebook. If the Chromebook is found to be used for activityoutside of school assignments, the Borrowing Agreement will be terminated.
I give my child permission to travel on the school bus with students and staff to local field trips for the entire school year.
I give permission to Atlas Learning Academy staff to take photos of my child during field trips, in-school activities, ClassDojo app, and
school Facebook page.
I give permission to Atlas Learning Academy staff to take my child on escorted local neighbourhood walks and other appropriate off-
site activities/locations, such as schools, the library, playgrounds, parks and museums.
Photo consent
Community Outing Consent
I give my child ____________________________________ in grade 7 or 8 (please check) permission to leave the Atlas Learning Academy campus over the school lunch hour. The lunch hour takes place from 12:00pm‐1:00pm. I understand and agree that Atlas Learning Academy school/staff is not responsible for my child when s/he is off campus. I understand that Atlas Learning Academy Administration reserves the right to suspend or cancel this agreement should ongoing behavioural issues or tardiness arise.
Off Campus Lunch Hour Consent
Child Care Policy We are aware that children at this early age are still developing socially, emotionally and cognitively. They may make inappropriate choices such as hitting, not co-operating, breaking the rules, or having temper tantrums. At our school, we believe in promoting positive behaviour and dealing with behavioural problems in an appropriate way. We believe if you model positive appropriate behavior, then children will learn and emulate this acceptable behaviour. Through the use of a patient and calm manner, we feel that it is necessary to explain to the children the reason why a particular behaviour is not acceptable. This allows the children to better understand the impact of such behaviour. We also believe in positive attention. Children need to be praised when they are playing well, sharing with others, including others in their activities, etc.
Staff and children need to be treated with respect and courtesy. Yelling and shouting is unacceptable. There is no hitting allowed. Children are not allowed to hit or hurt each other or the staff. This type of behaviour is
unacceptable and inexcusable. There will be age appropriate rules that children will need to follow that will result in logical and natural consequences, if not
adhered to. For example, if a child is throwing toys at someone, then they will no longer be permitted to play with that toy.These consequences will enable them to make better choices in the future. We take our time and deal with each situation ina calm and reasonable manner. Each situation is dealt with on an individual basis.
Child Care Licensing Regulations:
Our staff, with respect to the child in the program, will not inflict or cause to be inflicted any form of physical punishment,verbal or physical degradation or emotional deprivation. Our staff will also not deny or threaten to deny any basic necessity,or use or permit the use of any form of physical restraint, confinement or isolation.
I, ___________________________, have read and understand the Child Guidance Policy, and agree to this policy.
______________________ Date of Signature (MM/DD/YYYY)
Signing below gives permission to all above consent forms.
Atlas Learning Academy Tuition Agreement
Page 1
1. My child (Full Name) ________________________________ is enrolled at Atlas Learning Academy for the2020-2021 school year.
2. I/We agree to and shall pay the full tuition fees (“Tuition Fees”) set out in Appendix “A” in relation to the Studentfor the School Year in accordance with the Payment Schedule (Appendix “A”).
3. I/We understand and agree that:a) No refund or fee reduction in the Tuition Fees shall be allowed or applied to school closure due to inclement
whether, student illness or vacation;
b) If the Student is absent or is required to receive on-line distance learning/educational programming due to aforce majeure such as a pandemic), or due to extenuating circumstances:i. no refund or fee reduction shall be applied to the Tuition Fees; andii. no Tuition Fees shall be transferred to any other person
c) I/We understand that my/our failure to comply with this Agreement, may result in the School taking the stepsin law or equity it deems necessary for the collection of unpaid or overdue Tuition Fees.
d) If there are any outstanding (i.e. unpaid/overdue) Tuition Fees at July 1, 2021, unless an alternativearrangement has been made with the Head of School, I/We understand that the Student shall not be enrolledfor the following school year until all fees are paid in full.
e) Should I/We have difficulty in meeting the Tuition Fee obligations set out in this Agreement (including inAppendix “A”), I/ We shall notify the Head of School, so that special arrangements may be discussed to makealternative payment arrangements. New payment arrangements will be documented and signed by all parties.
f) If the Student moves or transfers to a different school before the end of the school year, only tuition for the monthsattended are required to be paid. A written/emailed notice of 30 days is required prior to a student withdrawing fromprogramming at Atlas Learning Academy. Failure to provide a 30-day notice will result in an obligation to pay thefollowing month’s tuition.
I ________________ / We ______________ have read, understand and agree to the terms and conditions of this Tuition Agreement. My/Our signature(s) on this Tuition Agreement recognizes that I/We agree to pay the Tuition Fees in accordance with this Agreement, including as set out at Appendix “A” below.
Name of Parent/Legal Guardian: ___________________ and ______________________ [If two guardians signing]
Parent/Legal Guardian Signature: _______________________________ Date: ______________ [If two guardians signing]
Student’s Name: ___________________________________Grade: _____ Student ID _________
Atlas Learning Academy Tuition AgreementKindergarten A to Gr 8
Page 1
APPENDIX “A” TUITION FEES AND PAYMENT SCHEDULE OF TUITION FEES
2020-2021 SCHOOL YEAR
Tuition Fees include the following: tuition, books, supplies, field trips, access to Chromebooks
Additional Costs which are not included in the Tuition Fees: • Lost or damaged Chromebooks (see Technology Agreement);• Uniforms;• Damage caused by Student to school property
STATEMENT OF ACCOUNTS
Each month a statement will be created reflecting the status of the student’s account, which is due and payable within 30 days. An interest charge of 2% per month will be applied to amounts outstanding 30 days following the statement date. A $35.00 service charge will be applied for any declined payments.
PAYMENT METHODS
1. Pre-Authorized Debit (Not available until October when our new Student Information System (SIS) is in place).
Payments can be automatically debited from your bank account.
2. E-Transfer Payments (Available until October)
E-Transfers can be sent to "[email protected]", please use the following password: "payment".
3. Credit Card
Credit card payments (Visa/MasterCard) are accepted and may be subject to a 2% administration fee. Credit card payments can be made at the main office until October 2020. An online payment portal will be available through our new SIS, SchoolCloud.
4. Cheque or Bank Draft
Cheques or Bank Drafts may be used for paying the entire Annual Tuition. A $35.00 service fee will be applied to cheques returned NSF. The School reserves the right to request that any cheque returned NSF be replaced with a bank draft.
COVID-19
In the event the School is required to provide online teaching during the 2020-2021 school year or is required to reduce its level of educational services during the 2020-2021 school year due to the COVID-19 pandemic, the Tuition Fee shall not be reduced and shall be paid by you for your child in accordance with this Tuition Agreement. This applies only for Grade 1 to Grade 8. Fees will be reduced by 25% for Jr Kindergarten, Kindergarten and Preschool.
Atlas Learning Academy Tuition Agreement
Page 1
JR KINDERGARTEN &KINDERGARTEN
Payment Amount
# of Payments TuitionTotal
Option 1-Full Payment $6000.00 1 Payment due September 30th
$6000.00
Option 2-Intallments (Preferred) $600.00/month
9 payments (after deposit) due on the 1st of
each month $6000.00
GRADES 1-4
$4800.00 1 Payment due September 30th
$4800.00
$480/month
9 payments (after deposit) due on the 1st
of each month$4800.00
GRADE 5-8
$5000.00 1 Payment due September 30th
$500/month
9 payments (after deposit) due on the 1st of
each month $5000.00
Option 1-Full Payment
Option 2-Installments (Preferred)
Option 1-Full Payment
Option 2-Installments (Preferred)
Payment Amount
# of Payments Tuition Total
Payment Amount # of Payments Tuition
Total
$5000.00
• Tuition is due the 1st of the month• Deposits for 2021-2022 school year may be paid in equal installments due February 15th/March 15th/
April 15th, 2021 OR may be paid in full February 15th, 2021.• A placement for the upcoming school year is considered held once the deposit is paid in full.• Deposits are non-refundable unless/until the placement can be filled by another prospective student.• Deposits may not be applied towards other amounts owing.• Tuition rates may vary.
APPENDIX “A” TUITION PAYMENT SCHEDULE
Family Discount:Each additional younger sibling that is enrolled in any of our school programs, will receive a discount on the tuition.
Second child receives $50 off per month ($500 annually)Third child receives $100 off per month ($1000 annually)
