Hamilton Wentworth Catholic District School Board - Continuing Education

INTERNATIONAL LANGUAGES - STUDENT REGISTRATION FORM  YEAR  ______

INTERNATIONAL  LANGUAGE :_____HUNGARIAN__________________________________________

name _____________________________________________________________________        M / F

address + city ______________________________________________   

                    ______________________________________________  postal code   ________________     

telephone # ________________________­­_________________        date of birth ___________________                                                                                                                    year  /  month  /  day

 name of father ______________________________  mother ____________________________________

 e-mail address : _________________________________________________________________________

 Name of emergency contact person other than parent -- must be completed

  ______________________________________________  telephone _______________________________

  This student attends ________________________________________________ school during the day

                                                                        name of school

and is PRESENTLY enrolled in grade ____________ in September. ONTARIO EDUCATION NUMBER:                                                                                                                                                                _______________________________

ARE THEREANY CONCERNS WE SHOULD BE MADE AWARE OF, E.G.

This student has the following medical problems / allergies about which we should be aware:   YES _______  NO _______

_____________________________________________________________________________________________________

 _____________________________________________________________________________________________________

 Parent /Guardian signature   ______________________________   date  ___________________________________             _________________________________________________________________________________________

PHOTO RELEASE FORM

From time to time, students' picture will be taken and might be used for flyers, brochures, websites and other promotional purposes by St. Charles Continuing Education Centres, the school board or communities.

I/We hereby consent to the inclusion of any photographs of my/our child (please print) _____________________________

in class, in hall displays, in class project, in promotional literature and the use of any photographs or videos.

I/We do not  consent to my child (please print) _____________________________ being photographed.

in class, in hall displays, in class project, in promotional literature and the use of any photographs or videos.

Parent/Guardian signature ______________________________ Date: _______________________________

Head Teacher signature _________________________________