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K-12 Reporting for Families
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StrongStart Registration
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Child Info
Legal First Name
Legal Last Name
Legal Middle Name(s)
Usual First Name
Usual Last Name
Usual Middle Name(s)
Birthdate
Gender at Birth
Female
Male
Gender Identity
Female
Male
Non-binary
Proof of Age
Original Birth Certificate
Passport
Landed Immigrant Auth
INAC Status Card
Proof of Age document image
Upload
One file only.
5 MB limit.
Allowed types: gif, jpg, jpeg, png, webp, pdf.
Custody (select one)
Both Parents
Mother
Father
Other, specify
Enter other…
Court Order (select one)
No
Yes, describe
Enter court order details…
Home Address
Address
Postal Code
Languages spoken at home
Which program will you attend most often?
- None -
Brent Kennedy Elementary
Blewett Elementary
Canyon Lister Elementary
Crawford Bay School
Creston Ed Center
Hume Elementary
Jewett Elementary
JVHumphries School
Redfish Elementary
Rosemont Elementary
South Nelson
W.E.Graham School
Winlaw Elementary
Will you attend any other programs? Choose all that apply
Brent Kennedy Elementary
Blewett Elementary
Canyon Lister Elementary
Crawford Bay School
Creston Ed Center
Hume Elementary
Jewett Elementary
JVHumphries School
Redfish Elementary
Rosemont Elementary
South Nelson
WE Graham
Winlaw Elementary
Parent/Guardian Info
Parent/Guardian
Parent/Guardian
First Name
Last Name
Parent/Guardian Type
Mother
Father
Other…
Enter other…
Phone
Email
Street Address
City
Province
Postal Code
Add a Parent/Guardian
Emergency Contact
Emergency Contact
Emergency Contact
First Name
Last Name
Relationship to Child
Home Phone
Work Phone
Cell Phone
Can this contact pick up the Child?
Yes
No
Add an Emergency Contact
Health Conditions
Life Threatening Condition
Yes
No
Yes, Anaphylactic
Anaphylactic details
Yes, Asthma that has resulted in hospitalization in the past year
Asthma details
Yes, Blood Clotting Disorder
Blood Clotting Disorder details
Yes, Diabetes
Diabetes details
Yes, Epilepsy with a history of Tonic-Clonic (Grand Mal) seizures in the past two years
Epilepsy details
Yes, Serious Heart Condition (e.g. heart murmur, heart repair)
Serious Heart Condition details
Yes, Other Health Conditions which may require emergency care - please specify
Other Health Conditions details
Non-Life Threatening Condition
Non Life Threatening Health Condition (food allergies/sensitivities): Please describe
Declaration: By submitting this information for StrongStart registration, I also certify that the information I have provided on this form is correct.
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