Please enable JavaScript in your browser to complete this form.What program are you registering your child for? *Select one.In school programming for 2020/21 school yearRemote learning for 2020-2021 school yearIf so, do you have a home laptop or iPad? *âhâ (yes)namôýa (no)Do you have access to internet at home? *âhâ (yes)namôýa (no)Legal Name (first/middle/last): *FirstMiddleLastDate of Birth: *Grade: *...Pre-KHeadstartKindergarten123456789101112Mailing Address: *Address Line 1Address Line 2CityState / Province / RegionPostal CodeAfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia (Republic of)MadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States of AmericaUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)Viet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweCountryHouse # *Piapot First nationTreaty Number: *Student's Treaty NumberBand *Which Band is the student registered.Hospitalization Number: *Saskatchewan Health Card Last School Attended: *Saskatchewan Learning Number (SDS):Bus Driver:Are youable to drive your child to school? *âhâ (yes)namôýa (no)Siblings: *How many siblings does student have?Name of sibling *FirstLastSibling 1Grade:...Pre-KHeadstartKindergarten123456789101112If Sibling 1 is also registered at Payepot School list grade.Name of sibling: *FirstLastSibling 2Grade:...Pre-KHeadstartKindergarten123456789101112If Sibling 2 is also registered at Payepot School list grade.Name of sibling: *FirstLastSibling 3Grade:...Pre-KHeadstartKindergarten123456789101112If Sibling 3 is also registered at Payepot School list grade.Name of sibling: *FirstLastSibling 4Grade:...Pre-KHeadstartKindergarten123456789101112If Sibling 4 is also registered at Payepot School list grade.Name of sibling: *FirstLastSibling 5Grade:...Pre-KHeadstartKindergarten123456789101112If Sibling 5 is also registered at Payepot School list grade.Name of sibling: *FirstLastSibling 6Grade:...Pre-KHeadstartKindergarten123456789101112If Sibling 6 is also registered at Payepot School list grade.Name of sibling: *FirstLastSibling 7Grade:...Pre-KHeadstartKindergarten123456789101112If Sibling 7 is also registered at Payepot School list grade.Name of sibling: *FirstLastSibling 8Grade:...Pre-KHeadstartKindergarten123456789101112If Sibling 8 is also registered at Payepot School list grade.____________________________________Parent/Guardian Information:(Mother/Female caregivers name:) *FirstLastPlease ensure the numbers are active and workingEmail *Home Number *Mother/Female caregivers number:Cell Number *Mother/Female caregivers number:Work NumberMother/Female caregivers number:____________________________________Parent/Guardian Information:(Father/Male caregivers name:) *FirstLastPlease ensure the numbers are active and workingEmail *Home Number *Father/Male caregivers name:Cell Number *Father/Male caregivers name:Work NumberFather/Male caregivers name:____________________________________Emergency Contact Information: *FirstLastPlease ensure the numbers are active and workingHome Number *Emergency Contact 1stCell Number *Emergency Contact 1stWork NumberEmergency Contact 1st____________________________________Emergency Contact Information: 2nd *FirstLastPlease ensure the numbers are active and workingHome Number *Emergency Contact 2ndCell Number *Emergency Contact 2ndWork NumberEmergency Contact 2nd____________________________________Student Medical Information:List all known Medical InformationAre immunizations up to date: *âhâ (yes)namôýa (no)Food Allergies: Drug Allergies: Treatment(s):Waiver/Release In case of emergency I give permission to Payepot School staff to release any medical information to our local health center(s) for proper care and transportation of your child to the nearest medical facility.I give permission to Payepot School to administer any Assessment/Testing for the purpose of Resource Support, measuring school goals and anything else deemed necessary for the academic growth of your child. (WIAT, TTFM, BASC)I give my child permission to attend any field trips or sporting events throughout the school year. A note/reminder will be sent out prior to the event.MEDIA RELEASE – I hereby agree and give my permission for Payepot School or partners to record, film, photograph, audiotape or videotape my child’s name, image, student work and performance (hereinafter collectively referred to as “Works”) to display, publish or distribute these Works for the purpose of publishing, posting on the Piapot First Nation/Payepot School website and or social media sites, posting in schools, and/or for broadcasting on television or radio as determined by Payepot School. I hereby waive any right to approve the use of the Works now or in the future, whether the use is known to me or unknown. I waive any right to any royalties related to the use of these Works. I understand that the Works may appear in electronic form on the internet or in other publications outside of the Payepot School’s control. I agree that I will not hold Payepot School responsible for any harm that may arise from such reproduction.I give permission for my child to see or be recommended to see appropriate professionals/staff and outside agencies in regards to my child’s emotional well being as the staff at the school deem necessary and for the best interest of my child. Waiver/Release *I have read Payepot School Waiver/Release for 2020/2021 School year and give my consent.Parent/Guardian Signature: *Clear SignatureI understand and gives consent to all of the above bulleted information/requests.MessageSubmit Share this:FacebookLike this:Like Loading...