Registration Form

Community Christian School Registration Form 2024-2025
Parent Information
Mother's Name*
First Last
Email - Mother*
Father's Name*
First Last
Email - Father*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
School Directory
School Directory
Community Christian School creates a school directory for distribution to our parent community. Do you consent to have your information published in this directory?*
- Yes
- No

Student Information
Last Name*
First Name*
Middle Name
Birthdate*
Grade for the 2024-2025 School Year*
Are your child's immunization records up to date?*
- Yes
- No
Does your child have a significant health concern of which the school should be aware?*
- Yes
- No
Describe health concern
Is the health concern life threatening?
- Yes
- No
Register an Additional Child*
- Yes
- No

Second Child
First Name*
Middle Name
Birthdate*
Grade for the 2024-2025 School Year*
Are your child's immunization records up to date?*
- Yes
- No
Does your child have a significant health concern of which the school should be aware?*
- Yes
- No
Describe health concern
Is the health concern life threatening?
- Yes
- No
Register an Additional Child*
- Yes
- No

Third Child
First Name*
Middle Name
Birthdate*
Grade for the 2024-2025 School Year*
Are your child's immunization records up to date?*
- Yes
- No
Does your child have a significant health concern of which the school should be aware?*
- Yes
- No
Describe health concern
Is the health concern life threatening?
- Yes
- No
Register an Additional Child*
- Yes
- No

Forth Child
First Name*
Middle Name
Birthdate*
Grade for the 2024-2025 School Year*
Are your child's immunization records up to date?*
- Yes
- No
Does your child have a significant health concern of which the school should be aware?*
- Yes
- No
Describe health concern
Is the health concern life threatening?
- Yes
- No
Register an Additional Child*
- Yes
- No

Fifth Child
First Name*
Middle Name
Birthdate*
Grade for the 2024-2025 School Year*
Are your child's immunization records up to date?*
- Yes
- No
Does your child have a significant health concern of which the school should be aware?*
- Yes
- No
Describe health concern
Is the health concern life threatening?
- Yes
- No

Additional Siblings
Does this student have any other siblings, younger and/or older, not attending or not registered for this school?*
- Yes
- No
Enter the full names and date of birth of any siblings.

Citizenship of Children
Country*
Add additional citizenships if registering multiple children and they hold different citizenship than their sibling.
Please include name of child and country.
Language
First Language*
Main Language Spoken at Home*
If answers are different for multiple children, please provide details.

Has your child(ren) ever been registered at a school within the Province of Ontario?*
- Yes
- No

Information of the School Most Recently Attended
School Name*
School Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
School Phone*
School Office Email
Special Education
Has your child(ren) ever had an IEP or received special education support?*
- Yes
- No
If yes, please provide details*
Have any of your children ever been suspended or expelled from a school or board?*
- Yes
- No
If yes, please provide dates and reason for suspension or explusion*

Emergency Contacts
Mother Emergency Contact Number - Cell*
Mother Emergency Contact Number - Place of Employment
Father Emergency Contact - Cell*
Father Emergency Contact Number - Place of Employment
Primary emergency contact if a parent cannot be reached*
First Last
Phone*
Email
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship of primary contact to the student*
Secondary emergency contact if a parent or the primary contact cannot be reached*
First Last
Phone*
Email
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship of secondary contact to the student*

Is there a custody agreement in place of which the school should be aware?*
- Yes
- No
Provide details of the agreement of which the school should be aware.
Is there anyone, through a legal court order that is not allowed to have contact with your child(ren)?
- Yes
- No
Provide details of the court order.

Deposit

If you are new to Community Christian School, Community Christian School requires a non-refundable $500 deposit to complete the registration for your child(ren), The deposit will be credited to your first tuition payment. Please e-transfer the amount to office@ccsdrayton.org or drop off the payment at the school office. If you have any questions about this deposit, please call 519-638-2935.
Phone
This field is for validation purposes and should be left unchanged.

Community Christian School Registration Form 2024-2025