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Student Information
Mother's Information
Father's Information
Student Medical Information
Immunization Record

The student's CURRENT immunization information is mandatory. A copy of the student's immunization record is requested, if not already submitted to the school.

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Canadian Guardian / Emergency Information
Emergency List

Name of the person to whom your child may be released to, including relationship to child. Please note that photo identification will be required upon release of the child.

Person #1
Person #2
Person #3
Person #4
Medical Waiver
, understand that in the event of an accident or illness occurring to my child, the School will make every attempt to contact me and/or my spouse. If however, I or my spouse cannot be reached, I hereby give Century Private School including its Directors, Officers, Agents and Employees authority to act on my behalf in case of an emergency and to take appropriate steps to have a doctor attend to my child. I also agree to release and indemnify Century Private School, including its Directors, Officers, Agents and Employees from any and all claims for damages arising from any injury or otherwise related actions to my child as a result of any accident, illness, injury or for any other reason arising from participation in any school activities.
Permission Granted to Leave Premises
, give permission for my son/daughter to take part in any out-of-school events. I will be notified again in writing before any particular visit or trip.
Photographic Waiver
, authorize my child to participate in a video interview to satisfy Century Private School evaluative entrance policy. I understand that only upon successful interview will the student be invited to attend. I also authorize my child's photographic images and/or video to be used by Century Private School for various forms of media to assist in publicity, promotional and marketing purposes.
Additional Information
Terms of Contract
1. All new applicants must pay a $500.00 non-refundable registration fee. This is a one-time fee per family.
2. With all methods of payments, the last month's fees are due at the time of registration or re-enrolment. This fee is non-refundable.
3. A charge of $50.00 will be levied against all N.S.F. cheques or cheques returned for any reason.
4. Written notice of withdrawal from a parent to the School with respect to a student must be received 30 days prior to the date of withdrawal.
5. There are no refunds for mid-month withdrawals, holidays, sick days, or days missed for any reason throughout the academic year.
6. After February 1, 2018, the refund policy will not be applicable and the remainder of the academic year must be paid in full.
7. A child is considered accepted into the School only upon written confirmation from the School.
8. All post-dated cheques must be dated for the first (1st) of each payable month. Please make cheques payable to Century Private School.
9. The child's full name must be written on the front of each cheque.
10. The safety of all children is our primary concern. The provision of our service is conditional on both your child's behaviour and your treatment of the School and its staff. Behaviour that poses a safety hazard for the other children or the staff will not be accepted and could result in immediate withdrawal of service.
11. For children in primary grades or lower, a late pick up charge will be applied at the rate of $3.00 per minute after 6:00 pm or at any time that a teacher has to remain beyond established hours to care for a child due to parental tardiness.
12. Transportation to and from the School is the responsibility of the parents/guardians.
13. A fee will be applied to lost or damaged textbooks.
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