Application to WRCA – White Rock Christian Academy

Local Student Application

Step 1 of 14 - Choose Application Type

Which application should I fill out?

New families (no children currently at WRCA or in the wait-pool): Fill out one New Family application for the first child, then a Sibling application for each subsequent child if you are applying for multiple children to attend WRCA.

Current WRCA families (with children currently attending WRCA or already in the wait-pool): Fill out a Sibling application for each additional child you would like to attend WRCA.

International Students: Please click here for information about our International Student Program (ISP).

Choose application type:

FATHER'S INFORMATION

First Name

Last Name

Cell Phone

Home Phone (if applicable)

Occupation

Employer

Country of citizenship

MOTHER'S INFORMATION

First Name

Last Name

Cell Phone

Home Phone (if applicable)

Occupation

Employer

Country of citizenship

FAMILY INFORMATION

Marital status of student's biological parents/legal guardians:

Married

Divorced

Separated

Widowed

Single

Domestic Partnership

Other

If biological parents/legal guardians are divorced and have re-married, what is/are the name(s) of the student's stepparent(s)?

Student lives with:(Required)

Both parents (in the same house)

Mother only

Father only

Mother and father (in separate houses)

Legal guardian(s)

Other

If other please explain.(Required)

Address at which student primarily resides:(Required)

Street Address Line 1 Street Address Line 2 City Province Postal Code

Home phone or primary family contact phone number:

Primary language spoken at home:

Please list all children in your family, the grade they are currently in, and the school they are currently attending. (List all children, whether applying for WRCA or not):(Required)

E.g.,
Child 1 Name, Gr3, Somename Elementary
Child 2 Name, Gr5, Somename Elementary

EMERGENCY CONTACTS

Please provide information for local contacts who are authorized to pick up your child(ren) if we can't reach parents.

Name of emergency contact #1(Required)

Relationship of emergency contact #1 to student(s)(Required)

Phone # of emergency contact #1(Required)

Name of emergency contact #2(Required)

Relationship of emergency contact #2 to student(s)(Required)

Phone # of emergency contact #2(Required)

OUT-OF-DISTRICT CONTACT

Please provide one emergency contact who lives outside the lower mainland. (This is in case of an earthquake when local contacts may be unreachable.)

Name of out-of-district contact

Relationship of out-of-district contact to student(s)

Phone # of out-of-district contact

FAMILY DOCTOR (if applicable)

Name of family doctor

Phone # of family doctor

Why do you desire to enroll your child(ren) at White Rock Christian Academy?(Required)

What is the church affiliation of parents/guardians?

Home Church

Denomination

Describe your family's church commitment and attendance pattern.(Required)

How would you describe your family's faith?(Required)

What strengths does your family offer to the school?(Required)

How did you hear about White Rock Christian Academy?

Do you know any current WRCA families who can vouch for your character?(Required)

Yes

If yes, which family or families?(Required)

FINANCIAL COMMITMENT

By signing here, I/we do hereby commit to pay all tuition and related fees in accordance with WRCA's 3501 Tuition Payments Policy.

Parent or Legal Guardian 1 Signature(Required)

Parent or Legal Guardian 1 Name(Required)

Parent or Legal Guardian 2 Signature

Parent or Legal Guardian 2 Name

CONFIRMATION

I/we have, to the best of our knowledge and ability, answered all questions in this Family Profile truthfully and completely.

Parent or Legal Guardian 1 Signature(Required)

Parent or Legal Guardian 1 Name(Required)

Parent or Legal Guardian 2 Signature

Parent or Legal Guardian 2 Name

Grandparents Contact Form

If the student(s) grandparents are local and are interested in being contacted by WRCA for relevant events (such as Grandparent's Day), please provide their names and email addresses.

Name

First Last

Name

First Last

Name

First Last

Name

First Last

Name

First Last

Sibling Name

Sibling's First Name(Required)

Sibling's Last Name(Required)

Student Legal Name

Please enter the student's name as it appears on legal documentation such as a birth certificate or passport.

Legal First Name(Required)

Legal Middle Name (if applicable)

Legal Last Name(Required)

Student Preferred Name

If the student has a different preferred name (not nickname), indicate the name the student would like to go by at WRCA.

Preferred First Name (if applicable)

Preferred Last Name (if applicable)

Date of Birth(Required)

DD slash MM slash YYYY

Place of birth (City, Country)(Required)

Country of citizenship(Required)

Care Card (MSP) #

Student's Personal Health Number (a.k.a., Care Card number, MSP #)

Requested start date at WRCA(Required)

When would you like this student to start at WRCA?

DD slash MM slash YYYY

Requested start grade at WRCA(Required)

What grade is this student applying for at WRCA?

List chronologically all previous schools attended, including Kindergarten.

e.g., 2020-2024, Somename Elementary, Gr 1-4

Describe your child's personality (shy, outgoing, nervous, strong-willed, cooperative, confident, etc.):(Required)

Previous academic achievement has been:

Superior

Above average

Average

Below average

Has the student ever received any learning assistance, ESL training, educational support or counselling?(Required)

Yes

Explain(Required)

Has the student ever repeated a grade or been retained?(Required)

Yes

If yes, state at which grade level and explain reasons.(Required)

Has the student ever been suspended or expelled?(Required)

Yes

If yes, state at which grade level and explain reasons.(Required)

How many days of school did the student miss last year?

Please enter a number from 0 to 100.

Explain the number of days absent.

Does your child have any life-threatening allergies or illnesses?(Required)

Yes

Life-threatening allergy or illness additional information

Name of child's family doctor or specialist(Required)

Doctor's phone number(Required)

Please upload a doctor’s note and emergency procedure instructions for WRCA regarding the life-threatening allergy or illness.(Required)

Drop files here or

Max. file size: 128 MB.

Does your child have any non-life-threatening allergies or illness?(Required)

Yes

Please describe the allergy or illness:(Required)

Does your child meet, or have they ever met the criteria for a BC Ministry of Education and Child Care designation?(Required)

Yes

Which designation?(Required)

Does your child currently have, or have they ever had an Individual Education Plan (IEP), Behaviour Plan, Student Learning Plan, ELL Plan, etc.?(Required)

Yes

Please upload the most recent copy of the Individual Education Plan (IEP), Behaviour Plan, Student Learning Plan, or ELL Plan.(Required)

Drop files here or

Max. file size: 128 MB.

Describe any physical, mental or emotional disabilities (hearing impaired, heart, speech impediment nervous condition, etc.):

Has your child been referred to any specialist (allergist, eye doctor, hearing, pediatrician, etc.)?(Required)

Yes

If yes, please explain.(Required)

What other medical information would help us understand your child better (speech, hearing, birth complications, heart, vision, development, etc.)?

Has your child ever received diagnostic testing?(Required)

Yes

Please upload copies of any relevant reports from specialists, such as a psycho-educational assessments, SLP reports (if applicable).

Drop files here or

Max. file size: 128 MB.

Is your child currently on any waitlist for agencies such as the Sunny Hill Centre, or to have a psycho-educational assessment?(Required)

Yes

If your child plays an instrument, which instrument and for how long have they played it?

If your child plays any sport, which sport?

Is there anything else you would like us to know about your child?

STANDARD OF CONDUCT

Student Commitment

As a student of White Rock Christian Academy, I will strive to model Godly character in every aspect of my life. I will remain committed to developing my relationship with God. I will serve God by serving the community in which I live. I will commit myself to:

1. attend church on a weekly basis.

2. follow the rules of the school.

3. exhibit diligent work habits.

4. wear my uniform according to the guidelines.

5. Show respect for my fellow students, teachers, and the authorities of the school.

6. refrain from immoral behaviour.

Should I be found negligent in any of the above commitments, I will accept the appropriate discipline. If I do not demonstrate an enthusiastic willingness to follow the above commitments, I will accept that I should withdraw myself from White Rock Christian Academy.

Student's Signature(Required)

(Parents please sign for students in Grade 4 and younger).

Date

DD slash MM slash YYYY

Parental Commitment

I/we will endeavor to ensure that our child faithfully obeys all the above commitments. Should our child be found negligent in any of the above commitments, I/we will accept the appropriate discipline for our child, or withdraw our child from White Rock Christian Academy. Additionally, I/we commit to the following:

1. I/we agree with WRCA's Core Values and Core Purpose, support the Statement of Faith, and understand and accept the contents of the Parent-Student Handbook.

2. I/We agree to give one month’s notice of withdrawal; or, in lieu of this, one month’s tuition fees.

3. In matters of discipline, my/our child will be subject to the disciplinary action of the staff and administration. I/We understand that I/we will be given the opportunity to discuss disciplinary matters affecting my/our child with the staff, administration and Board of Directors if necessary.

4. I/We understand my/our financial commitment and will immediately notify White Rock Christian Academy if I/we cannot meet our financial commitments to the school. I/We have read and understand the Tuition Payments Policy (Policy No: 3501, available online or by request) and agree to be bound by the terms of this policy.

5. I/We understand that the school reserves the right to dismiss any student who does not respect the standards of the school or cooperate in the education process as per WRCA’s Admissions and Enrolment Policy (Policy No: 3103, available online or by request).

6. I/We have, to the best of my knowledge and ability, answered all questions in this application package truthfully and completely.

Signature of Parent/Guardian 1(Required)

Name of Parent/Guardian 1(Required)

Signature of Parent/Guardian 2

Name of Parent/Guardian 2

Date

DD slash MM slash YYYY

STUDENT FAITH COMMITMENT

We believe that the goals of White Rock Christian Academy can only be realized if home, school and church are truly an extension of one another, thereby creating a united nucleus from which the student can develop the attributes for Godly character. The following questions are designed to help us in our student/family selection for White Rock Christian Academy.

The student’s attitude, conversation, and behaviour reflect the character of the institution from which he/she derives his/her training, both home and school. This form reflects the school’s attempt to help determine where home, school and church can truly be in partnership.

What church do you attend?

Do you attend church with your parents?

Yes

How often do you attend church?

Weekly

2 to 3 times a week

Once a month

2 to 3 times a month

Less than once a month

Other

Do you attend a youth group?

Yes

Where?

Who is your youth group leader?

Are you a Christian?

Yes

Grade K-5

Parents and student, discuss and briefly respond to the following question in the section below: Describe what Jesus Christ means to you.

Grade 6-12

Student, please answer the following questions in the section below:
1. Describe what Jesus Christ means to you.
2. Describe your commitment to being a Christian.
3. Describe your commitment to your church.

RESPONSES:(Required)

PRIVACY POLICY CONSENT FORM

Consent for the Collection, Use and Disclosure of Personal Information

I give consent to White Rock Christian Academy (WRCA) to collect and use the personal information contained within this application form, and otherwise collected by or on behalf of White Rock Christian Academy for the purposes of (1) communicating with the student and/or the student’s parent(s) or legal guardian(s) or emergency contacts; (2) processing a student’s application, enrolling the student at WRCA, and delivering educational services and co-curricular programs provided by the school authority; (3) enabling the school authority to operate its administrative function, including payment of fees and maintenance of ancillary school programs such as parent voluntary groups and fundraising activities; (4) providing specialized services in areas of health, psychological or legal support, or as adjunct information in delivering educational services that are in the best interests of the student.

I consent to the use and disclosure of the personal information contained within this application form, and otherwise collected by or on behalf of White Rock Christian Academy (1) for those purposes listed above; (2) when authorized by myself; (3) when permitted or required by law; and, (4) when necessary, to suppliers of specialized services, such as a Public Health Authority for vaccination administration or a printing company for the production of the yearbook or other printed materials. (For more detail, view WRCA’s Personal Information Privacy Policy for Parents and Students here.

White Rock Christian Academy is committed to ensuring that personal information is handled in accordance with all legal requirements. WRCA warrants that all collection, use, and disclosure of personal information is in accordance with the Personal Information Protection Act (PIPA).

Signature of Parent/Guardian 1(Required)

Name of Parent/Guardian 1(Required)

Signature of Parent/Guardian 2

Name of Parent/Guardian 2

Date

DD slash MM slash YYYY

Consent for the Use of Photographs and Work Samples

I grant to White Rock Christian Academy, its representatives and employees the right to take photographs and videos of my child. I authorize White Rock Christian Academy to use and publish photographs, video, and work samples of my child in print and/or online, for purposes such as yearbook, school newsletters, social media and website content, and promotional material.

I understand that by not signing this consent, my child will not be included in the yearbook, and will be asked to not participate in any group photo (such as photographs taken of school field trips, co-curricular activities, school assemblies or Grandparents’ Day).

Please note that the Personal Information Protection Act (PIPA), allows that personal information can be collected, used, and disclosed without your consent when the information is obtained at “a performance, sports meet or a similar event (i) at which the individual voluntarily appears, and (ii) that is open to the public” (sections 12, 15, and 18). Therefore, your child(ren)’s presence at, and participation in, public performances such as school concerts and drama productions constitutes your consent to the collection, use and disclosure of their personal information, including photographs.

I consent to having photographs, video and work samples of my child used by White Rock Christian Academy in the yearbook, newsletters, website, and other promotional materials.(Required)

Yes

PLEASE NOTE!
Not signing this consent means your child cannot be included in the yearbook. If you have concerns only about the public use of your child's photo, consider signing the Conditional Photography Consent below. For any additional concerns, please email records@wrca.ca.

Conditional Photography Consent:

I consent to having photographs, video and work samples of my child used by White Rock Christian Academy in the yearbook and school newsletters (internal use), but do not agree to any public usage of the student's photo/video/work samples.(Required)

Yes

Are you sure?
Not signing this consent means your child cannot be included in the yearbook. For additional information or help with your concerns, please email records@wrca.ca.

Signature of Parent/Guardian 1(Required)

Name of Parent/Guardian 1(Required)

Signature of Parent/Guardian 2

Name of Parent/Guardian 2

Please download the Legal Residency of Parents (LROP) Form, then fill it out, sign it and upload it along with the required supporting documentation.
DOWNLOAD LROP FORM HERE

1. Legal Residency of Parents (LROP) Form(Required)

Max. file size: 128 MB.

2. Supporting documentation for Legal Residency of Parents Form(Required)

(e.g., Copy of parent’s Canadian passport, citizenship card, permanent resident card or work permit.)

Drop files here or

Max. file size: 128 MB.

3. Supporting documentation for ordinary residency of BC(Required)

(e.g., Copy of parent's BC Care Card, BC Driver’s Licence or BC Services Card.)

Drop files here or

Max. file size: 128 MB.

Please upload copies of the following required documents:

1. Copy of student’s Canadian birth certificate showing parents’ names(Required)

If student was not born in Canada, please upload 1) the birth certificate from the country where student was born (with a certified English translation if in a language other than English), and 2) the student's passport.

Drop files here or

Max. file size: 128 MB.

2. Copy of student’s most recent report card (Grades 1-12) or progress report from preschool / kindergarten(Required)

If no report is available, please upload an explanatory note, or an acknowledgement that you will send the Preschool Reference Form (below) to the student's current teacher.

Drop files here or

Max. file size: 128 MB.

Preschool Reference Form

If your child is currently in a preschool or daycare which does not provide progress reports, please download this reference form and send it to your preschool or daycare teacher to return directly to WRCA as indicated on the form.
Download PDF Here

3. Copy of student’s immunizations(Required)

If no record is available, please upload an explanatory note.

Drop files here or

Max. file size: 128 MB.

4. Copy of any relevant court orders pertaining to custody or guardianship of student (if applicable)

Drop files here or

Max. file size: 128 MB.

Application Fee

Applications require a non-refundable fee of $150 per application, to a maximum of $300 per family, that can be paid online with PayPal. You will be directed to our online payment form after submitting this application. If you have already paid or wish to pay by e-transfer (to accounts@wrca.ca) then skip that step.

Language Assessment Requirement: Should it be determined that your child requires a language assessment this will be arranged directly with you prior to the family interview. The cost for the assessment is an additional $150 per student.

Pastoral Reference Form

Download this form and send it to your pastor to return directly to WRCA as indicated on the form.
Download PDF Here

Confirmation(Required)

I have, to the best of my knowledge and ability, answered all questions in this application form truthfully and completely.

Confirm Name(Required)

Confirm email(Required)

Signature(Required)

Comments

This field is for validation purposes and should be left unchanged.

Local Student Application

Which application should I fill out?

FATHER'S INFORMATION

MOTHER'S INFORMATION

FAMILY INFORMATION

EMERGENCY CONTACTS

OUT-OF-DISTRICT CONTACT

FAMILY DOCTOR (if applicable)

FINANCIAL COMMITMENT

CONFIRMATION

Grandparents Contact Form

Sibling Name

Student Legal Name

Student Preferred Name

Life-threatening allergy or illness additional information

STANDARD OF CONDUCT

Student Commitment

Parental Commitment

STUDENT FAITH COMMITMENT

Grade K-5

Grade 6-12

PRIVACY POLICY CONSENT FORM

Consent for the Collection, Use and Disclosure of Personal Information

Consent for the Use of Photographs and Work Samples

Please upload copies of the following required documents:

Preschool Reference Form

Application Fee

Pastoral Reference Form

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