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School Policies

Please see list below of school policies to stay up to date on and guide decisions made at WRCA.

School Policies

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P. 604 531 9186 | F. 604 531 1727 | wrca@wrca.ca

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© 2018 White Rock Christian Academy

Student Application

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Welcome

Please note that once your application has started you cannot save and return at a later time/date. Please set aside 1 hour to complete the full application package. Applications will not be considered complete unless all elements are submitted.

MANDATORY DOCUMENTS
Please have the following mandatory documents ready to upload prior to filling in the application form.
- Student’s birth certificate
- Copy of student’s immunizations
- Students most recent report cards (grades 1-12)
- Students immigration papers (if applicable)
- Pastoral Reference - Download PDF Here
- Legal Residency of Parents Form A - Download PDF Here
- Copy of parent’s citizenship paper/card or passport (if Canadian citizen)
- Copy of parent’s landed immigrant status paper or PR card (if permanent resident/landed immigrant If applicable.
APPLICATION FEE

A $50 non-refundable registration fee (per applicant to a maximum of $100 per family) is required upon submission of forms. Once you have completed the application form the Director of Advancement will arrange for next steps as well as payment of the application fee.

Upon acceptance, an enrollment deposit of $150 per student, for 3 or more students a deposit of $100 per student is required to a maximum of $300. This is applied to first month’s tuition.

STUDENT PROFILE
Student Information
Legal First Name*
Legal Last Name*
Legal Middle Name*
Usual First Name
(if different from legal)
Usual Last Name
(if different from legal)
Date of Birth (Day/Month/Year)*
Gender*
- Male
- Female
Place of Birth (City/Country)*
Student Citizenship*
- Canadian Citizen
- Landed Immigrant
- Student Visa
Personal Medical Number*
Immigration Papers*
Requested Grade Placement*
For Month*
For Year*
List chronologically all previous schools attended, including Kindergarten.*
Name of School Address, City, Postal Code Fax Number Year Grade

(Please provide the mailing address and fax number of the last school attended only. This will allow us to send for school records).
Previous academic achievement has been*
- Superior
- Above Average
- Average
- Below Average
- N/A
Has the student ever received any learning assistance, ESL training, special education instruction or counselling?*
- Yes
- No
Explain*
Has the student ever repeated a grade or been retained?*
- Yes
- No
State at which grade level and explain reasons*
Has the student ever been suspended or expelled?*
- Yes
- No
State at which grade level and explain reasons:*
How many days of school did the student miss last year?*
Explain*
Describe any physical, mental or emotional disabilities*
(allergies, heart, hearing impaired, speech impediment, nervous condition, etc.)
Describe your child’s personality*
(shy, nervous, outgoing, strong-willed, cooperative, confident, etc.)
Medical Information
Does your child have any life-threatening allergies or illness?*
- Yes
- No
Medical Condition*
Does your child have an EPI-PEN?*
- Yes
- No
Does your child wear a Medic Alert Bracelet?*
- Yes
- No
Does your child use a ventolin inhaler?*
- Yes
- No
Does your child manage their condition independently (carry/administer their own medication)?*
- Yes
- No
Comments:*
Kind of medication and dosage which must be stored at school:*
Emergency Instructions*
What other medical information would help us understand your child better*
(speech, hearing, birth complications, heart, vision, development, etc.)
Has your child been referred to any specialists*
(allergist, eye doctor, hearing, pediatrician, etc)
Has your child ever received any diagnostic testing?*
- Yes
- No
Is this diagnostic information available to the school?*
- Yes
- No
Dates of testing (if applicable)
Explanation*
Do any agencies such as the Child Development Centre, health clinics or speech pathologists have reports on your child?*
- Yes - Please attach any copies
- No
Is there anything else you would like us to know about your child?*
File 1*
File 2
Documents
Please attach the following documents
Copy of Birth Certificate*
Copy of most recent report card*
Copy of Immunizations*
Copy of any relevant reports from specialists (if applicable)
Parent/Guardian Signature*
Date*

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 the following areas:
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 in the student handbook
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*
(Parents to sign for students up to Grade 4)
Date*
PARENTAL COMMITMENT
We will endeavour to ensure that our child faithfully obeys all the above commitments. Should our child be found negligent in any of the above commitments, we will accept the appropriate discipline for our child, or withdraw our child from White Rock Christian Academy.
1. I agree with the vision of White Rock Christian Academy.
2. I agree to give one month’s notice of withdrawal; or, in lieu of this, one month’s fees.
3. In matters of discipline, my child(ren) will be subject to the disciplinary action of the staff and administration. I understand that I will be given the opportunity to discuss disciplinary matters affecting my child(ren) with the staff, administration and Board of Directors if necessary.
4. I understand my financial commitment and will immediately notify the office if I cannot meet that commitment.
5. I 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.
6. I have, to the best of my knowledge and ability, answered all questions truthfully and completely.
7. I’ve read and am in support of WRCA’s statement of faith.
Date*
Signed: Father or Guardian*
Signed: Mother or Guardian*
Note: Both signatures required where applicable

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.
Student Name*
Date*
What church do you attend?*
How often do you attend church?*
Do you attend church with your parents?*
- Yes
- No
Do you attend a youth group?*
- Yes
- No
Where?*
Who is your youth group leader?*
Are you a Christian?*
- Yes
- No
Grades K-5

Parents and student, discuss and briefly respond to the following question below: Describe what Jesus Christ means to you.
Grades 6-12

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

FAMILY PROFILE
Family Information
Last Name*
Phone*
Address*
Street Address City Province Postal Code Country
Father
Father's Name*
Email*
Cell*
Occupation*
Employer*
Business Phone
Mother
Mother's Name*
Email*
Cell*
Occupation*
Employer*
Business Phone
Communication
How did you hear about White Rock Christian Academy?*
Household Information
Citizenship of parents*
Primary language spoken at home*
Marital Status*
- Married
- Divorced
- Separated
- Widow(er)
- Single
If remarried, name of spouse*
Student lives with*
- Both Parents
- Father
- Mother
- Guardian
Guardian Name*
Home church affiliation of parents/guardians*
Denomination*
Family Doctor*
Phone*
Family Dentist
Phone
First emergency contact if parents cannot be reached*
Name Relationship to Child Phone Cell
Second emergency contact if parents cannot be reached
Name Relationship to Child Phone Cell
Out-of-Lower Mainland Emergency Contact (in case of an earthquake):*
Relationship to child*
Phone*
Cell
Enrollment
List all children you are enrolling at White Rock Christian Academy*
Child(ren) Name(s) Grade Birth Date (DD/MM/YYYY) Gender School Currently Attending
If you have a child enrolling in Kindergarten next September, please list name below:
Child's Name*
Gender*
Birth Date*
List your children not being enrolled White Rock Christian Academy:*
Child(ren) Name(s) Grade Birth Date (DD/MM/YYYY) Gender School Currently Attending
Why do you desire to enroll your child(ren) at White Rock Christian Academy?*
Describe your church commitment and attendance pattern.*
How would you describe your faith?*
What strengths does your family offer to the school?*
Family References*
- Families attending the school who can vouch for your character:
Family Name(s)*
FINANCIAL COMMITMENT
I pledge to pay the tuition for the aforementioned child/children in the following manner*
- In full – within the first week of school with a 2% discount
- In two – installments on September 1st and February 1st
- Monthly – by pre-authorized payments on the 15th or 30th (forms at the office)
- Monthly – by post-dated cheques on the 15th or 30th
Will someone other than yourself be paying all or part of the tuition?*
- Yes
- No
Name*
Phone*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Signature required of person(s) other than parent paying tuition*
Signature*
Parental Commitment
Date*
Signed: Father or Guardian*
Signed: Mother or Guardian*
Note: Both signatures required where applicable

The purpose of this consent form is to keep student information current and be in accordance with the Personal Information Privacy Policy implemented at White Rock Christian Academy September 2004.
GENERAL CONSENT
1. Upon acceptance to White Rock Christian Academy, I give consent to the school to collect personal information that may include student identification information, birth certificate, legal guardianship, court orders if applicable, parents’ work numbers and e-mail address, behavioural, academic and health information, most recent report card, emergency contact name and number, doctor’s name and number, health insurance number and any similar information.
2. I further consent to the use and disclosure of information contained in the application forms and otherwise collected by or on behalf of White Rock Christian Academy (1) for the purpose of establishing, maintaining, and terminating the student’s or parent’s relationship with White Rock Christian Academy, (2) for additional purposes identified when or before personal information is collected, and (3) as otherwise provided in White Rock Christian Academy’s Personal Information Privacy Policy, a copy of which is available on request.
3. I also consent to the collection, use and disclosure of such personal information by and to agents, contractors and service providers (e.g. Ministry of Education, Public Health Authority) of White Rock Christian Academy for the purposes listed above.
This information is required in order to register your child(ren) at this school and assist the school authority in making an informed decision as to your child’s suitability and appropriate placement in the school. It will also allow the school to respond immediately to an emergency. For more information, please contact the school’s Privacy Officer.
Parent’s Signature*
Date*
PHOTOGRAPHY & WORK SAMPLES
4. I consent to having photographs, video and work samples of my child(ren) used by White Rock Christian Academy in the yearbook, newsletters, website, and other promotional material.
Parent’s Signature*
Date*
PHONE DIRECTORY
5. I consent to having the following information included in the “school family” phone directory*
- Home Phone Number
- Address
- Email
Parent’s Signature*
Date*
White Rock Christian Academy acknowledges that there will be no disclosure of personal information to unauthorized personnel or third parties who are not directly involved in school management or the care, supervision and instruction of your child(ren) at this school, unless written authorization from a parent or legal guardian is provided to the school. The school will securely store all digital and hard copy parent and student personal information.

Legal Residency of Parents Form A

Attach a filled out copy of the Legal Residency of Parents form and applicable documents below.
If legal guardian, attach a copy of court order appointing you as a legal guardian
Legal Residency of Parents Form*
I (parent / legal guardian) am*
- A Canadian citizen
- A permanent resident/landed immigrant
- Lawfully admitted to Canada under one of the following documents
Please mark the appropriate box*
- Admission as a refugee claimant or have refugee status
- Student authorization (student visa) for one year or longer
- Employment authorization (working permit) for one year or longer
- A person carrying out official duties as a diplomatic or consular official (with a foreign representative acceptance counter foil in his/her passport)
Attach photocopy of document*
Attach photocopy of document*
Attach photocopy of document*

Pastoral Reference

Attach a filled out copy of the pastoral reference form below.
Pastoral Reference Form*
Comments
This field is for validation purposes and should be left unchanged.

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