PARENT AGREEMENT

The parents of International Students choosing to enroll their child in Black Gold School Division
must participate according to the following conditions:

1. I declare that my child has no history of criminal behavior, no criminal or civil law charges, no
behavioral problems or mental illness.

2. I have disclosed to Black Gold School Division any medical or physical problems concerning
my child.

3. I am aware that as a part of the school curriculum, my child may participate in field trips
outside of the school and I authorize the custodian to provide the necessary permissions.

4. Black Gold School Division is not liable for losses/expenses incurred as a result of being unable
to provide education owing to labor disputes, inclement weather or other causes beyond its
control.

5. I agree to provide sufficient funding for my child’s personal spending, living and travel
expenses.

6. I certify that all information provided on and within this application is complete, factually
accurate and honestly represented. Should it be discovered that false information was
provided in my application, or true information was omitted from my application,my child
can be sent home at my expense with no refund of tuition or other fees.

7. I hereby waive, release, absolve and agree to indemnify and save harmless Black Gold School
Division, its trustees, employees, agents and the host family from all liability, losses, and cost
arising free my child’s participation in the educational and host family program except such as
results solely from the willful neglect or willful default.

8. Any disputes will be governed by the laws of Alberta, Canada and the Courts of Alberta shall
have exclusive jurisdiction.

I have read and understood the guidelines and expectations and verify that all information
provided on this application form and attached documents is complete, true and accurate.
Date:

Date:
Parent Name:

Signature of Parent/Guardian:
 Collection/Use of Student Information:
International Students
The purpose of this form is to inform you about the collection and use of student information and
to gain your consent for the use of this information by the Black Gold School Division.

PARENTS / GUARDIANS / - PLEASE READ CAREFULLY

The following types of collection and use of student information do not require parental
consent as per the Alberta Freedom of Information and Protection of Privacy Act:

✓ The sharing of information on a “need-to-know” basis regarding students who have severe
or life-threatening medical conditions;
✓ The sharing of student information with Alberta Education;
✓ The taking of student names and photos and/or videos of classroom or other school
activities by students or Division personnel where the material will be used within the
school;
✓ The use of school newsletters to announce student success, events, and activities within
the school and its community (a welcome to new students by grade, names and photos of
students of the month, students achieving honours, news on sports teams and athletic
events, and photos of students involved in school projects – as such, they are public
documents);
✓ The taking of photos and videos of school activities that are open to the general public;
these may be used for purposes outside the school;

Some types of collection and uses of student information do require parental consent as
per the Alberta Freedom of Information and Protection of Privacy Act. We ask for your
consent so that your child’s limited identifying information (name, grade, photo) may be
used in the following situations:

• The use of student names, grade, photo or video in local newspapers or digital media.
• The use of student names, photo, video and comments within Black Gold School Division
including electronic and print publications/advertisements/presentations, websites,
newsletters, school/Division Facebook and Twitter accounts, and teacher/school/Division
blogs.
• The use of student names on artwork or other material displayed at school or Division
sites or at school sponsored displays in the community (Copyright Act – Canada)

I hereby give consent for the school and/or Division to use limited
identifying information for the required parental consent listed above
Yes No

My child ________________________________
(Name of Child – Please Print)

SIGNED: _____________________________ _____________________

Parent/Guardian Date

October 6, 2022 Black Gold School Division