STUDENT FILE CHECKLIST
Student’s Name: __________________________________________
( each item when completed)
Section 1
Application process—Rock Solid Refuge must receive these completed documents before the
applicant will be considered. (Documents must not be dated more than 3 months prior.)
 Student Application, including family history write-up, Behaviour Checklist, & Parent Agreement.
Students 16 and older must sign the Student Agreement. Students under 16 must be aware of the Student
Agreement and be prepared to sign it at, or prior to, intake.
 The names of two confidential references
 School transcript/grades/Education Intake
 Academic/psychiatric testing records
 Legal records/court documents/custody documents
 Immunization record
Section 2
Intake Forms—after acceptance is granted, Rock Solid Refuge must receive these completed
Intake Forms before you arrive at intake. Bring originals with you. (Must be dated not more than 3 months prior
to intake date.)
 General Expectations
 Agreement and Consent
 Grievance Policy Acknowledgement
 Family Counselling Agreement
 Student Handbook Acknowledgement/Agreement
 Consent for Publicity
 Conciliation & Arbitration Agreement
 Medical/Dental Release
 Authorization for Return of Juvenile
 Payment Agreement Form
 Health Insurance form
 Phone and Mail List/No Contact List
 Pre-entrance Medical—blood work/allergies
 Review the What to Pack list
Section 3
Temporary Grant of Authority and Indemnification in Favour of Rock Solid Refuge. Rock
Solid Refuge must receive these completed documents, signed in front of a Notary Public, before arrival at
Intake. Bring originals with you. (Must be dated not more than 3 months prior to intake date.)
 Page 11
 Page 15
 Page 16 & 17
Declaration of Legal Guardianship
Independent Legal Advice acknowledgement
Notary Public Certificate must be signed by a Notary Public
Section 4
Bring to Intake
 Provincial health card
 Legal photo ID
Rock Solid Refuge will need to keep these originals.
Section 5
Done on site
 Information for Drug Administration.
 Parent package
 Student’s personal effects see What to Pack
 All prescription medications must be
bubble packed.
 Weight, height, picture
 Student Inventory