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
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