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SILC REGISTRATION FORM





Quran ClassIslamic Studies


STUDENT INFORMATION

Parent/Guardian Information

EMERGENCY CONTACT FROM

STUDENT MEDICAL / HEALTH INFORMATION

Physician Address
Health Card Number ( OHIP )
Medical Condition / Allergies ( Please List )
YESNO

PARENTAL CONSENT FOR EMERGENCIES

in the event of any injury requiring any medical attention, i hearby grant permission to SILC to share any information listed within this form with the supervising teacher, staff or medical personnel in order to attend to my child during school of hours. i understand the every effort will be made to contact me, however, if the injury warrants emergency medical attention and i am unreachable, i grant permission to SILC school for necessary medical treatment to be given, including permission to transport my child/children to nearest medical facility.

EMAIL AUTHORIZATION