Admissions Form

What are your registering for?*

Day School Part Time

Which Semester are you registering for?*

Day School Full Time

Which Semester are you registering for?*

Night School

Which Semester are you registering for?*

Summer School

Which Semester are you registering for?*

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Course Information

Course Requested

Class vs. Private Study

Class

1on1

2on1

3on1

The "class" option is not available for the June semester. If 2on1 or 3on1 is selected and additional students do not register, the course will automatically become a 1on1.

Have you successfully completed the prerequisite for this course?

Yes

Please upload a Report Card or transcript indicating so.

Max. file size: 10 MB.

Please contact the school by phone (416-482-2521) or by email (info@cityacademy.ca).

Additional information regarding student availability:

City Academy reserves the right to cancel courses at any time due to insufficient enrollment or teacher availability. In this event, students will have priority placement in another course. If another course cannot be found the student will receive a refund of tuition paid for the course.

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Student Information

Name*

First Name * Last Name *

Gender M/F*

DOB*

Email Address*

Address*

Street Address * City * Postal Code *

Home Phone

Student Cell Phone*

Home School*

Previous School*

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Parent / Guardian Information

Primary Contact Name*

Relation*

Email Address*

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Address same as student

Address*

Street Address * City * Postal Code *

Home Phone

Cell Phone*

Please check if secondary contact n/a

Secondary Contact Name*

Relation*

Email Address*

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Address same as student

Address*

Street Address * City * Postal Code *

Home Phone

Cell Phone*

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Anaphylactic Shock

Sabrina’s Law is a Provincial legislation which was enacted January 1st, 2006 to protect anaphylactic students in school settings. “Anaphylactic shock” is a severe allergic reaction, which may be fatal.

DOES YOUR CHILD HAVE ANY LIFE-THREATENING ALLERGIES?*

Yes

List the substance(s) (food, insect, etc.) to which your child is allergic.*

Does your child carry a required epiPen?*

Yes

Will you supply the school with an appropriate EpiPen?*

Yes

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Consent to Transfer O.S.R.

Consent*

By ticking this box you give consent to transfer the student’s Ontario Student Record to City Academy.

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Expectations of Students and Evaluation Agreement

COVID-19 POLICIES AND PROCEDURES – Students are expected to understand and abide by all of the policies and procedures outlined in the COVID-19 Reopening Strategy document.
ATTITUDE – A positive, cooperative and focused attitude is expected from every student every day. A daily demonstration of superior effort is a school norm. Students will be treated as adults and therefore it is assumed they will behave like adults.
RESPECT – It is expected that students will actively demonstrate a respect for the school, the curriculum, the teachers and fellow students. Interference with the delivery of program and other students’ learning will not be tolerated.
ATTENDANCE - For maximum success all classes must be attended. After an absence of more than 5 days a final assessment of over 80% will be impossible without extra work. The school must be informed of a student absence before 8:15AM. A parent or doctor’s note explaining the absence must be presented to the teacher if a test or exam is missed. Missed work must be completed within 24 hours. Special arrangements may be made for severe health reasons, if absences do not compromise the integrity of the course content or the course delivery.
PUNCTUALITY - Latecomers interrupt the class and demonstrate a lack of respect for fellow students and the teacher; therefore, a late student may be refused entry to the class. After 5 unnecessary lates the student may be removed from the course.
HOMEWORK and CLASS PREPARATION - Students should plan to do a minimum of 1 hour of homework per class per night. Steady work will alleviate the last-minute panic and increase the chances of success. Failure to complete assigned homework lessens a student’s ability to benefit from classroom instruction.
ASSIGNMENTS - Assignments are an integral part of any course. Because we are preparing students for university it is expected that all assignments be completed and submitted on the due dates. Late submissions will be penalized.
PLAGIARISM - Plagiarism will result in a mark of zero and possible removal from the course and from the school.
SMOKING and VAPING – No smoking or vaping on school premises.
CELL PHONES and ELECTRONIC DEVICES – Cell phones and electronic devices are not to be used in the school except for subject-related activities.
CANNABIS and ILLEGAL SUBSTANCES - Possession, use or the after effects of use of cannabis or any illegal substances will result in an automatic removal from the school.

Evaluation Agreement

Evaluation is an integral part of any credit course. However, it is not an end, in and of itself. The most important aspects of the course are the new skills, attitudes and information, which will assure success in the future.

The mode of course delivery at City Academy will give every student the possibility for an assessment which is excellent, but only hard work, dedication and task focus will assure a top mark. There is no guarantee.

All students should establish a realistic goal for mark attainment. The structure of the school will assist in the achievement of that goal, but attendance here will not assure it.

I agree

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The 2019 Novel Coronavirus (COVID-19) Acknowledgement and Assumption of Risk

THE 2019 NOVEL CORONAVIRUS (COVID-19) ACKNOWLEDGEMENT AND ASSUMPTION OF RISK

By signing the below waiver, you are acknowledging that you believe to the best of your ability that the below statements are TRUE:

Neither the Student, nor any other person in your household, are currently experiencing COVID-19 symptoms nor has any person in your household had COVID-19 symptoms in the last 14 days.
Neither the Student, nor any other person in your household, have travelled outside of Canada or in an area under a travel health advisory in the last 14 days.
Neither the Student, or any other person in your household, have provided care or had close contact with any person with COVID-19 or with any person reasonably suspected of having COVID-19 or with any person who travelled outside of Canada in the last 14 days or with any person who travelled in an area under a travel health advisory in the last 14 days.

By signing this waiver, you represent and warrant to the Releasees that neither the Student nor any other person in your household have been advised by the Government of Canada or Ontario Public Health or your doctor or the Ontario Ministry of Health website to self-isolate due to possible exposure to COVID-19. You are fully aware of the risks and hazards with respect to COVID-19 inherent in the Student’s attendance at the School and participation in the activities associated with City Academy courses. You freely and voluntarily agree to assume the risk with respect to COVID-19, including the risk of death, bodily injury or property damage, regardless of severity, that you (or your Student) may sustain as a result of your/their participation in the activities associated with the School or attendance at City Academy classes, howsoever arising, including, but not limited to, the active or passive negligence of the Releasees.

You also agree that you and the Student will participate in, and comply with, such measures the School sees fit with regard to protecting students and teachers from transmission of COVID-19; including but not limited to: health screening including temperature taking, quarantine and isolation protocols, facemask usage, social distancing, hand washing/sanitizing, as well as all measures listed in City Academy’s 2020-2021 School Year COVID-19 Reopening Strategy.

I agree

Student Signature

Student Name*

Signature Acknowledgement*

Signed

Parent Signature

Parent Name*

Signature Acknowledgement*

Signed

This field is for validation purposes and should be left unchanged.