First Name

Last Name

Gender
MaleFemale

Place of birth

Date of birth

Medical card number

Address No

Street

Apt #

City

Province

Postal Code

Telephone

Email

Father's full name

Father's phone number

Mother's full name

Mother's Phone Number

Name of Person to contact in case of Emergency

Number of Person to contact in case of Emergency

Brothers and Sisters attending the school

Special medical care, allergies, etc.