Student Package

Highroad Academy

Student Package

School Admin Section
Please select one of the following

Making application changesSend out re-enrollmentNo further action required
What is the status of the application?

EnrolledApplication WithdrawnWaiting on Registration FeePendingNot acceptedOn hold
Date of Application Withdrawal

MonthDayYear
Date
Date of Enrolled

MonthDayYear
Date
Date of Edits

MonthDayYear
Date

End of Section

Finance Admin Section
Has the $250 registration fee been paid?

YesNoN/A

End of Section
Type a question

1. Student Information
Year Applying for*
Are you returning to Highroad Academy*

YesNo
if no, why?
Grade applying for*
Current Grade*
For every kindergarten student we need a recent photo of your child

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Student's Gender*

MaleFemale
Requested Start Date*

MonthDayYear
Date
Student First Name*
Student Middle Name*
Student Last Name*
Usual Name*
Home Address*

Street Address

Mailing Address

CityState / Province

Postal / Zip Code
Is the street address above the same as your mailing address?*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of birth*

MonthDayYear
Date
Place of Birth*
Is there a birth certificate on file at Highroad Academy?*

YesNo
Please upload a copy of the student's birth certificate or passport

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What is the citizenship status of your student?*

Canadian CitizenLanded ImmigrantTemporary VisaOther
Has the students citizenship status changed?*

YesNo
Please upload any new documentation

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Is the Parent/Legal Guardian a resident of BC?*

YesNo
Personal Health Number*
Pastor's Name*

First NameLast Name
Name of the church your family regularly attends*
Pastor's Email*
example@example.com
Church Phone Number*
Please enter a valid phone number.
Please select one of the following options*

Re-enrollmentNew Application
Have you already submitted a new application for another student?*

YesNo
Have you changed churches in the past year?*

YesNo
A Pastoral Reference may be required for your family based on what you answered above. Only one pastoral reference is required per family. To ensure that your pastor does not receive multiple reference forms, please select that you have submitted a new application
A Pastoral Reference may be required for your family based on what you answered above. Only one pastoral reference is required per family. To ensure that your pastor does not receive multiple reference forms, please select Re-enrollment then 'no' for have you changed churches in the past year.
We only require one registration fee per family. If you have already submitted an application for enrollment/re-enrollment for 2025/2026 please click yes below:*

YesNo
Registration Fee

A $250 registration fee is required for a completed student application. Upon your student being accepted that $250 will be deducted from your final tuition amount. After completing this form, you will be redirected to pay the $250. The payment method selected below will be the method setup to pay for your tuition.
How would you like to pay?*

Preauthorized DebitCredit Card
Both a void cheque and an authorization form are required. Upon finishing this form you will be redirected to sign an authorization form. Please upload ONLY A VOID CHEQUE
Void Cheque*

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We only require one tuition contract per family. If you have already submitted an application for enrollment/re-enrollment for a student please click the checkbox to the left.
2. Parent/Guardian
First Name *
Middle Initial
Last Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number
Please enter a valid phone number.
Work Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Email*
example@example.com
Are you HRA Alumni? If yes, what year?*
Employer*
Relationship to child*
Occupation*
Marital Status*

MarriedWidowedDivorcedSeparatedSingle
3. Parent/Guardian
First Name
Middle Initial
Do you live in the same household as Parent/Guardian 1?

YesNo
Last name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone Number
Please enter a valid phone number.
Work Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Email
example@example.com
Are you HRA Alumni? If yes, what year?
Employer
Relationship to child
Occupation
Marital Status

MarriedWidowedDivorcedSeparatedSingle
4. More Information
Student resides with?*

Father & MotherFatherMotherLegal Guardian
Is there a custody order in place?*

YesNo
Is there a custody order on file at Highroad Academy?

YesNo
Please upload a copy of the document*

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Does the applicant have First Nations Status?*

YesNo
Do they live on a reserve?*

YesNo
Band Name?*
How did you hear about Highroad Academy?*

0/5000
Why have you decided to register your child(ren) at Highroad Academy?*
Do you have other child(ren) enrolled in schools other than Highroad Academy?*
If yes, explain why*
5. Emergency Contacts

In case of an emergency in the event that a parent cannot be reached the following will be called.
Contact 1*

First NameLast Name
Contact 2*

First NameLast Name
Contact 1 Number*
Please enter a valid phone number.
Contact 2 Number*
Please enter a valid phone number.
Relationship to Student*
Relationship to Student*
Family Doctor*
Phone Number*
Please enter a valid phone number.
Scholastic Information

Please list the last two schools attended starting with the most recent and enclose a copy of your student's report cards for the last two grades completed
School Name*
Start Date*

MonthDayYear
Date
End Date*

MonthDayYear
Date
School Complete Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
School Name
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
School Complete Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student Report Card

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6. Educational Program and Class Placement Information

This section must be completed with your child’s history as acceptance to Highroad Academy is conditional upon its full and accurate completion. Information disclosure does not necessarily preclude a student’s acceptance into Highroad, but rather is used to ensure we will provide the best educational program possible with available staffing resources.
1. Please indicate the academic level of your child's previous work:*

ExcellentGoodAveragePoor
Has applicant ever repeated a grade?*

YesNo
If yes, explain*
2. Does your child have any specific learning needs that require additional or special education support?*

YesNo
Please describe*
3. Does your child have a CURRENT Individualized Education Plan(IEP)?*

YesNo
Is there a IEP on file at Highroad Academy?

YesNo
IEP Upload*

*Please note that registration is considered complete only when a copy of the IEP is submitted with the student’s most recent report card.
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4. Has your child undergone formal assessment? ie: Psychoeducational Assessment*

YesNo
Completion Date?*
Assessor/Evaluator?*
5. Has your child been designated as a child with special needs in the education system in BC?*

YesNo
If so, which category/designation*
6. Has your child had or is your child currently receiving tutoring outside of school?*

YesNo
If so, please indicate when and for which subjects*
7. Please indicate your child's first language*

EnglishOther
What language is primarily spoken in your home?*
8. Does your student CURRENTLY receive ELL/ESL support at school?*

YesNo
9. Has your child been diagnosed or do you suspect any of the following issues:*

ADD / ADHDAnxietyBehavioral IssuesNot Applicable
Please explain why you selected the choice above, and tell us if issues arise at school or home*
10. Has your child ever experienced any of the following:*

Social interaction/relationship issues at schoolEmotional (including anxiety) issues at schoolBehavioral issues at schoolThey have not experienced any of these
If you answered yes to any of the above, please explain*
11. Has your child EVER received the following services?*

Learning assistance pull-outLearning assistance in-class supportSpecial Ed ProgrammingEducational AssistanceESL or ELL ServicesSpeech & Language TherapyOccupational TherapyPhysical TherapyCounselling SupportBehavior PlanThey have not received any of the following services
If you answered yes, please list when and what school*
12. Have you previously attended a tuition-based school?*

YesNo
Have you always fulfilled your financial obligations?*

YesNo
13. Does your child have any allergies or medical conditions?*

YesNo
Explain
Does your child have any medical concerns that staff should be aware of?*

YesNo
If yes, explain*
14. Does your child take any prescription medication on a regular basis?*

YesNo
if yes, please list:*
15. What interests or hobbies does your child have?*
16. Has your child been suspended, expelled or refused admission to another school?*

YesNo
if yes, please explain*
7. Personal Information

This section is to be completed by the student if applying for entrance into grade seven through twelve or by the parent if the student applying is entering Kindergarten through grade six.
Have you ever been in trouble with the police or other authority figures?*

YesNo
If yes, explain*
Have you ever used alcohol or drugs?*

YesNo
8. Student’s Commitment

This section must be read and understood by all students. Students applying for entrance into grade four through twelve must sign below, indicating that they have read and commit to abide by these standards.
Please check the following: As a student of this Christian school, I agree to follow the Highroad Academy Code of Conduct, which is based on Biblical principles.*

I understand that these expectations apply at all times, regardless of whether I am at school, both online and offline.While I am not expected to be perfect, I am expected to continue to grow in my faith and to be willing to receive input, discipleship and mentoring from my teachers, leaders, and pastors (1 Tim. 4:12)I am committed to weekly participation in my local church and youth activities.I want to attend this school.
I agree to:*

Show respect for those placed in authority over me.Show respect of school property and the personal property for others.Promote courtesy, kindness, morality and honesty in my interactions with others.Refrain from any kind of discriminatory or bullying talk or behavior.Follow the uniform standards and standards of Biblical modesty in my clothing choices.Follow the appropriate usage standards for electronic devices and for Chrome book usage.Follow the expectations for student relationships.Faithfully and consistently attend church and youth.Show support for the goals, aims, and standards of Highroad Academy in how I speak and act
I will avoid participating in or talking favorably about:*

Cheating/ plagiarismStealingUsing inappropriate languageSmoking/ vapingImmoral behavior and pre-marital sexAlcohol useDrug use
I understand that Highroad Academy functions as a ministry of City Life Church and carries the spiritual values and flavour of City Life Church in worship, prayer, preaching/teaching in Chapel services, Bible classes and other related events, and as a member of this school community, I agree to show respect for these values.
Student Signature*

Clear
Date*

MonthDayYear
Date
9. Parent's Commitment

We recognize the vital and important role that parents and the home fulfill in providing a foundation for the success of our child. We understand and share the standards and values that Highroad Academy, under the leadership of City Life Church, seeks to instill and reinforce in our young people’s lives. We recognize and support the spiritual atmosphere and tone that the school’s administration seeks to maintain. In consideration of this, we commit our home and ourselves in the following ways, with God’s help and to the best of our ability.
Moral Standards: We are in agreement with the moral standards of Highroad Academy. We believe and are committed to live and model Biblical standards in every area of our family life and home. We do not tolerate profanity, obscenity in word or action, or dishonor to the Godhead, the Word of God, or the staff and leaders of the school and church. We understand the command of scripture to live in moral purity and commit our home and ourselves to being an example of Biblical morality, including godly expressions of sexuality. We acknowledge and agree that the Bible is the final authority on all areas of morality and sexual purity, including an understanding of covenant marriage between a man and a woman as the only acceptable standard for sexual expression. We stand against non-Biblical cultural attitudes that erode sexual purity in our young people.

I Agree
School Discipline: We agree to support the school policies and regulations and authorize the school staff to employ discipline as they deem just, wise and expedient for the training of our child. We understand that the school reserves the right, after parental conference, to dismiss any child who fails to comply with the established regulations and discipline or whose parents do not assume their responsibilities to the school.

I Agree
Academic Standards: We agree to uphold the high academic standard of the school by providing a place at home for our student to study and by encouraging our child in the completion of homework and assignments.

I Agree
School Participation: We understand that our child is expected to take part in school activities, including sports, special assemblies and concerts, local service-related activities and school sponsored trips away from the school building. We absolve the school from liability to us or our child in the case of any injury to them at supervised school activities.

I Agree
Financial Responsibilities: We commit to assume our scriptural and contractual responsibility to financially support the school by paying all tuition and other fees in a timely manner.

I Agree
Local Church Commitment: We understand the scriptural importance of being committed to and functioning in a local church. We understand the value that faithful and consistent church life adds to our family’s spiritual development and our ability as parents to train and nurture our child in the ways of the Lord. Our family demonstrates this commitment by weekly attendance at church services, involvement and function in church life, and consistent financial support of our local church.

I Agree
Handling Conflict: We agree to promote positive communication by following the biblical principles found in Matthew 18 and by speaking the truth in love when expressing a disagreement or resolving a problem. If there is a concern or complaint about a specific teacher, staff member, coach, and/or administrator, it is essential that the initial communication be with the specific individual. If the concern continues or is not resolved, the next step would be to speak with the appropriate administrator. The appropriate process is: staff member- department head-principal-school board.

I Agree
It is our intent to partner with you as you raise your children. On our part, we commit to providing a Christ-centered education with individualized learning supports, the necessary courses and preparation for life beyond high school, and information, resources and parent workshops.
How will you commit to partner with us? Please check all that apply.*

Time (volunteering in a classroom, for hot lunch, for supervision, coaching a sports team, etc.)Skills (sharing your time and/or expertise with staff or students for the development of facilities or programsResources (money or specific items you can provide for school programs and activities)Other
More Details*
Parent Signature*

Clear
Signature Date*

MonthDayYear
Date
Parent Signature

Clear
Signature Date

MonthDayYear
Date

Highroad Academy

Disclosure of Personal Information
This information is required in order to register your child at this school and assist the school authority in

making an informed decision as to your child’s suitability and appropriate placement in the school. It will also

allow the school to respond immediately to an emergency. For more information, the privacy officer for

Highroad Academy is Mrs. Denise Kraubner who may be reached at 604-792-4680.

Highroad Academy acknowledges that there will be no disclosure of personal information to unauthorized

personnel or third parties who are not directly involved in school management or the care, supervision and

instruction of your child at this school, unless written authorization from a parent or legal guardian is

provided to the school. The school will securely store all digital and hard copy parent and student personal

information.

1.

I consent to having Highroad Academy collect personal information that may include student

identification information, birth certificate, legal guardianship, court order if applicable, parents’ work

numbers and e-mail address, behavioral, academic and health information, most recent report card,

emergency contact name and number, doctor’s name and number, health insurance number and any

similar information needed for registration.

I further consent to the use and disclosure of information contained in this form and otherwise collected

by or on behalf of Highroad Academy (1) for the purpose of establishing, maintaining, or terminating the

student’s and parent’s relationship with Highroad Academy, (2) for additional purposes identified when

or before personal information is collected, and (3) as otherwise provided in Highroad Academy’s

Personal Information Privacy Policy, a copy of which is available on request. I also consent to the

collection, use and disclosure of such personal information by and to agents, contractors, Highroad

Academy’s website and service providers of Highroad Academy.
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
I consent to having photographs of my child used by Highroad Academy in the yearbook, classroom blogs, athletic blogs, the Highroad website (both the public portion and the password-protect MyHRA section), and on social media (including but not limited to Facebook and Instagram). I consent to my child's participation in videos that are used at in-school concerts and which are then shared on the password protected MyHRA section and videos that appear on the school website and clips that are used on social media.I wish to clarify the areas of consent.
I consent to the use of my child's photo and recorded video of my child in the following areas (Please note that we never post a student's name on social media):*

Yearbook. The year book staff is comprised of students with a teacher who oversees the creation of the yearbook. All photos of students used in the yearbook have been taken by the yearbook staff, a staff member of Highroad or in rare instances, a parent who has given permission for us to use their photo.Newsletter. In September we send out a newsletter letting parents know important beginning of the year information. Another form of newsletter that might be used at Highroad is an Alumni Newsletter which would be sent to students who have graduated from Highroad to keep them connected and involved in what is happening at Highroad.Social Media. Photos of students are used on the stories of Instagram and Facebook (they appear for 24hours and then are deleted). We use this as an opportunity to share with parents what is happening at Highroad. For example, a field trip, a special guest speaker in class, a chapel, a concert or event. Social media posts are used as a way of sharing upcoming events and giving parents information about what's happening at school, no photos of students will be used on Facebook posts.Website. Our Highroad website (the public portion) is used to promote Highroad to the community and potential families. We share photos and videos of our students participating in Highroad events to show our amazing community.Website (MyHRA section). Our MyHRA section is password protected (the password is given to families whose children attend Highroad). Included in this section is a media page which contains our athletic photos, videos of our concerts and important events, videos from parent nights, our Theatre production, etc.Blogs. Classroom blogs and athletic blogs are used by the teachers in our Elementary department and Athletics department. These blogs are available for parents to subscribe to as a means of communication between parents and teachers. Photos are sometimes added to these blogs to share what's been happening throughout the week. These blogs are hosted by public sites, however, within our community their links are only found on the password protected MyHRA section.
Please let us know if you have any questions or comments on any of the above.*
If you want to discuss this further, please contact the office 604-792-4680 or info@highroadacademy.com and we will set up an appointment for you.
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
First/Last Name of Student*
Grade*

Highroad Academy

Pastor's Confidential Reference Form
This form is required for all new families making application to Highroad Academy and on behalf of any applicants for teaching, support staff or TOC positions.

To be completed by the applicant:
First/Last Name of Student
Grade
First/Last Name of Student
Grade
First/Last Name of Student
Grade
First/Last Name of Student
Grade
Family name:*
Parent/Guardian name(s):*
Name and grade of student applicant(s):
Pastors Name*
Church*
As parents, we understand that the information contained in this form is held in confidence between the school and the pastor and waive our right to examine it at any time.
Parent/Guardian Signature*

Clear
Signature Date*

MonthDayYear
Date
Parent/Guardian Signature

Clear
Signature Date

MonthDayYear
Date

Independent School Student Records

Requirements and Best Practices Guidelines
APPENDIX II

The following are suggested formats for Student Registration Forms to verify parental/legal guardian lawful admission to

Canada and residency in British Columbia. This information must be included in the student records.

STATUS OF PARENT/GUARDIAN (ADMISSION TO CANADA AND RESIDENCY) - FORM A

(if parents are deceased, use Form B)

To be completed and signed by a parent or legal (court-appointed) guardian. (If legal guardian, attach copy of court

order appointing you as legal guardian).

(Lawfully Admitted into Canada)
1. Which of these are you? Please select one*

A Canadian citizen (if not born in Canada, please attach a photocopy of citizenship paper/card)A Permanent Resident (landed immigrant) (attach photocopy of landed immigrant status paper or PR card)Admission as a refugee or refugee claimantValid student permit for two or more years (or issued for one year but anticipated to be renewed for one or more additional yearsValid employment authorization (work permit) for two or more years (or issued for one year but anticipated to be renewed for one or more additional years)A person carrying out official duties under the authority of the Visiting Forces Act or as an accredited diplomatic agent, preclearance officer, consular officer or official representative in Canada of a foreign government with a consular post in British Columbia.Other - please explain document description
Document description*
Upload Proof of Document Type

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(Residency in British Columbia)
2. I am a resident of British Columbia*

YesNo
Residency Address*
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

Base Tution Rate 2024/2025

	K-Full - Gr. 6	Gr. 7 - 9	Gr. 10 - 12
Child 1	$5,845	$6,430	$6,880
Child 2	$3,634	$3,997	$4,277
Child 3	$2,362	$2,599	$2,780
Child 4	$1,591	$1,751	$1,873

Base Tution Rate 2025/2026

	K-Full - Gr. 6	Gr. 7 - 9	Gr. 10 - 12
Child 1	$6,137	$6,751	$7,224
Child 2	$3,816	$4,197	$4,491
Child 3	$2,480	$2,728	$2,919
Child 4	$1,671	$1,838	$1,966

Highroad Academy

1. Student Information

Registration Fee

2. Parent/Guardian

3. Parent/Guardian

4. More Information

5. Emergency Contacts

Scholastic Information

6. Educational Program and Class Placement Information

7. Personal Information

8. Student’s Commitment

9. Parent's Commitment

Highroad Academy

Highroad Academy

Independent School Student Records