{"id":94690,"date":"2024-01-29T08:39:58","date_gmt":"2024-01-29T16:39:58","guid":{"rendered":"https:\/\/nides.sd71.bc.ca\/?page_id=94690"},"modified":"2026-04-15T10:42:08","modified_gmt":"2026-04-15T17:42:08","slug":"navigate-nides-k-9-program-registration","status":"publish","type":"page","link":"https:\/\/nides.sd71.bc.ca\/?page_id=94690","title":{"rendered":"K-9 Registration | Navigate-NIDES"},"content":{"rendered":"<div  class='flex_column av-150iw5e-569a562ae38b2cc0ccd00cc17f4b145a av_one_full  avia-builder-el-0  el_before_av_codeblock  avia-builder-el-first  first flex_column_div  '     ><p>\n<style type=\"text\/css\" data-created_by=\"avia_inline_auto\" id=\"style-css-av-lrzi8ljj-10f0a8893eb4cc97f0a37640adf84864\">\n.avia-image-container.av-lrzi8ljj-10f0a8893eb4cc97f0a37640adf84864 img.avia_image{\nbox-shadow:none;\n}\n.avia-image-container.av-lrzi8ljj-10f0a8893eb4cc97f0a37640adf84864 .av-image-caption-overlay-center{\ncolor:#ffffff;\n}\n<\/style>\n<div  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avia-builder-el-2  el_after_av_image  el_before_av_textblock  av-desktop-hide av-medium-hide av-small-hide'   itemprop=\"image\" itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/ImageObject\" ><div class=\"avia-image-container-inner\"><div class=\"avia-image-overlay-wrap\"><img decoding=\"async\" fetchpriority=\"high\" class='wp-image-94718 avia-img-lazy-loading-not-94718 avia_image ' src=\"https:\/\/nides.sd71.bc.ca\/wp-content\/uploads\/2024\/01\/NavigateNIDES_K9_Bnr_Mobile.webp\" alt='' title='NavigateNIDES_K9_Bnr_Mobile'  height=\"900\" width=\"1000\"  itemprop=\"thumbnailUrl\" srcset=\"https:\/\/nides.sd71.bc.ca\/wp-content\/uploads\/2024\/01\/NavigateNIDES_K9_Bnr_Mobile.webp 1000w, https:\/\/nides.sd71.bc.ca\/wp-content\/uploads\/2024\/01\/NavigateNIDES_K9_Bnr_Mobile-300x270.webp 300w, https:\/\/nides.sd71.bc.ca\/wp-content\/uploads\/2024\/01\/NavigateNIDES_K9_Bnr_Mobile-768x691.webp 768w, https:\/\/nides.sd71.bc.ca\/wp-content\/uploads\/2024\/01\/NavigateNIDES_K9_Bnr_Mobile-705x635.webp 705w\" sizes=\"(max-width: 1000px) 100vw, 1000px\" \/><\/div><\/div><\/div><br \/>\n<section  class='av_textblock_section av-302276-d85306893959b26b203a226ba56310e9 '   itemscope=\"itemscope\" itemtype=\"https:\/\/schema.org\/CreativeWork\" ><div class='avia_textblock'  itemprop=\"text\" ><p><!--\n\n\n\n\n\n\n<p style=\"text-align: center;\"><strong>This form will open at 9:00AM on February 24th.<\/strong><\/p>\n\n\n\n\n\n\n--><\/p>\n<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_123' style='display:none'>\n                        <div class='gform_heading'>\n                            <h2 class=\"gform_title\">K-9 Full-Time Registration: All Programs - 2026-2027<\/h2>\n                            <p class='gform_description'><\/p>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_123'  action='\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F94690' data-formid='123' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_123' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_123_259\" class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_259'>LinkedIn<\/label><div class='ginput_container'><input name='input_259' id='input_123_259' type='text' value='' autocomplete='new-password'\/><\/div><div class='gfield_description' id='gfield_description_123_259'>This field is for validation purposes and should be left unchanged.<\/div><\/div><div id=\"field_123_256\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div style=\"background-color: #e35812; padding: 20px 30px; border-radius: 15px; display: flex; align-items: center; justify-content: center; border: 5px solid #313f45; \">\n  <img decoding=\"async\" src=\"https:\/\/nides.sd71.bc.ca\/wp-content\/uploads\/2024\/02\/YieldSign_White.png\" alt=\"yield sign\" style=\"width: 50px; height: 50px; margin-right: 15px;\">\n  <p style=\"color: white; font-size: 130%; margin: 0;\">Registration is closed for the 2024-25 school year - only registrations for <u>September 2025<\/u> are being accepted.<\/p>\n<\/div>\n<\/div><div id=\"field_123_240\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><!--\n<div style=\"background-color: #ff4949; padding: 30px 15px; border-radius: 15px; text-align: center;\">\n<img decoding=\"async\" src=\"https:\/\/nides.sd71.bc.ca\/wp-content\/uploads\/2024\/02\/YieldSign_White.png\" alt=\"yield sign\">\n<p style=\"color: white; font-size: 170%;\">This form is currently only accepting applications for <u>Kindergarten students!<\/u><\/p><p style=\"color: white; font-size: 140%; \">Applications for all grades will be accepted starting <u>February 20th!<\/u><\/p>\n<\/div>\n--><\/div><div id=\"field_123_108\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class=\"message-box\">\n<strong style=\"font-size: 24px; color: white; margin-bottom: 10px;\">Have your identification documents handy:<\/strong>\n<ul style=\"margin: 5px 0 5px 7px;\">\n<li>\n<p style=\"margin: 0\">Valid Residency Proof: <u>BC Care Card \/ Services Card, BC ID Card, BC Driver's License, or current utility bill<\/u><\/p>\n<\/li>\n<li>\n<p style=\"margin: 0\"><u>Student's<\/u> Valid Canadian Citizenship Proof: <u>Birth Certificate, Passport, or Permanent Resident Card<\/u><\/p>\n<\/li>\n<\/div><\/div><div id=\"field_123_143\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Confirm Program Selection<\/h3><\/div><fieldset id=\"field_123_255\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Status of the student applying:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_255'>\n\t\t\t<div class='gchoice gchoice_123_255_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_255' type='radio' value='re-reg'  id='choice_123_255_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_123_255\"   \/>\n\t\t\t\t\t<label for='choice_123_255_0' id='label_123_255_0' class='gform-field-label gform-field-label--type-inline'>I am a current NIDES student and re-registering<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_255_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_255' type='radio' value='pre-reg'  id='choice_123_255_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_255_1' id='label_123_255_1' class='gform-field-label gform-field-label--type-inline'>I am a new NIDES student and registering for the first time<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_123_255'>Please note if you choose re-registration and are a new student, this may cause delays in your enrolment.<\/div><\/fieldset><div id=\"field_123_250\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_123_250'>Submission Type<\/label><div class='ginput_container ginput_container_text'><input name='input_250' id='input_123_250' type='text' value='primary' class='large'      aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_123_212\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >I confirm that I am registering as a full-time Navigate-NIDES student<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_212'><div class='gchoice gchoice_123_212_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_212.1' type='checkbox'  value='Yes'  id='choice_123_212_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_212_1' id='label_123_212_1' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_227\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><\/div><fieldset id=\"field_123_146\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Which program would you like to register for?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_146'>\n\t\t\t<div class='gchoice gchoice_123_146_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='Online Only'  id='choice_123_146_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_146_0' id='label_123_146_0' class='gform-field-label gform-field-label--type-inline'>Online Only<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_146_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='7 Summits'  id='choice_123_146_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_146_1' id='label_123_146_1' class='gform-field-label gform-field-label--type-inline'>7 Summits<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_146_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='Aligned Learning Society'  id='choice_123_146_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_146_2' id='label_123_146_2' class='gform-field-label gform-field-label--type-inline'>Aligned Learning Society (Mid-Island)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_146_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='Compass'  id='choice_123_146_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_146_3' id='label_123_146_3' class='gform-field-label gform-field-label--type-inline'>Compass (Comox Valley, Nanaimo, Parksville)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_146_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='FAe'  id='choice_123_146_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_146_4' id='label_123_146_4' class='gform-field-label gform-field-label--type-inline'>Fine Arts eCademy (FAe)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_146_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='Flip City Gymnastics Academy'  id='choice_123_146_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_146_5' id='label_123_146_5' class='gform-field-label gform-field-label--type-inline'>Flip City Gymnastics Academy 4-12<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_146_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='HLC'  id='choice_123_146_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_146_6' id='label_123_146_6' class='gform-field-label gform-field-label--type-inline'>Heartwood Learning Communities (HLC)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_146_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='Island Hockey Club'  id='choice_123_146_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_146_7' id='label_123_146_7' class='gform-field-label gform-field-label--type-inline'>Island Hockey Club (Nanaimo)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_146_8'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='Love 2 Dance'  id='choice_123_146_8' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_146_8' id='label_123_146_8' class='gform-field-label gform-field-label--type-inline'>Love 2 Dance<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_146_9'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='Maple Ridge Hockey Academy'  id='choice_123_146_9' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_146_9' id='label_123_146_9' class='gform-field-label gform-field-label--type-inline'>Maple Ridge Hockey Academy 2-7<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_146_10'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='NSA'  id='choice_123_146_10' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_146_10' id='label_123_146_10' class='gform-field-label gform-field-label--type-inline'>North Shore Academy (NSA) 8\/9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_146_11'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='Prime'  id='choice_123_146_11' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_146_11' id='label_123_146_11' class='gform-field-label gform-field-label--type-inline'>Prime\u2019<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_146_12'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='Pro Merita'  id='choice_123_146_12' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_146_12' id='label_123_146_12' class='gform-field-label gform-field-label--type-inline'>Pro Merita<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_244\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div style=\"background-color: #fc9003; padding: 23px 30px 15px; border-radius: 15px; display: flex; align-items: center;\">\n  <div style=\"flex: 0 0 auto;\">\n    <img decoding=\"async\" src=\"https:\/\/nides.sd71.bc.ca\/wp-content\/uploads\/2024\/02\/YieldSign_White.png\" alt=\"Yield Sign\" style=\"width: 120px;\"\/>\n  <\/div>\n  <div style=\"flex: 1; color: white; padding-left: 20px;\">\n    <h3 style=\"margin: 0; color: white;  font-size: 140%; font-weight: 400;\">Many of our Heartwood Learning Communities are full at this time. Please note that you will be added to a waitlist and we will contact you if there is a space available.<\/h3>\n  <\/div>\n<\/div>\n<\/div><div id=\"field_123_237\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><article id=\"program-description\"><\/article><\/div><fieldset id=\"field_123_213\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Heartwood Learning Communities<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_213'>\n\t\t\t<div class='gchoice gchoice_123_213_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Black Creek Farm and Forest K-9'  id='choice_123_213_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_0' id='label_123_213_0' class='gform-field-label gform-field-label--type-inline'>Black Creek Farm and Forest K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Burns Lake K-9'  id='choice_123_213_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_1' id='label_123_213_1' class='gform-field-label gform-field-label--type-inline'>Burns Lake K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Cobble Hill K-9'  id='choice_123_213_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_2' id='label_123_213_2' class='gform-field-label gform-field-label--type-inline'>Cobble Hill K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Cowichan Everwild K-9'  id='choice_123_213_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_3' id='label_123_213_3' class='gform-field-label gform-field-label--type-inline'>Cowichan Everwild K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Errington K-9'  id='choice_123_213_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_4' id='label_123_213_4' class='gform-field-label gform-field-label--type-inline'>Errington K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Golden K-9'  id='choice_123_213_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_5' id='label_123_213_5' class='gform-field-label gform-field-label--type-inline'>Golden K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Grand Forks K-9'  id='choice_123_213_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_6' id='label_123_213_6' class='gform-field-label gform-field-label--type-inline'>Grand Forks K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Hope K-4'  id='choice_123_213_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_7' id='label_123_213_7' class='gform-field-label gform-field-label--type-inline'>Hope K-4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_8'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Invermere Mt Nelson Junior Gr. 2-5'  id='choice_123_213_8' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_8' id='label_123_213_8' class='gform-field-label gform-field-label--type-inline'>Invermere Mt Nelson Junior Gr. 2-5<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_9'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Invermere Mt Nelson Middle  Gr. 6-9'  id='choice_123_213_9' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_9' id='label_123_213_9' class='gform-field-label gform-field-label--type-inline'>Invermere Mt Nelson Middle  Gr. 6-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_10'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Kamloops Imaginative Eco. K-3'  id='choice_123_213_10' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_10' id='label_123_213_10' class='gform-field-label gform-field-label--type-inline'>Kamloops Imaginative Eco. K-3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_11'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Kamloops Outdoor Ed K-9'  id='choice_123_213_11' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_11' id='label_123_213_11' class='gform-field-label gform-field-label--type-inline'>Kamloops Outdoor Ed K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_12'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Kaslo K-7'  id='choice_123_213_12' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_12' id='label_123_213_12' class='gform-field-label gform-field-label--type-inline'>Kaslo K-7<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_13'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Kelowna Outdoor K-9'  id='choice_123_213_13' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_13' id='label_123_213_13' class='gform-field-label gform-field-label--type-inline'>Kelowna Outdoor K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_14'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Kimberley\/Cranbrook K-8'  id='choice_123_213_14' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_14' id='label_123_213_14' class='gform-field-label gform-field-label--type-inline'>Kimberley\/Cranbrook K-8<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_15'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Kootenays Intermediate 7-9'  id='choice_123_213_15' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_15' id='label_123_213_15' class='gform-field-label gform-field-label--type-inline'>Kootenays Intermediate 7-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_16'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Kootenays - Krestova Outdoor K-6'  id='choice_123_213_16' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_16' id='label_123_213_16' class='gform-field-label gform-field-label--type-inline'>Kootenays - Krestova Outdoor K-6<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_17'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Kootenays Slocan Outdoor K-6'  id='choice_123_213_17' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_17' id='label_123_213_17' class='gform-field-label gform-field-label--type-inline'>Kootenays Slocan Outdoor K-6<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_18'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Kootenays-Winlaw Outdoor K-6'  id='choice_123_213_18' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_18' id='label_123_213_18' class='gform-field-label gform-field-label--type-inline'>Kootenays-Winlaw Outdoor K-6<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_19'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Mission K\u20135'  id='choice_123_213_19' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_19' id='label_123_213_19' class='gform-field-label gform-field-label--type-inline'>Mission K\u20135<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_20'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Nanaimo K\u20139'  id='choice_123_213_20' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_20' id='label_123_213_20' class='gform-field-label gform-field-label--type-inline'>Nanaimo K\u20139<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_21'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='OK Falls Intermediate 4-9'  id='choice_123_213_21' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_21' id='label_123_213_21' class='gform-field-label gform-field-label--type-inline'>OK Falls Intermediate 4-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_22'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='OK Falls Primary K-3'  id='choice_123_213_22' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_22' id='label_123_213_22' class='gform-field-label gform-field-label--type-inline'>OK Falls Primary K-3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_23'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Parsons K-9'  id='choice_123_213_23' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_23' id='label_123_213_23' class='gform-field-label gform-field-label--type-inline'>Parsons K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_24'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Port Alberni Outdoor K-9'  id='choice_123_213_24' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_24' id='label_123_213_24' class='gform-field-label gform-field-label--type-inline'>Port Alberni Outdoor K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_25'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Port Alberni - Sproat Lake Hybrid K-9'  id='choice_123_213_25' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_25' id='label_123_213_25' class='gform-field-label gform-field-label--type-inline'>Port Alberni - Sproat Lake Hybrid K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_26'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Prince George K-6'  id='choice_123_213_26' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_26' id='label_123_213_26' class='gform-field-label gform-field-label--type-inline'>Prince George K-6<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_27'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Quesnel Echen Healing Society K-3'  id='choice_123_213_27' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_27' id='label_123_213_27' class='gform-field-label gform-field-label--type-inline'>Quesnel Echen Healing Society K-3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_28'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Salmon Arm K-9'  id='choice_123_213_28' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_28' id='label_123_213_28' class='gform-field-label gform-field-label--type-inline'>Salmon Arm K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_29'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Saltspring Island K-5'  id='choice_123_213_29' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_29' id='label_123_213_29' class='gform-field-label gform-field-label--type-inline'>Saltspring Island K-5<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_30'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Smithers Hazelton K-9'  id='choice_123_213_30' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_30' id='label_123_213_30' class='gform-field-label gform-field-label--type-inline'>Smithers Hazelton K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_31'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Smithers Houston K-9'  id='choice_123_213_31' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_31' id='label_123_213_31' class='gform-field-label gform-field-label--type-inline'>Smithers Houston K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_32'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Smithers K-9'  id='choice_123_213_32' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_32' id='label_123_213_32' class='gform-field-label gform-field-label--type-inline'>Smithers Intermediate 3-5<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_33'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Smithers K-9'  id='choice_123_213_33' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_33' id='label_123_213_33' class='gform-field-label gform-field-label--type-inline'>Smithers Intermediate 6-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_34'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Smithers K-9'  id='choice_123_213_34' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_34' id='label_123_213_34' class='gform-field-label gform-field-label--type-inline'>Smithers Primary K-2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_35'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Sooke Outdoor K-4'  id='choice_123_213_35' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_35' id='label_123_213_35' class='gform-field-label gform-field-label--type-inline'>Sooke Outdoor K-4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_36'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Sooke Outdoor 5-9'  id='choice_123_213_36' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_36' id='label_123_213_36' class='gform-field-label gform-field-label--type-inline'>Sooke Outdoor 5-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_37'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Surrey K-9'  id='choice_123_213_37' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_37' id='label_123_213_37' class='gform-field-label gform-field-label--type-inline'>Surrey K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_38'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Tofino Fine Arts School 4-9'  id='choice_123_213_38' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_38' id='label_123_213_38' class='gform-field-label gform-field-label--type-inline'>Tofino 4-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_39'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Ucluelet Forest School 4-9'  id='choice_123_213_39' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_39' id='label_123_213_39' class='gform-field-label gform-field-label--type-inline'>Ucluelet Forest School 4-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_40'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Ucluelet Foundations K-3'  id='choice_123_213_40' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_40' id='label_123_213_40' class='gform-field-label gform-field-label--type-inline'>Ucluelet Foundations K-3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_41'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Victoria Colquitz Outdoor K-9'  id='choice_123_213_41' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_41' id='label_123_213_41' class='gform-field-label gform-field-label--type-inline'>Victoria Colquitz Outdoor K-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_42'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Victoria EPIC Outdoor K-5'  id='choice_123_213_42' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_42' id='label_123_213_42' class='gform-field-label gform-field-label--type-inline'>Victoria EPIC Outdoor K-5<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_43'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Victoria Intermediate 4-9'  id='choice_123_213_43' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_43' id='label_123_213_43' class='gform-field-label gform-field-label--type-inline'>Victoria Intermediate 4-9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_44'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Victoria Primary K-4'  id='choice_123_213_44' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_44' id='label_123_213_44' class='gform-field-label gform-field-label--type-inline'>Victoria Primary K-4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_45'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Victoria Westshore Outdoor K-6'  id='choice_123_213_45' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_45' id='label_123_213_45' class='gform-field-label gform-field-label--type-inline'>Victoria Westshore Outdoor K-6<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_46'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Windermere 3\u20139'  id='choice_123_213_46' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_46' id='label_123_213_46' class='gform-field-label gform-field-label--type-inline'>Windermere 3\u20139<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_213_47'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_213' type='radio' value='Yarrow Farm and Forest Outdoor K-7'  id='choice_123_213_47' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_213_47' id='label_123_213_47' class='gform-field-label gform-field-label--type-inline'>Yarrow Farm and Forest Outdoor K-7<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_249\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Compass Program Locations<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_249'>\n\t\t\t<div class='gchoice gchoice_123_249_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_249' type='radio' value='Comox Valley'  id='choice_123_249_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_249_0' id='label_123_249_0' class='gform-field-label gform-field-label--type-inline'>Comox Valley (Kindergarten \u2013 grade 9)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_249_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_249' type='radio' value='Nanaimo'  id='choice_123_249_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_249_1' id='label_123_249_1' class='gform-field-label gform-field-label--type-inline'>Nanaimo (grades 8-12)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_249_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_249' type='radio' value='Parksville'  id='choice_123_249_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_249_2' id='label_123_249_2' class='gform-field-label gform-field-label--type-inline'>Parksville (grades 8-12)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_257\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Prime&#039; Program Locations<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_257'>\n\t\t\t<div class='gchoice gchoice_123_257_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_257' type='radio' value='Nanaimo Baseball Academy'  id='choice_123_257_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_257_0' id='label_123_257_0' class='gform-field-label gform-field-label--type-inline'>Nanaimo Baseball Academy (grades 6\u201312)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_257_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_257' type='radio' value='Nanaimo Hockey Academy'  id='choice_123_257_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_257_1' id='label_123_257_1' class='gform-field-label gform-field-label--type-inline'>Nanaimo Hockey Academy (grades 6\u201312)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_258\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Pro Merita Program Locations<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_258'>\n\t\t\t<div class='gchoice gchoice_123_258_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_258' type='radio' value='Atomic Hockey Academy - Langley'  id='choice_123_258_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_258_0' id='label_123_258_0' class='gform-field-label gform-field-label--type-inline'>Atomic Hockey Academy (Langley - grades 4\u20137)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_258_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_258' type='radio' value='North Vancouver'  id='choice_123_258_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_258_1' id='label_123_258_1' class='gform-field-label gform-field-label--type-inline'>North Vancouver (grades 6\u201311)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_258_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_258' type='radio' value='Squamish'  id='choice_123_258_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_258_2' id='label_123_258_2' class='gform-field-label gform-field-label--type-inline'>Squamish (grades 5\u201311)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_251\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >If there is difficulty placing the student in the FAe program, would you be interested in our Compass program?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_251'>\n\t\t\t<div class='gchoice gchoice_123_251_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_251' type='radio' value='Yes'  id='choice_123_251_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_251_0' id='label_123_251_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_251_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_251' type='radio' value='No'  id='choice_123_251_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_251_1' id='label_123_251_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_252\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >If there is difficulty placing the student in the Compass program, would you be interested in our FAe program?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_252'>\n\t\t\t<div class='gchoice gchoice_123_252_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_252' type='radio' value='Yes'  id='choice_123_252_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_252_0' id='label_123_252_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_252_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_252' type='radio' value='No'  id='choice_123_252_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_252_1' id='label_123_252_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_254\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Would you also be interested in our Online Learning program?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_254'>\n\t\t\t<div class='gchoice gchoice_123_254_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_254' type='radio' value='Yes'  id='choice_123_254_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_254_0' id='label_123_254_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_254_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_254' type='radio' value='No'  id='choice_123_254_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_254_1' id='label_123_254_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_245\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_123_245'>Administrators Name<\/label><div class='ginput_container ginput_container_text'><input name='input_245' id='input_123_245' type='text' value='Meghan McMillen' class='small'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_123_226\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full program-notification-email field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_123_226'>Program Notification Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_226' id='input_123_226' type='email' value='Meghan.McMillen@sd71.bc.ca' class='small'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_123_5\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Student Information<\/h3><\/div><div id=\"field_123_211\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div style=\"padding: 30px 10px 30px 10px; border-radius: 10px; background-color:#ff4747; width:60%; margin: auto; color: white; text-align: center; font-size: 1.5rem;\">\nPlease contact <u><a href=\"mailto:meghan.mcmillen@sd71.bc.ca?subject=Re: Starting K-9 Immediately\" style=\"color: white; font-weight: bold;\">Meghan McMillen<\/a><\/u> to discuss starting immediately.\n<\/div><\/div><fieldset id=\"field_123_138\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Start Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_138'>\n\t\t\t<div class='gchoice gchoice_123_138_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_138' type='radio' value='September 2026'  id='choice_123_138_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_138_0' id='label_123_138_0' class='gform-field-label gform-field-label--type-inline'>September 2026<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_86\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_third gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_86'>Legal First Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_86' id='input_123_86' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_123_87\" class=\"gfield gfield--type-text gfield--input-type-text gf_middle_third gfield--width-third gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_87'>Legal Middle Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_87' id='input_123_87' type='text' value='' class='medium'  aria-describedby=\"gfield_description_123_87\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_123_87'>Or 'None' if not applicable<\/div><\/div><div id=\"field_123_88\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_third gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_88'>Legal Last Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_88' id='input_123_88' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_123_72\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Usual Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_123_72'>\n                            \n                            <span id='input_123_72_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_72.3' id='input_123_72_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_123_72_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_123_72_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_72.6' id='input_123_72_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_123_72_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><fieldset id=\"field_123_7\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datedropdown gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Date of Birth<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_123_7' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_dropdown_year ginput_container ginput_container_date gform-grid-col' id='input_123_7_3_container'><label for='input_123_7_3' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Year<\/label><select name='input_7[]' id='input_123_7_3'   aria-required='true'  ><option value=''>Year<\/option><option value='2027' >2027<\/option><option value='2026' >2026<\/option><option value='2025' >2025<\/option><option value='2024' >2024<\/option><option value='2023' >2023<\/option><option value='2022' >2022<\/option><option value='2021' >2021<\/option><option value='2020' >2020<\/option><option value='2019' >2019<\/option><option value='2018' >2018<\/option><option value='2017' >2017<\/option><option value='2016' >2016<\/option><option value='2015' >2015<\/option><option value='2014' >2014<\/option><option value='2013' >2013<\/option><option value='2012' >2012<\/option><option value='2011' >2011<\/option><option value='2010' >2010<\/option><option value='2009' >2009<\/option><option value='2008' >2008<\/option><option value='2007' >2007<\/option><option value='2006' >2006<\/option><option value='2005' >2005<\/option><option value='2004' >2004<\/option><option value='2003' >2003<\/option><option value='2002' >2002<\/option><option value='2001' >2001<\/option><option value='2000' >2000<\/option><option value='1999' >1999<\/option><option value='1998' >1998<\/option><option value='1997' >1997<\/option><option value='1996' >1996<\/option><option value='1995' >1995<\/option><option value='1994' >1994<\/option><option value='1993' >1993<\/option><option value='1992' >1992<\/option><option value='1991' >1991<\/option><option value='1990' >1990<\/option><option value='1989' >1989<\/option><option value='1988' >1988<\/option><option value='1987' >1987<\/option><option value='1986' >1986<\/option><option value='1985' >1985<\/option><option value='1984' >1984<\/option><option value='1983' >1983<\/option><option value='1982' >1982<\/option><option value='1981' >1981<\/option><option value='1980' >1980<\/option><option value='1979' >1979<\/option><option value='1978' >1978<\/option><option value='1977' >1977<\/option><option value='1976' >1976<\/option><option value='1975' >1975<\/option><option value='1974' >1974<\/option><option value='1973' >1973<\/option><option value='1972' >1972<\/option><option value='1971' >1971<\/option><option value='1970' >1970<\/option><option value='1969' >1969<\/option><option value='1968' >1968<\/option><option value='1967' >1967<\/option><option value='1966' >1966<\/option><option value='1965' >1965<\/option><option value='1964' >1964<\/option><option value='1963' >1963<\/option><option value='1962' >1962<\/option><option value='1961' >1961<\/option><option value='1960' >1960<\/option><option value='1959' >1959<\/option><option value='1958' >1958<\/option><option value='1957' >1957<\/option><option value='1956' >1956<\/option><option value='1955' >1955<\/option><option value='1954' >1954<\/option><option value='1953' >1953<\/option><option value='1952' >1952<\/option><option value='1951' >1951<\/option><option value='1950' >1950<\/option><option value='1949' >1949<\/option><option value='1948' >1948<\/option><option value='1947' >1947<\/option><option value='1946' >1946<\/option><option value='1945' >1945<\/option><option value='1944' >1944<\/option><option value='1943' >1943<\/option><option value='1942' >1942<\/option><option value='1941' >1941<\/option><option value='1940' >1940<\/option><option value='1939' >1939<\/option><option value='1938' >1938<\/option><option value='1937' >1937<\/option><option value='1936' >1936<\/option><option value='1935' >1935<\/option><option value='1934' >1934<\/option><option value='1933' >1933<\/option><option value='1932' >1932<\/option><option value='1931' >1931<\/option><option value='1930' >1930<\/option><option value='1929' >1929<\/option><option value='1928' >1928<\/option><option value='1927' >1927<\/option><option value='1926' >1926<\/option><option value='1925' >1925<\/option><option value='1924' >1924<\/option><option value='1923' >1923<\/option><option value='1922' >1922<\/option><option value='1921' >1921<\/option><option value='1920' >1920<\/option><\/select><\/div><div class='gfield_date_dropdown_month ginput_container ginput_container_date gform-grid-col' id='input_123_7_1_container'><label for='input_123_7_1' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Month<\/label><select name='input_7[]' id='input_123_7_1'   aria-required='true'  ><option value=''>Month<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><\/select><\/div><div class='gfield_date_dropdown_day ginput_container ginput_container_date gform-grid-col' id='input_123_7_2_container'><label for='input_123_7_2' class='gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text'>Day<\/label><select name='input_7[]' id='input_123_7_2'   aria-required='true'  ><option value=''>Day<\/option><option value='1' >1<\/option><option value='2' >2<\/option><option value='3' >3<\/option><option value='4' >4<\/option><option value='5' >5<\/option><option value='6' >6<\/option><option value='7' >7<\/option><option value='8' >8<\/option><option value='9' >9<\/option><option value='10' >10<\/option><option value='11' >11<\/option><option value='12' >12<\/option><option value='13' >13<\/option><option value='14' >14<\/option><option value='15' >15<\/option><option value='16' >16<\/option><option value='17' >17<\/option><option value='18' >18<\/option><option value='19' >19<\/option><option value='20' >20<\/option><option value='21' >21<\/option><option value='22' >22<\/option><option value='23' >23<\/option><option value='24' >24<\/option><option value='25' >25<\/option><option value='26' >26<\/option><option value='27' >27<\/option><option value='28' >28<\/option><option value='29' >29<\/option><option value='30' >30<\/option><option value='31' >31<\/option><\/select><\/div><\/div><\/fieldset><fieldset id=\"field_123_6\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Gender<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_6'>\n\t\t\t<div class='gchoice gchoice_123_6_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='Male'  id='choice_123_6_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_6_0' id='label_123_6_0' class='gform-field-label gform-field-label--type-inline'>Male<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_6_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='Female'  id='choice_123_6_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_6_1' id='label_123_6_1' class='gform-field-label gform-field-label--type-inline'>Female<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_6_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='Prefer to Self-Describe'  id='choice_123_6_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_6_2' id='label_123_6_2' class='gform-field-label gform-field-label--type-inline'>Prefer to Self-Describe<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_206\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_206'>Your preferred gender description:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_206' id='input_123_206' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_123_24\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you of First Nations, Metis, Inuit, or Indigenous ancestry?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_24'>\n\t\t\t<div class='gchoice gchoice_123_24_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='No Ancestry'  id='choice_123_24_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_24_0' id='label_123_24_0' class='gform-field-label gform-field-label--type-inline'>No Ancestry<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_24_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='Status - On Reserve'  id='choice_123_24_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_24_1' id='label_123_24_1' class='gform-field-label gform-field-label--type-inline'>Status - On Reserve<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_24_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='Status - Off Reserve'  id='choice_123_24_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_24_2' id='label_123_24_2' class='gform-field-label gform-field-label--type-inline'>Status - Off Reserve<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_24_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='Non Status (with ancestry)'  id='choice_123_24_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_24_3' id='label_123_24_3' class='gform-field-label gform-field-label--type-inline'>Non Status (with ancestry)<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_24_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='Metis'  id='choice_123_24_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_24_4' id='label_123_24_4' class='gform-field-label gform-field-label--type-inline'>Metis<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_24_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_24' type='radio' value='Inuit'  id='choice_123_24_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_24_5' id='label_123_24_5' class='gform-field-label gform-field-label--type-inline'>Inuit<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_131\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class=\"form-message\"><h3 style=\"color:white;\">Self-Identification<\/h3><hr><p>Self-identified means if a student (parent\/guardian) identifies themselves as having Indigenous ancestry then they qualify to receive service from Indigenous Education Services.<\/p><p>No one is required to provide 'proof' of ancestry when they self declare (e.g. Status card.) Indigenous ancestry can go back several generations.<\/p><\/div><\/div><div id=\"field_123_132\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Residency &amp; Citizenship<\/h3><\/div><div id=\"field_123_75\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p style=\"color:blue\">You must be a resident of BC to register with Navigate-NIDES.<\/p>\n<p style=\"color:blue\">If you have any questions please contact us at 1-800-663-7925<\/p><\/div><fieldset id=\"field_123_13\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Resident of British Columbia?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_13'>\n\t\t\t<div class='gchoice gchoice_123_13_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='Yes'  id='choice_123_13_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_13_0' id='label_123_13_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_13_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_13' type='radio' value='No'  id='choice_123_13_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_13_1' id='label_123_13_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_144\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div class=\"message-box\"><h3 style=\"font-size: 1.4rem;\">IMPORTANT<\/h3><hr>\n<p>If you are sending an image of your BC Driver's License or BC Care Card \/ Services Card  - please note that we only need an image of the <u>FRONT<\/u> of the card.<\/p><\/div><\/div><div id=\"field_123_208\" class=\"gfield gfield--type-image_hopper gfield--input-type-image_hopper gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_208'>Proof of Residency Upload<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_image_hopper gform-theme__no-reset--children'><input\n\t\tname=\"input_208\"\n\t\tid=\"input_123_208\"\n\t\ttype=\"file\"\n\t\tclass=\" \"\n\t\t\n\t\t\n\t\taria-required=\"true\"\n\t\taria-invalid=\"false\"\n\t\tdata-image-resize-target-height='1400'\n\t\tdata-image-resize-target-width='1400'\n\t\tdata-max-files='1'\n\t\t\n\t\t\t\n\t\tdata-max-file-size=\"20MB\"\n\t\tdata-image-transform-output-quality=\"90\"\n\t\tdata-allow-image-crop=\"false\"\n\t\tdata-image-resize-upscale=\"false\"\n\t\tdata-image-validate-size-min-width=\"1\"\n\t\tdata-image-validate-size-min-height=\"1\"\n\t\tdata-image-transform-output-quality-mode=\"optional\"\n\t\tdata-form-id=\"123\"\n\t\tdata-field-id=\"208\"\n\t\tdata-files=\"\"\n\t\tdata-nonce=\"f6363e55fa\"\n\t\tdata-min-image-warning=\"\"\n\t\tdata-min-image-warning-width=\"\"\n\t\tdata-min-image-warning-height=\"\"\n\t\tdata-editor='{&quot;enableEditor&quot;:true,&quot;instantEdit&quot;:false,&quot;cropToSize&quot;:&quot;&quot;,&quot;upscaleImageToCropSize&quot;:&quot;&quot;,&quot;defaultEditorView&quot;:&quot;field_crop&quot;,&quot;defaultFilter&quot;:&quot;&quot;,&quot;editorAppearance&quot;:&quot;auto&quot;,&quot;markupDefaultColor&quot;:&quot;#ff4136&quot;,&quot;markupDefaultTool&quot;:&quot;&quot;,&quot;enabledFeatures&quot;:{&quot;field_crop&quot;:true,&quot;field_rotate_left&quot;:true,&quot;field_rotate_right&quot;:true,&quot;field_manual_rotation&quot;:true}}' \/><\/div><div class='gfield_description' id='gfield_description_123_208'>Acceptable proof of Residency includes images of: BC Care Card \/ Services Card, BC ID Card, BC Driver's License, or current utility bill.<\/div><\/div><fieldset id=\"field_123_14\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Citizenship Status<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_14'>\n\t\t\t<div class='gchoice gchoice_123_14_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Canadian Citizen'  id='choice_123_14_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_14_0' id='label_123_14_0' class='gform-field-label gform-field-label--type-inline'>Canadian Citizen<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_14_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_14' type='radio' value='Landed Immigrant'  id='choice_123_14_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_14_1' id='label_123_14_1' class='gform-field-label gform-field-label--type-inline'>Landed Immigrant<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_209\" class=\"gfield gfield--type-image_hopper gfield--input-type-image_hopper gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_209'>Proof of Student&#039;s Canadian Citizenship Upload<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_image_hopper gform-theme__no-reset--children'><input\n\t\tname=\"input_209\"\n\t\tid=\"input_123_209\"\n\t\ttype=\"file\"\n\t\tclass=\" \"\n\t\t\n\t\t\n\t\taria-required=\"true\"\n\t\taria-invalid=\"false\"\n\t\tdata-image-resize-target-height='1000'\n\t\tdata-image-resize-target-width='1000'\n\t\tdata-max-files='1'\n\t\t\n\t\t\t\n\t\tdata-max-file-size=\"20MB\"\n\t\tdata-image-transform-output-quality=\"90\"\n\t\tdata-allow-image-crop=\"false\"\n\t\tdata-image-resize-upscale=\"false\"\n\t\tdata-image-validate-size-min-width=\"1\"\n\t\tdata-image-validate-size-min-height=\"1\"\n\t\tdata-image-transform-output-quality-mode=\"optional\"\n\t\tdata-form-id=\"123\"\n\t\tdata-field-id=\"209\"\n\t\tdata-files=\"\"\n\t\tdata-nonce=\"46be6b0385\"\n\t\tdata-min-image-warning=\"\"\n\t\tdata-min-image-warning-width=\"\"\n\t\tdata-min-image-warning-height=\"\"\n\t\tdata-editor='{&quot;enableEditor&quot;:true,&quot;instantEdit&quot;:false,&quot;cropToSize&quot;:&quot;&quot;,&quot;upscaleImageToCropSize&quot;:&quot;&quot;,&quot;defaultEditorView&quot;:&quot;field_crop&quot;,&quot;defaultFilter&quot;:&quot;&quot;,&quot;editorAppearance&quot;:&quot;auto&quot;,&quot;markupDefaultColor&quot;:&quot;#ff4136&quot;,&quot;markupDefaultTool&quot;:&quot;&quot;,&quot;enabledFeatures&quot;:{&quot;field_crop&quot;:true,&quot;field_rotate_left&quot;:true,&quot;field_rotate_right&quot;:true,&quot;field_manual_rotation&quot;:true}}' \/><\/div><div class='gfield_description' id='gfield_description_123_209'>Acceptable proof of Canadian Citizenship: Birth Certificate, Passport, or Permanent Resident Card. We require proof of the student's citizenship - not parent's \/ guardian's citizenship information.<\/div><\/div><div id=\"field_123_12\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Student Information<\/h3><\/div><div id=\"field_123_109\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_109'>Primary language spoken in the home<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_109' id='input_123_109' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_123_8\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_8'>Home Phone:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_8' id='input_123_8' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_123_15\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Home Address:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_123_15' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_123_15_1_container' >\n                                        <label for='input_123_15_1' id='input_123_15_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_15.1' id='input_123_15_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_123_15_2_container' >\n                                        <label for='input_123_15_2' id='input_123_15_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_15.2' id='input_123_15_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_123_15_3_container' >\n                                    <label for='input_123_15_3' id='input_123_15_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_15.3' id='input_123_15_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_123_15_4_container' >\n                                        <label for='input_123_15_4' id='input_123_15_4_label' class='gform-field-label gform-field-label--type-sub '>Province<\/label>\n                                        <select name='input_15.4' id='input_123_15_4'     aria-required='true'    ><option value='' ><\/option><option value='Alberta' >Alberta<\/option><option value='British Columbia' selected='selected'>British Columbia<\/option><option value='Manitoba' >Manitoba<\/option><option value='New Brunswick' >New Brunswick<\/option><option value='Newfoundland and Labrador' >Newfoundland and Labrador<\/option><option value='Northwest Territories' >Northwest Territories<\/option><option value='Nova Scotia' >Nova Scotia<\/option><option value='Nunavut' >Nunavut<\/option><option value='Ontario' >Ontario<\/option><option value='Prince Edward Island' >Prince Edward Island<\/option><option value='Quebec' >Quebec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><option value='Yukon' >Yukon<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_123_15_5_container' >\n                                    <label for='input_123_15_5' id='input_123_15_5_label' class='gform-field-label gform-field-label--type-sub '>Postal Code<\/label>\n                                    <input type='text' name='input_15.5' id='input_123_15_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_15.6' id='input_123_15_6' value='Canada' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><fieldset id=\"field_123_40\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >My mailing address is...<\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_40'>\n\t\t\t<div class='gchoice gchoice_123_40_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='the same as my home address'  id='choice_123_40_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_40_0' id='label_123_40_0' class='gform-field-label gform-field-label--type-inline'>the same as my home address<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_40_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_40' type='radio' value='different from my home address'  id='choice_123_40_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_40_1' id='label_123_40_1' class='gform-field-label gform-field-label--type-inline'>different from my home address<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_16\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Mailing Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_123_16' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_123_16_1_container' >\n                                        <label for='input_123_16_1' id='input_123_16_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_16.1' id='input_123_16_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_123_16_2_container' >\n                                        <label for='input_123_16_2' id='input_123_16_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                        <input type='text' name='input_16.2' id='input_123_16_2' value=''     aria-required='false'   \/>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_123_16_3_container' >\n                                    <label for='input_123_16_3' id='input_123_16_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_16.3' id='input_123_16_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_123_16_4_container' >\n                                        <label for='input_123_16_4' id='input_123_16_4_label' class='gform-field-label gform-field-label--type-sub '>Province<\/label>\n                                        <select name='input_16.4' id='input_123_16_4'     aria-required='true'    ><option value='' ><\/option><option value='Alberta' >Alberta<\/option><option value='British Columbia' selected='selected'>British Columbia<\/option><option value='Manitoba' >Manitoba<\/option><option value='New Brunswick' >New Brunswick<\/option><option value='Newfoundland and Labrador' >Newfoundland and Labrador<\/option><option value='Northwest Territories' >Northwest Territories<\/option><option value='Nova Scotia' >Nova Scotia<\/option><option value='Nunavut' >Nunavut<\/option><option value='Ontario' >Ontario<\/option><option value='Prince Edward Island' >Prince Edward Island<\/option><option value='Quebec' >Quebec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><option value='Yukon' >Yukon<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_123_16_5_container' >\n                                    <label for='input_123_16_5' id='input_123_16_5_label' class='gform-field-label gform-field-label--type-sub '>Postal Code<\/label>\n                                    <input type='text' name='input_16.5' id='input_123_16_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_16.6' id='input_123_16_6' value='Canada' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_123_114\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Guardian \/ Parent #1 Information<\/h3><\/div><fieldset id=\"field_123_19\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name of Parent \/ Guardian #1<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_123_19'>\n                            \n                            <span id='input_123_19_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_19.3' id='input_123_19_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_123_19_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_123_19_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_19.6' id='input_123_19_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_123_19_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_123_20\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_20'>Relationship To Student<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_123_20' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_123_188\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this guardian\/parent&#039;s home address the same as the student home address?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_188'>\n\t\t\t<div class='gchoice gchoice_123_188_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_188' type='radio' value='Yes, they live at the same address'  id='choice_123_188_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_188_0' id='label_123_188_0' class='gform-field-label gform-field-label--type-inline'>Yes, they live at the same address<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_188_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_188' type='radio' value='No, it&#039;s a different address'  id='choice_123_188_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_188_1' id='label_123_188_1' class='gform-field-label gform-field-label--type-inline'>No, it's a different address<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_92\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Primary Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_123_92' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_123_92_1_container' >\n                                        <label for='input_123_92_1' id='input_123_92_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_92.1' id='input_123_92_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_123_92_3_container' >\n                                    <label for='input_123_92_3' id='input_123_92_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_92.3' id='input_123_92_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_123_92_4_container' >\n                                        <label for='input_123_92_4' id='input_123_92_4_label' class='gform-field-label gform-field-label--type-sub '>Province<\/label>\n                                        <select name='input_92.4' id='input_123_92_4'     aria-required='true'    ><option value='' ><\/option><option value='Alberta' >Alberta<\/option><option value='British Columbia' selected='selected'>British Columbia<\/option><option value='Manitoba' >Manitoba<\/option><option value='New Brunswick' >New Brunswick<\/option><option value='Newfoundland and Labrador' >Newfoundland and Labrador<\/option><option value='Northwest Territories' >Northwest Territories<\/option><option value='Nova Scotia' >Nova Scotia<\/option><option value='Nunavut' >Nunavut<\/option><option value='Ontario' >Ontario<\/option><option value='Prince Edward Island' >Prince Edward Island<\/option><option value='Quebec' >Quebec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><option value='Yukon' >Yukon<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_123_92_5_container' >\n                                    <label for='input_123_92_5' id='input_123_92_5_label' class='gform-field-label gform-field-label--type-sub '>Postal Code<\/label>\n                                    <input type='text' name='input_92.5' id='input_123_92_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_92.6' id='input_123_92_6' value='Canada' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_123_204\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br>\n<hr><\/div><div id=\"field_123_202\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_202'>Phone - Home<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_202' id='input_123_202' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_123_119\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_119'>Phone - Cell<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_119' id='input_123_119' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_123_122\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_122'>Parent\/Guardian #1 Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_122' id='input_123_122' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><fieldset id=\"field_123_184\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Would you like to add a second Parent\/Guardian?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_184'>\n\t\t\t<div class='gchoice gchoice_123_184_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_184' type='radio' value='Yes'  id='choice_123_184_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_184_0' id='label_123_184_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_184_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_184' type='radio' value='No'  id='choice_123_184_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_184_1' id='label_123_184_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_116\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Guardian \/ Parent #2 Information<\/h3><\/div><fieldset id=\"field_123_21\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Name of Parent \/ Guardian #2<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_123_21'>\n                            \n                            <span id='input_123_21_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_21.3' id='input_123_21_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_123_21_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_123_21_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_21.6' id='input_123_21_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_123_21_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_123_22\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_22'>Relationship To Student<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_22' id='input_123_22' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_123_189\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is this guardian\/parent&#039;s home address the same as the student home address?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_189'>\n\t\t\t<div class='gchoice gchoice_123_189_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_189' type='radio' value='Yes, they live at the same address'  id='choice_123_189_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_189_0' id='label_123_189_0' class='gform-field-label gform-field-label--type-inline'>Yes, they live at the same address<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_189_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_189' type='radio' value='No, it&#039;s a different address'  id='choice_123_189_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_189_1' id='label_123_189_1' class='gform-field-label gform-field-label--type-inline'>No, it's a different address<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_117\" class=\"gfield gfield--type-address gfield--input-type-address gfield_contains_required field_sublabel_above gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Primary Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend>    \n                    <div class='ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row' id='input_123_117' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_123_117_1_container' >\n                                        <label for='input_123_117_1' id='input_123_117_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                        <input type='text' name='input_117.1' id='input_123_117_1' value=''    aria-required='true'    \/>\n                                   <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_123_117_3_container' >\n                                    <label for='input_123_117_3' id='input_123_117_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                    <input type='text' name='input_117.3' id='input_123_117_3' value=''    aria-required='true'    \/>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_123_117_4_container' >\n                                        <label for='input_123_117_4' id='input_123_117_4_label' class='gform-field-label gform-field-label--type-sub '>Province<\/label>\n                                        <select name='input_117.4' id='input_123_117_4'     aria-required='true'    ><option value='' ><\/option><option value='Alberta' >Alberta<\/option><option value='British Columbia' selected='selected'>British Columbia<\/option><option value='Manitoba' >Manitoba<\/option><option value='New Brunswick' >New Brunswick<\/option><option value='Newfoundland and Labrador' >Newfoundland and Labrador<\/option><option value='Northwest Territories' >Northwest Territories<\/option><option value='Nova Scotia' >Nova Scotia<\/option><option value='Nunavut' >Nunavut<\/option><option value='Ontario' >Ontario<\/option><option value='Prince Edward Island' >Prince Edward Island<\/option><option value='Quebec' >Quebec<\/option><option value='Saskatchewan' >Saskatchewan<\/option><option value='Yukon' >Yukon<\/option><\/select>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_123_117_5_container' >\n                                    <label for='input_123_117_5' id='input_123_117_5_label' class='gform-field-label gform-field-label--type-sub '>Postal Code<\/label>\n                                    <input type='text' name='input_117.5' id='input_123_117_5' value=''    aria-required='true'    \/>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_117.6' id='input_123_117_6' value='Canada' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/fieldset><div id=\"field_123_205\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><br>\n<hr><\/div><div id=\"field_123_203\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_203'>Phone - Home<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_203' id='input_123_203' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_123_121\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_121'>Phone - Cell<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_121' id='input_123_121' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_123_123\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_123'>Parent\/Guardian #2 Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_123' id='input_123_123' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_123_18\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Living Arrangements<\/h3><\/div><fieldset id=\"field_123_112\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Legal Alert<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_112'>\n\t\t\t<div class='gchoice gchoice_123_112_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_112' type='radio' value='Yes'  id='choice_123_112_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_112_0' id='label_123_112_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_112_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_112' type='radio' value='No'  id='choice_123_112_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_112_1' id='label_123_112_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_113\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Court Order<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_113'>\n\t\t\t<div class='gchoice gchoice_123_113_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_113' type='radio' value='Yes'  id='choice_123_113_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_113_0' id='label_123_113_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_113_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_113' type='radio' value='No'  id='choice_123_113_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_113_1' id='label_123_113_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_115\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_115'>Is there any other information you wish to add relating to the Legal Alert \/ Court Order?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_115' id='input_123_115' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_123_232\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"padding: 15px 20px 10px; background-color: #ffb970; border-radius: 4px;\">\n<h4>Please provide our office with any relevant documentation relating to the legal alert \/ court order.<\/h4>\n<\/div><\/div><div id=\"field_123_233\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_123_233'>Legal Alert \/ Court Order Notification Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_233' id='input_123_233' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_123_185\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Emergency Contact<\/h3><\/div><fieldset id=\"field_123_175\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Emergency Contact #1 Name:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_123_175'>\n                            \n                            <span id='input_123_175_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_175.3' id='input_123_175_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_123_175_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_123_175_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_175.6' id='input_123_175_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_123_175_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_123_176\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_176'>Emergency Contact #1 Phone Number:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_176' id='input_123_176' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_123_177\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_177'>Emergency Contact #1 Relationship to Student:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_177' id='input_123_177' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_123_187\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Would you like to add a second Emergency Contact?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_187'>\n\t\t\t<div class='gchoice gchoice_123_187_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_187' type='radio' value='Yes'  id='choice_123_187_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_187_0' id='label_123_187_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_187_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_187' type='radio' value='No'  id='choice_123_187_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_187_1' id='label_123_187_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_186\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Emergency Contact #2<\/h3><\/div><fieldset id=\"field_123_180\" class=\"gfield gfield--type-name gfield--input-type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Emergency Contact #2 Name:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_123_180'>\n                            \n                            <span id='input_123_180_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_180.3' id='input_123_180_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_123_180_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_123_180_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_180.6' id='input_123_180_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_123_180_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/fieldset><div id=\"field_123_181\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_181'>Emergency Contact #2 Phone Number:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_181' id='input_123_181' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_123_182\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_182'>Emergency Contact #2 Relationship to Student:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_182' id='input_123_182' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_123_25\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Medical Information<\/h3><\/div><div id=\"field_123_26\" class=\"gfield gfield--type-number gfield--input-type-number gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_26'>Student&#039;s Care Card \/ Services Card Number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_number'><input name='input_26' id='input_123_26' type='number' step='any'   value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"  \/><\/div><\/div><div id=\"field_123_31\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_31'>Any allergies or health conditions?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_31' id='input_123_31' class='textarea medium'  aria-describedby=\"gfield_description_123_31\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_123_31'>(Enter 'none' if there are no allergies or health conditions)<\/div><\/div><fieldset id=\"field_123_32\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Is it life threatening?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_32'>\n\t\t\t<div class='gchoice gchoice_123_32_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='Yes'  id='choice_123_32_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_32_0' id='label_123_32_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_32_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_32' type='radio' value='No'  id='choice_123_32_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_32_1' id='label_123_32_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_96\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does your child require medication?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_96'>\n\t\t\t<div class='gchoice gchoice_123_96_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_96' type='radio' value='Yes'  id='choice_123_96_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_96_0' id='label_123_96_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_96_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_96' type='radio' value='No'  id='choice_123_96_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_96_1' id='label_123_96_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_74\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_74'>Please indicate the medication and the procedure for administering it. For example - will someone at the school be required to assist with medication?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_74' id='input_123_74' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_123_234\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_123_234'>Medical Alert Notification Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_234' id='input_123_234' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_123_33\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Education<\/h3><\/div><fieldset id=\"field_123_38\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Does the student have an IEP (Individualized Education Plan) - either currently or in the past?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_38'>\n\t\t\t<div class='gchoice gchoice_123_38_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='Yes'  id='choice_123_38_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_123_38\"   \/>\n\t\t\t\t\t<label for='choice_123_38_0' id='label_123_38_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_38_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='No'  id='choice_123_38_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_38_1' id='label_123_38_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_38_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_38' type='radio' value='I don&#039;t know'  id='choice_123_38_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_38_2' id='label_123_38_2' class='gform-field-label gform-field-label--type-inline'>I don't know<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_123_38'>If your child has an IEP or designation and you do not declare it here, it may impact your enrolment.<\/div><\/fieldset><div id=\"field_123_235\" class=\"gfield gfield--type-email gfield--input-type-email gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><label class='gfield_label gform-field-label' for='input_123_235'>IEP Notification Email<\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_235' id='input_123_235' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_123_214\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">IEP Questions<\/h3><\/div><div id=\"field_123_215\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>Please complete the questions below and please note that one of our administrators will contact you prior to finalizing this registration.<\/p><\/div><div id=\"field_123_216\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_216'>Please provide the student&#039;s Ministry Designation (if you don&#039;t know the student&#039;s Ministry Designation, please enter &#039;unknown&#039;)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_216' id='input_123_216' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_123_217\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Please indicate which support the student has received (currently or in the past)<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_217'><div class='gchoice gchoice_123_217_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_217.1' type='checkbox'  value='Speech Language Pathologist'  id='choice_123_217_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_217_1' id='label_123_217_1' class='gform-field-label gform-field-label--type-inline'>Speech Language Pathologist<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_123_217_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_217.2' type='checkbox'  value='Occupational Therapist'  id='choice_123_217_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_217_2' id='label_123_217_2' class='gform-field-label gform-field-label--type-inline'>Occupational Therapist<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_123_217_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_217.3' type='checkbox'  value='Physical Therapist'  id='choice_123_217_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_217_3' id='label_123_217_3' class='gform-field-label gform-field-label--type-inline'>Physical Therapist<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_123_217_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_217.4' type='checkbox'  value='Counseling'  id='choice_123_217_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_217_4' id='label_123_217_4' class='gform-field-label gform-field-label--type-inline'>Counseling<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_123_217_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_217.5' type='checkbox'  value='Behavioural Interventionist'  id='choice_123_217_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_217_5' id='label_123_217_5' class='gform-field-label gform-field-label--type-inline'>Behavioural Interventionist<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_123_217_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_217.6' type='checkbox'  value='Teacher of the Visually Impaired'  id='choice_123_217_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_217_6' id='label_123_217_6' class='gform-field-label gform-field-label--type-inline'>Teacher of the Visually Impaired<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_123_217_7'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_217.7' type='checkbox'  value='Teacher of the Deaf and Hard of Hearing'  id='choice_123_217_7'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_217_7' id='label_123_217_7' class='gform-field-label gform-field-label--type-inline'>Teacher of the Deaf and Hard of Hearing<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_123_217_8'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_217.8' type='checkbox'  value='Academic Supports'  id='choice_123_217_8'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_217_8' id='label_123_217_8' class='gform-field-label gform-field-label--type-inline'>Academic Supports<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_123_217_9'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_217.9' type='checkbox'  value='Other'  id='choice_123_217_9'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_217_9' id='label_123_217_9' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_225\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_225'>Type of Support<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_225' id='input_123_225' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_123_218\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >Is the student currently enrolled in any of the following programs?<\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_218'><div class='gchoice gchoice_123_218_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.1' type='checkbox'  value='Gifted'  id='choice_123_218_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_218_1' id='label_123_218_1' class='gform-field-label gform-field-label--type-inline'>Gifted<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_123_218_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.2' type='checkbox'  value='Alternate'  id='choice_123_218_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_218_2' id='label_123_218_2' class='gform-field-label gform-field-label--type-inline'>Alternate<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_123_218_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.3' type='checkbox'  value='Resource Room'  id='choice_123_218_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_218_3' id='label_123_218_3' class='gform-field-label gform-field-label--type-inline'>Resource Room<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_123_218_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.4' type='checkbox'  value='Learning Assistance'  id='choice_123_218_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_218_4' id='label_123_218_4' class='gform-field-label gform-field-label--type-inline'>Learning Assistance<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_123_218_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.5' type='checkbox'  value='English as a Second Language'  id='choice_123_218_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_218_5' id='label_123_218_5' class='gform-field-label gform-field-label--type-inline'>English as a Second Language<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_123_218_6'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_218.6' type='checkbox'  value='Other'  id='choice_123_218_6'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_218_6' id='label_123_218_6' class='gform-field-label gform-field-label--type-inline'>Other<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_224\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_224'>Name of Program<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_224' id='input_123_224' type='text' value='' class='large'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_123_219\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_219'>Additional comments that may assist us in planning the student&#039;s program<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_219' id='input_123_219' class='textarea small'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_123_45\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Previous Education<\/h3><\/div><fieldset id=\"field_123_46\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Are you currently enrolled with Navigate-NIDES?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_46'>\n\t\t\t<div class='gchoice gchoice_123_46_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='Yes'  id='choice_123_46_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_46_0' id='label_123_46_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_46_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_46' type='radio' value='No'  id='choice_123_46_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_46_1' id='label_123_46_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_239\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><!--\n\n<div style=\"background-color: #ff7a7a; padding: 10px; border-radius: 5px; text-align: center;\">\n<p style=\"color: white;\"><u style=\"font-size: 200%; \">This form is currently only accepting applications for Kindergarten students!<\/u><br><strong style=\"color: white; margin-bottom: 10px;\">It is not a mistake that only Kindergarten is listed below, this form is not yet open for grades 1-9<\/strong>.<br><br> Applications for all grades will be accepted starting <u>February 20th.<\/u><\/p>\n<\/div>\n\n--><\/div><fieldset id=\"field_123_47\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Grade you are applying for (September 2026)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_47'>\n\t\t\t<div class='gchoice gchoice_123_47_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='K'  id='choice_123_47_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_47_0' id='label_123_47_0' class='gform-field-label gform-field-label--type-inline'>K<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_47_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='1'  id='choice_123_47_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_47_1' id='label_123_47_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_47_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='2'  id='choice_123_47_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_47_2' id='label_123_47_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_47_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='3'  id='choice_123_47_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_47_3' id='label_123_47_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_47_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='4'  id='choice_123_47_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_47_4' id='label_123_47_4' class='gform-field-label gform-field-label--type-inline'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_47_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='5'  id='choice_123_47_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_47_5' id='label_123_47_5' class='gform-field-label gform-field-label--type-inline'>5<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_47_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='6'  id='choice_123_47_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_47_6' id='label_123_47_6' class='gform-field-label gform-field-label--type-inline'>6<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_47_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='7'  id='choice_123_47_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_47_7' id='label_123_47_7' class='gform-field-label gform-field-label--type-inline'>7<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_47_8'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='8'  id='choice_123_47_8' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_47_8' id='label_123_47_8' class='gform-field-label gform-field-label--type-inline'>8<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_47_9'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_47' type='radio' value='9'  id='choice_123_47_9' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_47_9' id='label_123_47_9' class='gform-field-label gform-field-label--type-inline'>9<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_50\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_50'>Name of last school<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_50' id='input_123_50' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_123_51\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_51'>Reasons for withdrawal:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_123_51' type='text' value='' class='medium'  aria-describedby=\"gfield_description_123_51\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_123_51'>(Enter 'none' if student was not at another school)<\/div><\/div><div id=\"field_123_52\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_52'>Location of last school:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_52' id='input_123_52' type='text' value='' class='medium'  aria-describedby=\"gfield_description_123_52\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_123_52'>(Enter 'none' if student was not at another school)<\/div><\/div><fieldset id=\"field_123_90\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Navigate-NIDES will become my home school (School of Record)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_90'>\n\t\t\t<div class='gchoice gchoice_123_90_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_90' type='radio' value='I understand'  id='choice_123_90_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_90_0' id='label_123_90_0' class='gform-field-label gform-field-label--type-inline'>I understand<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_236\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"padding: 15px 20px 10px; background-color: #ffb970; border-radius: 4px;\">\n<h4>Please note that if you wish to enroll a sibling, each student must complete a separate registration form.<\/h4>\n<\/div><\/div><div id=\"field_123_150\" class=\"gfield gfield--type-section gfield--input-type-section gsection permissions-section-header field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Permissions<\/h3><div class='gsection_description' id='gfield_description_123_150'>We reserve the right to make changes to the following Permission Forms at any time. If we make any changes, we will update this website to include such changes. Such changes will be effective when posted.<\/div><\/div><div id=\"field_123_151\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Canadian Anti-Spam Legislation Consent<\/h3><\/div><div id=\"field_123_152\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"background-color: #ffeab5; padding: 10px 20px; border-radius: 15px;\">\n<p>Canada\u2019s anti-spam legislation came into force on July 01, 2014. As a result, School District No. 71 (Comox Valley) would like to ensure that we have your consent to send you newsletters, announcements and other electronic messages which may contain advertising or promotions including field trips, fundraising, yearbooks, student pictures, school activities, or similar events and offers that would be considered Commercial Electronic Messages under the legislation.<\/p>\n<p>If you have any questions, please contact us at:\n<table>\n    <tr>\n        <td style=\"width: 30%;\"><strong>School District Information and Privacy Officer<\/strong><\/td>\n        <td><\/td>\n    <\/tr>\n    <tr>\n        <td><strong>Business Address:<\/strong><\/td>\n        <td>607 Cumberland Road<\/td>\n    <\/tr>\n    <tr>\n        <td><\/td>\n        <td>Courtenay, BC<\/td>\n    <\/tr>\n    <tr>\n        <td><\/td>\n        <td>V9N 7G5<\/td>\n    <\/tr>\n    <tr>\n        <td><strong>Telephone No.:<\/strong><\/td>\n        <td>250-334-5500<\/td>\n    <\/tr>\n<\/table>\n<p>You may withdraw your consent at any time by communicating directly with the school in writing. Failure to \n provide alternative consent, will mean you will not receive certain communications from the school or School Board Office that would be considered Commercial Electronic Messages.<\/p>\n<\/div><\/div><fieldset id=\"field_123_153\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Canadian Anti-Spam Legislation Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_153'>\n\t\t\t<div class='gchoice gchoice_123_153_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_153' type='radio' value='Yes, I have read the above text and consent to receiving newsletters, announcements and other electronic messages from Navigate-NIDES and Comox Valley Schools'  id='choice_123_153_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_153_0' id='label_123_153_0' class='gform-field-label gform-field-label--type-inline'>Yes, I have read the above text and consent to receiving newsletters, announcements and other electronic messages from Navigate-NIDES and Comox Valley Schools<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_153_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_153' type='radio' value='No, I do not consent'  id='choice_123_153_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_153_1' id='label_123_153_1' class='gform-field-label gform-field-label--type-inline'>No, I do not consent<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_159\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Navigate-NIDES Code of Conduct<\/h3><\/div><div id=\"field_123_160\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"background-color: #ffeab5; padding: 8px 0 1px 10px; border-radius: 5px; margin: 10px 0; font-size: medium; padding-bottom: 5px;\"><u><a style=\"color: black;\" href=\"http:\/\/www.navigatenides.com\/wp-content\/uploads\/2018\/05\/Code-of-Conduct.pdf\" target=\"_blank\" rel=\"noopener\">Link to the Code of Conduct<\/u><\/a><\/div><\/div><fieldset id=\"field_123_161\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >I have read the Code of Conduct and understand my child&#039;s responsibilities<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_161'><div class='gchoice gchoice_123_161_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_161.1' type='checkbox'  value='I agree'  id='choice_123_161_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_161_1' id='label_123_161_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_168\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Outside Media Consent<\/h3><\/div><div id=\"field_123_169\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"background-color: #ffeab5; border-radius: 5px; margin: 10px 0; font-size: medium; padding: 20px 30px; color: black;\">I have read the information contained in the <u><a style=\"color: black;\" href=\"https:\/\/www.navigatenides.com\/wp-content\/uploads\/2018\/05\/Consent-for-Outside-Media.pdf\" target=\"_blank\" rel=\"noopener\">Outside Media Consent<\/u><\/a> and understand that outside media may on occasion be authorized by the school to be present at the school, at school events or at public events where students are present. I understand that the School does not control the images or material printed by external media, and that it is my responsibility to communicate with the school if I have a concern about the collection of my child's image or information by external media that are authorized by the school to be present on school property or at school events.<\/div><\/div><fieldset id=\"field_123_170\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Outside Media Consent response:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_170'>\n\t\t\t<div class='gchoice gchoice_123_170_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_170' type='radio' value='Yes, I agree that my child&#039;s image may be published by outside media.'  id='choice_123_170_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_170_0' id='label_123_170_0' class='gform-field-label gform-field-label--type-inline'>Yes, I agree that my child's image may be published by outside media.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_170_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_170' type='radio' value='No, I do not authorize outside media to have access to my child or any information or images of my child for publication. (I understand my child will not be in the graduation insert in the newspaper - if applicable.)'  id='choice_123_170_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_170_1' id='label_123_170_1' class='gform-field-label gform-field-label--type-inline'>No, I do not authorize outside media to have access to my child or any information or images of my child for publication. (I understand my child will not be in the graduation insert in the newspaper - if applicable.)<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_171\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Personal Information Consent<\/h3><\/div><div id=\"field_123_172\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"background-color: #ffeab5; border-radius: 5px; margin: 10px 0; font-size: medium; padding: 20px 30px; color: black;\"><p>I have read the information contained in the <u><a href=\"http:\/\/www.navigatenides.com\/wp-content\/uploads\/2018\/05\/Personal-Information-Consent.pdf\" target=\"_blank\" rel=\"noopener\">Personal Information Consent<\/a><\/u> and understand that outside media may on occasion collect photographs, video or electronic images of students or their work for publication on the School's website or in other publications for the purposes of recognizing student or school achievement, promoting school activities or events, or informing the school community and members of the public about school programs and activities.<\/p><\/div><\/div><fieldset id=\"field_123_173\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >Personal Information Consent response:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_173'>\n\t\t\t<div class='gchoice gchoice_123_173_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_173' type='radio' value='Yes, I consent to the collection, use and disclosure of my child&#039;s image and work product for the purposes described above and in the Personal Information Consent.'  id='choice_123_173_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_173_0' id='label_123_173_0' class='gform-field-label gform-field-label--type-inline'>Yes, I consent to the collection, use and disclosure of my child's image and work product for the purposes described above and in the Personal Information Consent.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_173_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_173' type='radio' value='No, I do not consent to the use of my child&#039;s image or work product as described above.'  id='choice_123_173_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_173_1' id='label_123_173_1' class='gform-field-label gform-field-label--type-inline'>No, I do not consent to the use of my child's image or work product as described above.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_162\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Technology Rights and Responsibilities<\/h3><\/div><div id=\"field_123_163\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"background-color: #ffeab5; padding: 8px 0 1px 10px; border-radius: 5px; margin: 10px 0; font-size: medium; padding-bottom: 5px;\"><u><a style=\"color: black;\" href=\"https:\/\/www.navigatenides.com\/wp-content\/uploads\/2018\/05\/Technology-Rights-and-Responsibilites.pdf\" target=\"_blank\" rel=\"noopener\">Link to the Technology Rights and Responsibilities<\/u><\/a><\/div><\/div><fieldset id=\"field_123_164\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >I have read the Technology Rights and Responsibilities document and understand my child&#039;s responsibilities<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_164'><div class='gchoice gchoice_123_164_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_164.1' type='checkbox'  value='I agree'  id='choice_123_164_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_164_1' id='label_123_164_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_165\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">School Emergency Program Guide<\/h3><\/div><div id=\"field_123_166\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"background-color: #ffeab5; padding: 8px 0 1px 10px; border-radius: 5px; margin: 10px 0; font-size: medium; padding-bottom: 5px;\"><u><a style=\"color: black;\" href=\"https:\/\/www.navigatenides.com\/wp-content\/uploads\/2018\/05\/School-Emergency-Program-info-Guide.pdf\" target=\"_blank\" rel=\"noopener\">Link to the School Emergency Program Guide<\/u><\/a><\/div><\/div><fieldset id=\"field_123_167\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >I have read and understand the School Emergency Program Guide<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_167'><div class='gchoice gchoice_123_167_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_167.1' type='checkbox'  value='I agree'  id='choice_123_167_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_167_1' id='label_123_167_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_190\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Media &amp; Website Consent of Storage &amp; Access of Information<\/h3><\/div><div id=\"field_123_192\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"background-color: #ffeab5; padding: 8px 0 1px 10px; border-radius: 5px; margin: 10px 0; font-size: medium; padding-bottom: 5px;\"><u><a style=\"color: black;\" href=\"https:\/\/www.navigatenides.com\/wp-content\/uploads\/2018\/05\/Media-_-Website-Consent-for-Storage-_-Access-of-Info_2016.pdf\" target=\"_blank\" rel=\"noopener\">Media & Website Consent of Storage & Access of Information link<\/u><\/a><\/div><\/div><fieldset id=\"field_123_193\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >I have read and understand the Media &amp; Website Consent of Storage &amp; Access of Information<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_193'><div class='gchoice gchoice_123_193_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_193.1' type='checkbox'  value='I agree'  id='choice_123_193_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_193_1' id='label_123_193_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_154\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Google Apps for Education (GAFE) Permission<\/h3><\/div><div id=\"field_123_194\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"background-color: #ffeab5; padding: 8px 0 1px 10px; border-radius: 5px; margin: 10px 0; font-size: medium; padding-bottom: 5px;\"><u><a style=\"color: black;\" href=\"https:\/\/www.navigatenides.com\/wp-content\/uploads\/2021\/02\/GAFE_Permission.pdf\" target=\"_blank\" rel=\"noopener\">Link to the Google Apps for Education (GAFE) Permission Form<\/u><\/a><\/div><\/div><fieldset id=\"field_123_156\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >GAFE Consent:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_156'>\n\t\t\t<div class='gchoice gchoice_123_156_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_156' type='radio' value='Yes, I agree to the collection, use, disclosure and storage of my child\u2019s personal information inside or outside of Canada while using the technology described above for the purposes of engaging in the class activities described above. I am aware of and understand the identifiable privacy risks as described above and will support the classroom teacher in minimizing the exposure of my child\u2019s and other people\u2019s personal information while my child is using the technology and review materials the teacher provides.'  id='choice_123_156_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_123_156\"   \/>\n\t\t\t\t\t<label for='choice_123_156_0' id='label_123_156_0' class='gform-field-label gform-field-label--type-inline'>Yes, I agree to the collection, use, disclosure and storage of my child\u2019s personal information inside or outside of Canada while using the technology described above for the purposes of engaging in the class activities described above. I am aware of and understand the identifiable privacy risks as described above and will support the classroom teacher in minimizing the exposure of my child\u2019s and other people\u2019s personal information while my child is using the technology and review materials the teacher provides.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_156_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_156' type='radio' value='No, I do not agree to the collection, use, disclosure and storage of my child\u2019s personal information inside or outside of Canada while using the technology described above for the purposes of engaging in the class activities described above.'  id='choice_123_156_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_156_1' id='label_123_156_1' class='gform-field-label gform-field-label--type-inline'>No, I do not agree to the collection, use, disclosure and storage of my child\u2019s personal information inside or outside of Canada while using the technology described above for the purposes of engaging in the class activities described above.<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_123_156'>This consent is valid for the duration of the student\u2019s enrollment at Navigate-NIDES unless revoked by me in writing and delivered to the teacher.<\/div><\/fieldset><div id=\"field_123_221\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">SeeSaw Consent<\/h3><\/div><div id=\"field_123_222\" class=\"gfield gfield--type-html gfield--input-type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><div style=\"background-color: #ffeab5; padding: 8px 0 1px 10px; border-radius: 5px; margin: 10px 0; font-size: medium; padding-bottom: 5px;\"><u><a style=\"color: black;\" href=\"https:\/\/www.navigatenides.com\/index.php\/seesaw-consent-form\/\" target=\"_blank\" rel=\"noopener\">Link to the SeeSaw Consent page<\/u><\/a><\/div><\/div><fieldset id=\"field_123_223\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label' >SeeSaw Consent<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_123_223'>\n\t\t\t<div class='gchoice gchoice_123_223_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_223' type='radio' value='Yes, I have read the SeeSaw Consent text and consent to its use'  id='choice_123_223_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_223_0' id='label_123_223_0' class='gform-field-label gform-field-label--type-inline'>Yes, I have read the SeeSaw Consent text and consent to its use<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_123_223_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_223' type='radio' value='No, I do not consent'  id='choice_123_223_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_123_223_1' id='label_123_223_1' class='gform-field-label gform-field-label--type-inline'>No, I do not consent<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_134\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Confirmations<\/h3><\/div><fieldset id=\"field_123_207\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >The Applicant understands that enrolling in an online education program requires an up-to-date computer and operating system. A printer and internet access are also required. Primary students will need paper, pencils, as well as basic art supplies such as scissors and crayons.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_207'><div class='gchoice gchoice_123_207_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_207.1' type='checkbox'  value='I agree'  id='choice_123_207_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_207_1' id='label_123_207_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_53\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >The Applicant confirms that the information in this form is accurate and complete, that the Applicant(s) have the legal right to enroll the student in Navigate-NIDES; and that enrollment remains valid for seven months (extensions granted with Teacher permission.)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_53'><div class='gchoice gchoice_123_53_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_53.1' type='checkbox'  value='I agree'  id='choice_123_53_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_53_1' id='label_123_53_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_55\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >The Applicant agrees to meet formally with the assigned Navigate-NIDES teacher (face-to-face or virtually) to develop and sign a Student Learning Plan document for each student.  The Applicant agrees to consistent and regular engagement with the learning which includes weekly submissions of student work and weekly communication with the Navigate-NIDES teacher.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_55'><div class='gchoice gchoice_123_55_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_55.1' type='checkbox'  value='I agree'  id='choice_123_55_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_55_1' id='label_123_55_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_56\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >The applicant understands that if the student becomes inactive and does not meet the goals and outcomes established in the Student Learning Plan, that he\/she may be referred to enroll in a school program elsewhere.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_56'><div class='gchoice gchoice_123_56_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_56.1' type='checkbox'  value='I agree'  id='choice_123_56_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_56_1' id='label_123_56_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_58\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >The Applicant hereby authorizes the release of all previous records to Navigate-NIDES, and authorizes Navigate-NIDES to report to schools, school districts, or post-secondary institutions where records exist.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_58'><div class='gchoice gchoice_123_58_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_58.1' type='checkbox'  value='I agree'  id='choice_123_58_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_58_1' id='label_123_58_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_59\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >The Applicant agrees that he\/she will submit official documents that confirm BC Residency (i.e. digital copy of Care Card \/ Services Card, Drivers License, or recent utility bill), as well as proof of official citizenship status (i.e. digital copy of Birth Certificate, Permanent Resident Card, or Visas) upon registration.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_59'><div class='gchoice gchoice_123_59_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_59.1' type='checkbox'  value='I agree'  id='choice_123_59_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_59_1' id='label_123_59_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_60\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >The Applicant declares that the student and legal guardian are ordinarily resident in British Columbia, and if traveling outside of the province of BC, the Applicant will inform the registrar (registrar@sd71.bc.ca) in writing of their intended return date to British Columbia.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_60'><div class='gchoice gchoice_123_60_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_60.1' type='checkbox'  value='I agree'  id='choice_123_60_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_60_1' id='label_123_60_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_210\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >The Applicant hereby authorizes the release of all previous records (including confidential files) to Navigate-NIDES, and authorizes Navigate-NIDES to report to schools, school districts, or post-secondary institutions where records exist.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_210'><div class='gchoice gchoice_123_210_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_210.1' type='checkbox'  value='I agree'  id='choice_123_210_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_210_1' id='label_123_210_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_61\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >By completing this form and submitting it, it is assumed that the Applicant agrees to the above conditions of enrollment.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_61'><div class='gchoice gchoice_123_61_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_61.1' type='checkbox'  value='I agree'  id='choice_123_61_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_61_1' id='label_123_61_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_123_91\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >I consent to receive Indigenous Student Support from Navigate.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_91'><div class='gchoice gchoice_123_91_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_91.1' type='checkbox'  value='I agree'  id='choice_123_91_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_91_1' id='label_123_91_1' class='gform-field-label gform-field-label--type-inline'>I agree<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_123_62\" class=\"gfield gfield--type-textarea gfield--input-type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_62'>Questions\/Comments<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_62' id='input_123_62' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><div id=\"field_123_136\" class=\"gfield gfield--type-signature gfield--input-type-signature field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_123_136'>Parent\/Guardian&#039;s Signature:<\/label><input type='hidden' value='' name='input_136' id='input_123_136_signature_filename'\/><div class='gfield_signature_ui_container gform-theme__no-reset--children' ><div id='input_123_136_Container' class='gfield_signature_container ginput_container' style='height:180px; width:300px; ' ><canvas id='input_123_136' width='300' height='180' style='border-style: Dashed; border-width: 2px; border-color: #DDDDDD; background-color:#FFFFFF; cursor: url(https:\/\/nides.sd71.bc.ca\/wp-content\/plugins\/gravityformssignature\/assets\/img\/pen.cur), pointer;'><\/canvas><\/div><div id='input_123_136_toolbar' style='margin:5px 0;position:relative;height:20px;width:300px;max-width:100%;'><img id = 'input_123_136_resetbutton' src='data:image\/png;base64,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' style='cursor:pointer;float:right;height:24px;width:24px;border:0px solid transparent' alt='Clear Signature' \/ ><\/div><input type='hidden' id='input_123_136_data' name='input_123_136_data' value=''><\/div><\/div><fieldset id=\"field_123_147\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' >*IMPORTANT* - Email Confirmation of Submission<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_123_147'><div class='gchoice gchoice_123_147_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_147.1' type='checkbox'  value='I am aware that I will receive an email confirmation within 15 minutes of submitting this form. If no confirmation arrives, then my registration was not received and I will need to resubmit. [Please check that it is not in your junk mail folder.]'  id='choice_123_147_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_123_147_1' id='label_123_147_1' class='gform-field-label gform-field-label--type-inline'>I am aware that I will receive an email confirmation within 15 minutes of submitting this form. If no confirmation arrives, then my registration was not received and I will need to resubmit. [Please check that it is not in your junk mail folder.]<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><\/div><\/div>\n        <div class='gform-footer gform_footer top_label'> <input type='submit' id='gform_submit_button_123' class='gform_button button' onclick='gform.submission.handleButtonClick(this);' data-submission-type='submit' value='Submit'  \/> \n            <input type='hidden' class='gform_hidden' name='gform_submission_method' data-js='gform_submission_method_123' value='postback' \/>\n            <input type='hidden' class='gform_hidden' name='gform_theme' data-js='gform_theme_123' id='gform_theme_123' value='gravity-theme' \/>\n            <input type='hidden' class='gform_hidden' name='gform_style_settings' data-js='gform_style_settings_123' id='gform_style_settings_123' value='[]' \/>\n            <input type='hidden' class='gform_hidden' name='is_submit_123' value='1' \/>\n            <input type='hidden' class='gform_hidden' name='gform_submit' value='123' 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