Enrollment Demo

For Office Use

Admission Date

Student Number

Start Date

Registration Fee Paid

Program Selection

Daycare Options

Full Day (12:30 - 17:30) Half Day (12:30 - 15:00)

Other (specify):

Creche Options

Full Day (07:30 - 17:30) Half Day (07:30 - 13:00)

Other (specify):

Student Details

Surname

Name

Gender

Preferred Name

Date of Birth

Current Age

ID Number

Current School

Contact Person at Current School

Contact Number at Current School

Home Language

Medical Information

Medical Aid

Medical Aid Number

Family Doctor

Doctor Contact Number

Medical Conditions (including allergies, physical, and learning conditions)

Behavioral/Developmental Information (including fears, speech difficulties, habits)

Does your child require any medication

Toilet Training - needs help?

Yes No

Details if they need help

Parent/Guardian Details

Father/Guardian

Surname

Full Names

ID Number

Work Number

Cell Number

Email Address

Residential Address

Mother/Guardian

Surname

Full Names

ID Number

Work Number

Cell Number

Email Address

Residential Address

Who may collect the student from enrollment

Who is responsible for the fees

Emergency Contact (other than parent)

Name

Relation to student

Cell Number

Tel Number

Banking Details

Bank

Branch Code

Account Name

Account Type

Account Number

Payment Reference

Fees are paid in advance before the 1st of every month.

EFT or direct deposit is accepted unless otherwise arranged.

1 Months' notice must be given in writing before the 1st of the month (for Aftercare children).

Agreements

I/we hereby accept the responsibility of paying all fees for my child that are due to enrollment. I/we agree that in the event of non-payment of school fees, after exhaustion of all other options, my/our outstanding account will be handed over.

I/we hereby acknowledge the one months' notice from the 1st of the month must be given in writing and notice for the following year must be given by the end of October (for Aftercare children).

I have read the above instructions and information and understand and accept the contents thereof.

Indemnities

General Indemnity

I/we, the undersigned, being the legal guardian/s of the above-named child, do hereby waive all and any claims against owners or personnel or employees of enrollment, from any liability howsoever caused, arising out of the injury, sickness or death of the above-named child and/or injury to the above-named child caused by other children to such child when such child is under the care of the owners or personnel or employees at enrollment.

In the event of the above-named child having to be removed from the care of enrollment facility at the request of either parent/guardian, with or without the consent of the absent parent/guardian, then such request shall be deemed to be a request by both parents/guardians and the owners or personnel, or employees of enrollment shall be required to hand said child to such parent/guardian making the request.

By signing this form, I confirm that I have read and understood the Indemnities and agree to the terms outlined above.

Student's Full Name

Date

Parent/Guardian Signature

Medical Indemnity

In the event of any injury being caused to the above-named child, howsoever caused, we authorise the owners/personnel/employees of enrollment to instruct a Medical Practitioner to treat the said child at the discretion of such Practitioner, and that I/we accept full responsibility for any medical expenses relating hereto. Further, I/we authorise the said owners/personnel/employees to take the said child to the Medicross or Linmed for treatment and/or to engage an ambulance to affect such treatment.

By signing this form, I confirm that I have read and understood the Medical Indemnity and agree to the terms outlined above.

POPIA (Protection of Personal Information Act) Consent

As part of our commitment to ensuring the privacy and protection of all children in our care, we comply with the Protection of Personal Information Act (POPIA). We request that parents or guardians provide consent for the collection and use of personal information, including photographs of their child, for purposes related to the aftercare and holiday club activities.

Please read the following options and select your preference:

1. Sharing of Photos and Videos

I hereby give permission for photographs and videos of my child to be taken during aftercare and holiday club activities. These images may be shared with other parents or used in our internal communications.

Yes, I consent to my child's photos being shared. No, I do not consent to my child's photos being shared.

2. Personal Information Use

I acknowledge that any personal information provided will be used solely for the purpose of providing care and communicating with parents regarding aftercare and holiday club activities. This information will not be shared with third parties without prior consent, unless required by law.

By signing this form, I confirm that I have read and understood the POPIA consent and agree to the terms outlined above.

Student's Full Name

Date

Parent/Guardian Signature

Document Upload

Birth Certificate

Upload a scan of the student's birth certificate (PDF, JPG, PNG)

ID Document (if applicable)

Immunization Records

Previous Report Card (if applicable)

For Office Use

Program Selection

Daycare Options

Creche Options

Student Details

Medical Information

Parent/Guardian Details

Father/Guardian

Mother/Guardian

Emergency Contact (other than parent)

Banking Details

Agreements

Indemnities

General Indemnity

Medical Indemnity

POPIA (Protection of Personal Information Act) Consent

1. Sharing of Photos and Videos

2. Personal Information Use

Document Upload

Enrollment Summary