Download Medical and First Aid policy.
Start Date (New): ______________
Deposit Paid Date New)(: _____
First Name __________________ Home Language __________________
Middle Name __________________ Previous School __________________
Last Name __________________ Religion __________________
Date of Birth __________________ Age __________________
ID Number __________________ Sex __________________ Class __________________
Street Address __________________ Siblings & ages __________________
Postal Address __________________ __________________ __________________ __________________
Parents and Guardians
Mothers Name __________________ Fathers Name __________________
Mother (H) __________________ Father (H) __________________
Mother (W) __________________ Father (W) __________________
Mother (Cell) __________________ Father (Cell) __________________
Mothers E-Mail __________________ Fathers E-Mail __________________
Mothers Occupation __________________ Fathers Occupation __________________
Mothers Company __________________ Fathers Company __________________
Marital Status __________________ Collected By __________________
Please submit a copy of your child’s Immunisation Card
Doctors Name __________________ Emergency Name __________________
Doctors Contact __________________ Emergency Contact __________________
Medical Aid __________________ Emergency Contact __________________
Medical Aid No __________________
Medical Problems _________________________________________________________
(Measles, German Measles, Chicken Pox, Mumps, Hepatitis, Scarlet Fever, Whooping Cough, others)
I__________________________________________________ the parent / legal guardian of
___________________________________________________ declare that the above given
Information is correct and I agree to abide by the Little Scholars rules and regulations, terms and conditions and policies.
Parent ID ________________________
TERMS AND CONDITIONS
I ____________________________________________ the undersigned hereby agree to the following terms and conditions for the enrolment of:
______________________________________________________ ( Full name of child)
¨ The school operates between 07H15 until 17H30
¨ The following fees are payable:
1. A non-refundable fee of R792.00 plus the first months school fees
2. Annually complete and agree to Monthly fees i.e. complete “undertaking to pay school fees’ document.
3. Agree to pay and understand late fee penalty.
4. Agree to pay and understand late pick up penalty.
Extra Mural activities are optional and these fees are payable in advance by term to the applicable persons.
¨ Fees will increase in January every year.
¨ Termination of Enrolment:
The school requires one calendar month’s written notice by the first of the month, otherwise a full month’s fees will be payable. The fees for the notice period are payable whether or not your child attends school. Any notice given on the first day of October or November will not exempt you from the liability of paying December fees.
¨ December and January fees are compulsory.
¨ The principal uses her own discretion for the right of admission or further attendance. If a child has been requested to leave the schoo,l then a full months fees are payable.
¨ The school is responsible only to the person who signed this form concerning any matter relative to the child. In the event of any dispute between two parties and controversial instructions, we will use our own discretion and are not responsible for the consequences.
¨ The principle or any other member of the schools staff is not responsible for any damages or injury due to accidents, or any other mishaps, during the entire period of attendance.
¨ I, the undersigned accept that all reasonable precautions will be taken to ensure the safety and welfare of my child. However, should any damage or injury be suffered, or sustained by the child, I shall be liable for the payment of all medical and / or hospital accounts in connection herewith. I hereby expressly waive any claim and / or indemnify the school against any claims, whatsoever, in respect of any such damage and / or injury.
¨ I, the undersigned, hereby give my permission for my child to be taken to a doctor and / or hospital in the event of an emergency.
¨ In the event of any change of address, email or phone number, I will be responsible to advise the school.
¨ In the event of any dishonour, I agree to pay all attorneys and own client costs for collection of my debt.
¨ No responsibility will be accepted for clothes and other items that have not been properly marked.
¨ No member of the Little Scholars staff may be poached by any parent, relative, or, friend.
I have read and understood all the terms and conditions and will abide by them.
NB - Please enclose/attach a copy of your ID, your child’s birth certificate and your child’s immunization card. ( Only new enrolments)
Signed by: ________________________ in Sandton on this ____ (day) of______ (month) 20___ (year)
Witness 1 ____________________________ Witness 2 ___________________________