SQUIRRELS PLAYGROUP AND DAYCARE CENTRE. WELLINGTON SCHOOL TEL:

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Gladys Rice
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1 SQUIRRELS PLAYGROUP AND DAYCARE CENTRE Successful futures are built on solid foundations REG NO: 13/3/1/245 Est.1987 WELLINGTON SCHOOL TEL: PAARL SCHOOL TEL: SECTION A: APPLICANT S INFORMATION Name of child (Surname) (First names) Gender Date of birth Day Month Year Date of entry Day Month Year Year Group Religious affiliation First language Other languages spoken Nationality Citizenship If not a citizen of South Africa has he/she. Permanent residence Temporary residence 1

2 SECTION B: PARENTS INFORMATION Relationship to child Parent 1 Parent 2 Surname First name Title ID Number Marital status Nationality Home telephone number Work Telephone number Cellular number Facsimile number address Physical address Postcode Postal address Postcode Occupation Employer s name Employer s address 2

3 SECTION C: MEDICAL INFORMATION Family Doctor Telephone number Name of medical scheme Medical aid number Name of alternative contact person for emergencies Relationship to child Telephone number Serious allergies/medical conditions Specify medication your child is on Please attach a copy of your child s Clinic Card as well as a copy of their Birth Certificate to this Application Form SECTION D: FAMILY DETAILS Other siblings Name Position in family Age 3

4 SECTION E: PAYMENT OF MONIES Fees are payable over a12 Month period. All fees must be paid in advance on or before the 1st of a month. Fees are not refundable for illness or absence due to the child going on holiday. Fees must be paid into the Schools Banking Account either by Debit Order or Internet Banking. No cash may be paid into the bank account, but may be paid directly to me. Please use your child s name as reference for all banking transactions. Late payment of fees will result in your child not being allowed to attend the school and should we for some reason have to hand unpaid accounts over for collection, you the parent will be responsible for all additional legal feesan Attorney-Own Client scale for collectionof said amountsin arrears. Interest of 2,5% per month will be charged on any amounts in arrears.. BANKING DETAILS (Wellington School) H.S.van Dyk Attorneys ABSA Bank Paarl Account Number: (cheque account) (Paarl School) The Oaks Preparatory School Nedbank Paarl Branch Code: Account Number:

5 Name of Parent responsible for payment of school fees: Contact name Address Postcode Telephone number Fax number Cellular number SECTION F: PAYMENT OF REGISTRATION FEE A registration fee of R is payable on registration of a child. Please note that this Registration Fee is non- refundable even if the child does not take up their place in the school. It can also not be deducted from any other payment made. SECTION G: PLEASE NOTE THAT ONE FULL MONTHS WRITTEN NOTICE OR ONE FULL MONTHS FEES IS REQUIRED IF YOU SHOULD DECIDE TO REMOVE YOUR CHILD FROM OUR SCHOOL/CENTRE FOR ANY REASON. THIS NOTICE MUST BE HANDED IN ON THE LAST DAY OF MONTH. NOTICE MAY NOT BE GIVEN IN THE MIDDLE OF A MONTH! Signed at on day of 20 Signature of Mother Signature of Father 5

6 SECTION H: SUGGESTION: All posessions of children should be clearly marked with permanent marker or lable to ensure against loss or confusion. For Office Use METHOD OF PAYMENT Registration Cash Cash Cheque Bank transfer Date Receipt number Fees 6

7 INDEMNITY/AUTHORITY FORM: I / We as parents/guardian of my/our child hereby accept that the principal and staff of Squirrels Playschool and Daycare shall not be liable for any damage or injury what so ever caused, provided that all reasonable precautions have been taken to ensure the safety and wellbeing of my/our child while in attendance at the school. I /we also grant permission for them to transport my / our child to an emergency facility should this be necessary. I further accept that I/we shall be responsible for all medical and hospital expenses for my / our child arising from injury or accident ( including, but not limited to, those related to any allergic condition present) and hereby indemnify the principal and staff against such costs. I accept that the school is not responsible for the loss of clothes or toys that have not been properly marked and confirm that I have read and accepted the rules as outlined in the Prospectus. I also confirm that I will pay all school fees on time as indicated. Monthly Fees: Payable on or before the 1 st day of the month. SIGNED AT ON THIS DAY OF 20 FATHER MOTHER WITNESS I / we and staff undertake to ensure that all precautions within our control and ability will be undertaken to ensure the good care of your child, to ensure your child s security and happy wellbeing during his/her stay at Squirrels. SIGNED SQUIRRELS PRINCIPAL 7

ADMISSION FORM. Surname: Name: Gender: Grade: Date of birth: Surname: Surname: Name: Name: ID number: ID number: Profession: Profession:

ADMISSION FORM. Surname: Name: Gender: Grade: Date of birth: Surname: Surname: Name: Name: ID number: ID number: Profession: Profession: ADMISSION FORM LEARNER Surname: Name: Gender: Grade: Date of birth: PARENTS/GUARDIANS FATHER MOTHER Surname: Surname: Name: Name: ID number: ID number: Profession: Profession: Tel. no: (W) Tel. no: (W)