APPLICATION FOR ADMISSION

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Matilda Griffith
5 years ago
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1 APPLICATION FOR ADMISSION PLEASE COMPLETE ALL SECTIONS Initial every page. Photograph Year of Entry: Grade to Enter: Start Date: Learner s Full Name: Learners Full Surname: Date of Birth: Position in Family: No. of Siblings: ID/Passport Number: Home Language: Present School name: School contact no: School Extra-mural interests: List of Allergies List of Chronic Illnesses: Leaners: Height: Weight: Estimated Drop-Off time: Estimated Pick-up Time: Emergency Contact Person 1: Name: Number: Emergency Contact Person 2: Name: Number: 1 P a g e

2 Person Responsible for Account Full Name and Surname: Parent/ Guardians Details Father s or Legal Guardian s Full Name: Mother s or Legal Guardian s Full Name: ID number: ID number: Postal Address: Postal Address: Home Address: Home Address: Work Phone: Home Phone: Cell Phone: address: Occupation: Employer Details: Employer Physical Address: Work Phone: Home Phone: Cell Phone: address: Occupation: Employer Details: Employer Physical Address: Net Salary: Net Salary: The following documents must accompany the Application Form: The non-refundable application fee of R (FOUR HUNDRED AND TWENTY RAND) should accompany this form via a Deposit/EFT payment. 1. Banking Details and reference: Learner s name and surname; Name: Elandspark Private Academy (Pty) LTD Bank: First National Bank Account Number: Type: Current Account Branch Code: Certified copy of the Learner s birth certificate or Identity document; 3. Latest School reports for Grade R and Primary Level 4. Certified copies of Learner s school report i.e. latest end of year report or latest term report; 5. Proof of Learner s immunisation and/or vaccines; 6. Certified ID copies of both Parent(s)/Guardian(s); 7. Proof of Residential Address, (if Parent(s)/Guardian(s) live apart then proof of address for both Parent(s)/Guardian(s); and 8. Proof of Parent(s)/Guardian(s) salary advise; I/ We, the undersigned,, hereby give my/our consent for Elands Park Private Academy School ( EPA ) to conduct credit checks on me/us and acquire such other information as may be necessary to assess my/our credit history, which may involve information being requested from any registered credit bureau. Date: Signature: Name: Date: Signature: Name: 2 P a g e

3 ALL LEARNER ENROLMENTS AT EPA ARE SUBJECT TO THE BELOW TERMS AND CONDITIONS WHICH YOU, AS PARENT(S)/GUARDIAN(S) AND/OR LEGAL GUARDIAN, CONSENT TO UPON SIGNATURE OF THIS APPLICATION FORM Terms and Conditions: 1. Subject to any relevant legislation, EPA reserves the right to, within its sole discretion, refuse or grant the Learner s admission application. 2. In the event that EPA provisionally accepts the admission of the Learner, an acceptance fee of two thousand rand will be required before such provisional acceptance will be regarded as final. 3. It is essential that all Parent(s)/Guardian(s) ensure that EPA is notified, in writing, of any change in his/her/their personal details provided in page 1 above. 4. This contract shall commence on the Start Date and shall continue for a period of 24 (TWENTY-FOUR) months. The Parent(s)/Guardian(s) may cancel this contract at any stage during the aforementioned fixed term period by providing EPA with 20 (TWENTY) business days written notice thereof. 5. EPA may terminate this contract at any time provided that the Learner or Parent(s)/Guardian(s) failed to rectify a material breach of this contract within a period of 20 (TWENTY) business days after having been required to do so in terms of clause 15 below. 6. Upon the Parent(s)/Guardian(s) cancellation of this contract, as per clause 4 above, the Parent(s)/Guardian(s) will remain liable to EPA for any and all fees owed to EPA, in terms of this contract, up to date of cancellation; together with an early cancellation penalty of 1(ONE) school term s fees. 7. Save for gross negligence on the part of EPA, its officers, directors, shareholders, employees, agents or representatives; under no circumstances shall EPA, its officers, directors, shareholders, employees, agents and representatives (and their successors, heirs and assigns of the foregoing) be liable for any consequential, indirect, special, punitive or incidental damages, whether foreseeable or unforeseeable based on claims of the Learner or Parent(s)/Guardian(s) arising out of breach or failure of express or implied warranty, breach of contract, misrepresentation, negligence, strict liability in delict or otherwise, whether based on this contract, any commitment performed or undertaken under or in connection therewith or otherwise. In no event will the aggregate liability which EPA may incur in any action or proceeding exceed, the lesser of, the aggregate of the fees paid to EPA in terms of this contract for the period of 6 (SIX) months preceding the date of notification of any claim. 8. Save for gross negligence on the part of EPA, its officers, directors, shareholders, employees, agents or representatives; EPA shall not be liable for any injury or death of the Learner and/or Parent(s)/Guardian(s) occurring on its school premises. The Parent(s)/Guardian(s) hereby indemnifies and holds harmless EPA, its officers, directors, shareholders, employees, agents and representatives and the successors, heirs and assigns of the foregoing from and against any and all claims, demands, actions, causes of action, suits, proceedings, losses, damages costs and expenses (including but not limited to attorney's fees on an attorney and own client scale) arising out of or in connection with this contract, any act or omission of EPA or any obligation or representation or warranty of EPA hereunder. 9. Save for gross negligence on the part of EPA, its officers, directors, shareholders, employees, agents or representatives; EPA will not be responsible for any loss, theft or damage to personal property of the Learner or Parent(s)/Guardian(s), and the Parent(s)/Guardian(s) hereby waives any rights to claim any damages and/or loss from EPA as a result of personal property being lost or stolen on or at EPA s school premises. 10. The Parent(s)/Guardian(s) hereby indemnifies EPA, its directors, employees, agents, consultants, contractors and representatives and holds them harmless against any and all claims arising out of any damage to the property of third party/ies caused by the Learner and/or Parent(s)/Guardian(s), whether caused intentionally or accidentally. 11. In the event of the Learner becoming ill and/or injured the Parent(s)/Guardian(s) confirm that the EPA shall be entitled to admit the Learner to any hospital or retain the services of any medical practitioner and authorise the aforesaid parties to take all the necessary steps to the treat the Learner. The Parent(s)/Guardian(s) acknowledge that they will be liable for all costs incurred therein. (Parent(s)/Guardian(s) (s)/guardian(s) will be contacted immediately. EPA will not refer a Learner 3 P a g e

4 to a doctor or a hospital until arrangements are made by the Parent(s)/Guardian(s). If the Parent(s)/Guardian(s) cannot be contacted, EPA will refer the Learner to the family doctor, the nearest doctor, or the Casualty Section at the nearest hospital). 12. Each Learner enrolments at EPA is subject to relevant EPA Rules, Regulations, Policies and/or Procedures as determined and/or updated, by EPA in its sole discretion, from time-to-time. The Parent(s)/Guardian(s) confirms that it remains his/her/their sole responsibility to familiarize himself/herself/themselves with the content of all relevant EPA Rules, Regulations, Policies and/or Procedures (copies of which will be made available to the Parent(s)/Guardian(s), upon request, free of charge) and furthermore confirms that he/she/they, as well as the Learner, will strictly adhere thereto. 13. In the event of one or more of this contract s terms and conditions, or any in force EPA Rules, Regulations, Policies and/or Procedures, being found to be unlawful and/or unenforceable, same will not affect any other legal and enforceable terms hereof and be deemed to be severable from the remainder of this contract. 14. EPA reserves the right to unilaterally amend and/or update these terms and conditions upon written notification thereof to the Parent(s)/Guardian(s). 15. In the event that: 15.1 The Parent(s)/Guardian(s) fail to pay any fees and/or other costs ancillary thereto by the due date; The Learner fails to adhere and behave in accordance with any relevant EPA Rules, Regulations, Policies and/or Procedures; or the Parent(s)/Guardian(s) and/or Learner breaches any other term of this contract; and fails to rectify such breach within 20 (TWENTY) business days after being required to do so by EPA, EPA shall be entitled to either terminate this contract immediately or to demand specific performance. This clause shall not prejudice any of the rights of EPA to claim damages from the Parent(s)/Guardian(s). 16. By enrolling the Learner with EPA, the Parent(s)/Guardian(s) accepts liability for payment of the following fees: SCHEDULE OF FEES Fees Annual Fees Per month School Fees R R After Care R R Annual Print Levy R R Stationery R R 17. All EPA fees, as per clause 16 above, are payable free of bank charges, set-off or any other deductions and are monthly in advance, on or before the 30 th day of each calendar month. 18. It is specifically recorded that the Parent(s)/Guardian(s) remains liable for all fees payable in terms of this contract, irrespective of whether the Learner attends EPA / selected classes or not. 19. In the event that the Parent(s)/Guardian(s) fails to pay any fees on the due date thereof, he/she shall be liable to pay all costs in connection with the collection of such fees, including legal costs on the scale as between attorney-and-own-client together with collection commission. 20. Should the Parent(s)/Guardian(s) fail to make payment of any fees on the due date thereof; the outstanding amount will attract interest at a rate of 2% per month, calculated from the due date thereof until date of final payment. 21. In the event that Parent(s)/Guardian(s) fails to make payment of any fees on the due date thereof, EPA reserves the right to refuse the Learner access to its school premises until such time as EPA has received payment, in full, of all arrear fees, interest accrued thereon, legal costs on the scale as between attorney-and-own-client and collection commission, if any. EPA further reserves the right to deny the Learner access to extra-mural activities until full payment of all outstanding fees. 22. Should the Parent(s)/Guardian(s) make payment in advance of the total school fees for the year ahead, EPA will allow a 5% (FIVE PERCENT) discount on the fees due. 23. Should the Parent(s)/Guardian(s) settle the full amount of fees due 30 days before the date on which the agreement terminates then EPA will allow a 5% (FIVE PERCENT) discount on the total amount due. 4 P a g e

5 24. All notices and processes shall be delivered or served upon the Parent(s)/Guardian(s) at the physical address or address as recorded in page 1 hereof, which physical address the Parent(s)/Guardian(s) hereby chooses as his/her/their domicilium citandi et executandi. 25. EPA shall be entitled to cede or assign all or any part of its rights and/or obligations under this contract, without notice to, or consent of, the Parent(s)/Guardian(s). 26. The Parent(s)/Guardian(s) warrant that any and all information contained in page 1 of this contract is true and correct SIGNED at on this the day of 20 Parent(s)/Guardian(s) Signature NAME: SURNAME: SIGNED at on this the day of 20 Parent(s)/Guardian(s) Signature NAME: SURNAME: 5 P a g e

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)