Registration form | Dudes and Divas Nursery School

1. Child’s information

Surname *

First names *

Date of birth *

Sex *

ID Number

Age

Other schools attended

Enrolment date *

Other information regarding the family which you feel we should understand

2. Administration information

Home language *

Who will bring the child?

Who will fetch the child?

Home address *

Postal address

Home tel

Mother cell

Father cell

3. Mother’s details

First name

Surname

ID number

Occupation

Company

Work address

Work tel

4. Father’s details

First name

Surname

ID number

Occupation

Company

Work address

Work tel

5. Relative details

Details of relative

Work tel

Cell

6. Medical information

Allergies

Family doctor

Doctor tel

Medical aid scheme

Medical aid number

Has your child been vaccinated up to date?

Yes No

Authority for treatment in case of emergency

I give consent that my child may be given medical treatment / taken to hospital if parents cannot be reached.
I do not give consent.

Any other important information

7. Consent and indemnity

We hereby give consent to our child to take part in the educational group’s activities and to make use of the educational and play equipment available. We understand that all activities are undertaken at our child’s own risk and we indemnify the Management, Principal and all staff of Dudes and Divas Nursery School from any claims which may arise, while reasonable precautions for safety and welfare are taken.

I/we have read and accept the consent and indemnity statement.

Place signed

Date

Mother full name

Father full name

8. Photo / POPI consent

We occasionally take photos of pupils for celebrations, birthday parties and other school events. Some photos may be shared with parents on WhatsApp and/or used on the school’s Facebook page. Please indicate your consent.

Parent / guardian name (Mr/Mrs + name and surname)

Child name 1

Child name 2

Photo permission *

I give full permission that photos of my child(ren) may be taken at school and shared on WhatsApp / Facebook as described.
I do not give permission for photos of my child(ren) to be used.

Place signed

Date

Back to home

By submitting this form you confirm that the information supplied is true and correct to the best of your knowledge and that you are authorised to complete this form on behalf of the child. Final enrolment is subject to availability, completion of any additional documentation and acceptance of the school’s terms and conditions.