Enrollment form – Princess Park College Rosslyn

Princess Park College Rosslyn

"Empowering Young Minds for a Brighter Future!"

Enrolment Form 2023

DO YOU HAVE ANY LEARNERS CURRENTLY/PREVIOUSLY IN THIS SCHOOL?

Yes No

Name of other learner(s)

LEARNER INFORMATION

Full names:

Surname:

Date of birth:

ID number:

Nationality:

RSA Other

Religious denomination

Gender:

Male Female

Ethnic group:

Home language:

Learner mobile number:

Learner e-mail address:

Admission date:

Grade in 2022

Years in grade for 2022

Attach ALL relivant documantation as stated below (jpg, jpeg and PDF allowed)

LEARNER
× Birth certificate
× 1 colour ID-size photo (to be attached to the application form)
× Transfer card / letter from the previous school
× Most recent report card

PARENT / GUARDIAN
× Copy of ID of both parents/guardian
× Proof of residence(not older than 1 month)
x Latest report card of learner.

FOREIGN NATIONALS / FOREIGN STUDENT
× Valid passport and birth certificate
× Study permit

FOREIGN PARENTS / GUARDIAN
× Valid passport / refugee permit / asylum permit
× Working visa
× Temporary or permanent residences permit from the Department of Home Affairs of parents & learners.

Method of transport:

Taxi/Bus registration number:

Name of driver:

Contact number:

NEXT OF KIN INFORMATION

Name:

Contact number:

Alternative contact number:

Relation:

FAMILY INFORMATION

Parents deceased:

Mother Father None

LEARNER HEALTH INFORMATION

Chronic diseases:

Allergies:

Medication:

MEDICAL AID INFORMATION

Name

Telephone number

Member number

Primary member

FAMILY DOCTOR INFORMATION

Name:

Telephone number:

Business address:

INFORMATION OF PREVIOUS SCHOOL/PLAY GROUP/NURSERY

First registration of learner in Gauteng?

Yes No

Learner attended school last year?

Yes No

If yes, in wich province/country?

Previous school

Telephone number

Adress

Province

Highest grade in previous school

Reason for leaving the school

BIOLOGICAL PARENT / LEGAL GUARDIAN 1 INFORMATION

Title:

Full names:

Surname

Initials

ID number:

Home language:

Communication preference:

SMS E-mail Mail By hand

Language preference:

Mobile number:

Home tel

Fax:

Parent E-mail

Residential address:

Postal address:

Occupation

Employer

Work telephone number

Employer physical address

Is the learner living with this parent?

Yes No

BIOLOGICAL PARENT / LEGAL GUARDIAN 2 INFORMATION

Title:

Full names:

Surname

Initials

ID number:

Home language:

Communication preference:

SMS E-mail Mail By hand

Language preference:

Mobile number:

Home tel

Fax:

Parent E-mail

Residential address:

Postal address:

Occupation

Employer

Work telephone number

Employer physical address

Is the learner living with this parent?

Yes No

DECLARATION BY PARENT / GUARDIAN

(Name of Parent / Guardian) hereby declare that the information supplied in this form is true and just and that I, by way of my signature hereunder, authorise the Chairperson of the School Governing Body or his/her representative to control and confirm any of the details supplied. I am aware that should any information supplied be found not to be true, I may be liable to a criminal offence.

Signed at

day of

Acceptance of Parent / Guardian

Please tick the box to accept and declare that all information is correct and valid.

ACCOUNTABLE PERSON'S INFORMATION

Biological Parent 1 Biological Parent 2 Other

Only if 'Other', please complete section A or B below:

A) INDIVIDUAL

Title:

Full Names

Surname:

Initials

Preferred name

ID Number

Home Language

Communication preference:

SMS E-mail Mail By Hand

Language preference:

Mobile number

Telephone number

Fax number:

E-mail:

Residential address

Postal address

Postal Code

B) COMPANY / CLOSED CORPORATION / TRUST

Title

Name

Registration number

Language preference

Contact number

Fax number

Business address

Postal address

BANKING DETAILS

Bank

Branch

Branch code

Account type

Cheque Transmission Savings

Bank account number

Account holder

CONTRACT WITH SCHOOL WITH REGARDS TO PAYMENT

Agreement between PRINCESS PARK COLLEGE ROSSLYN and

with regards to the payment of school fees.

a) Accept responsibility for the payment of fees for above child before or on the seventh (7th) day of each month:

Monthly Cash Internet transfer Stop order

b) I agree to inform the Principal in writing if I am unable to pay the fees. My child's admission will be secured for one (1) month.
c) I understand that the school will take the necessary legal steps to recover any outstanding fees.
d) I agree to give one (1) calendar month's notice should my child no longer attend school. In the last term, I undertake to give notice in October as November doesn't serve as a notice month.
e) I declare that the forms have been completed correctly. I have read and understand the acceptance requirements and school rules.
f) If you prefer to receive statements by e-mail, please indicate e-mail address
g) I / We the parents / guardian of

undertake to honour the agreement as set out above.

Date:

Acceptance of Parent / Guardian:

I, the above mentioned parent/legal guardion

PERMISSION / CONSENT TO TAKE PART IN ALL ORGANISED ACADEMIC, SPORT AND CULTURE ACTIVITIES

1. I, parent / guardian of

hereby give permission that he/she may participate in all academic, sport and culture activities presented by the school in an organised manner. To participate in tests conducted by the school support team with the object of improvement in school work and to identify other problems.
2. I grant permission that my child may be transported by a public bus company approved by the school management. If there is only a small group of learners that needs to be transported, parents / teachers with valid drivers licences may be asked to transport them.
3. I accept that all reasonable precautions will be taken for the safety and wellbeing of my child and that I will be held responsible for the payment of the medical and / or hospital fees if enforced upon, in case of an injury which cannot be ascribed to the responsible personnel's coarse negligence.
4. I hereby delegate my powers as parent / guardian to the Principal of the school or representative if medical or surgical treatment may be needed for my child. As far as I know, he/she is physically able to participate in any organised activities and resides in good health.
5. I confirm that all medical information supplied in the Learner Information section of this form is accurate and complete. This information may be used in case of an emergency.
6. I undertake to inform the school if any of the above information may change.
7. I undertake to support my child to obey the Code of Conduct and the disciplinary system of PRINCESS PARK COLLEGE ROSSLYN as included in the Policy of the school.
8. I hereby confirm that the school is allowed to use imagery of my child in any publication, in any format.

Date:

Acceptance of Parent / Guardian:

I, the above mentioned parent/legal guardion

INDEMNITY

I/We the parents of/I the guardian of

(name of learner) indemnify unconditionally and without restriction PRINCESS PARK COLLEGE ROSSLYN and/or the shareholders of PRINCESS PARK COLLEGE ROSSLYN or any person employed by PRINCESS PARK COLLEGE ROSSLYN or any person acting on behalf of PRINCESS PARK COLLEGE ROSSLYN against any losses, claims, injury or death that may be caused to the above learner by virtue of his or her use of any of the facilities provided by PRINCESS PARK COLLEGE ROSSLYN.

Signed at

day of

Acceptance of Parent / Guardian:

Please tick the box to accept and declare that all information is correct and valid.

Princess Park College Rosslyn

"Empowering Young Minds for a Brighter Future!"

Enrolment Form 2023

LEARNER INFORMATION

NEXT OF KIN INFORMATION

FAMILY INFORMATION

LEARNER HEALTH INFORMATION

MEDICAL AID INFORMATION

FAMILY DOCTOR INFORMATION

INFORMATION OF PREVIOUS SCHOOL/PLAY GROUP/NURSERY

BIOLOGICAL PARENT / LEGAL GUARDIAN 1 INFORMATION

BIOLOGICAL PARENT / LEGAL GUARDIAN 2 INFORMATION

DECLARATION BY PARENT / GUARDIAN

ACCOUNTABLE PERSON'S INFORMATION

Only if 'Other', please complete section A or B below:

CONTRACT WITH SCHOOL WITH REGARDS TO PAYMENT

PERMISSION / CONSENT TO TAKE PART IN ALL ORGANISED ACADEMIC, SPORT AND CULTURE ACTIVITIES

INDEMNITY

ABOUT US

LEGAL

CONTACT US