Student Enrolment Form

Family Details

Place in Family

Out of

Students born outside of New Zealand must complete the following

Parents Date of Entry into New Zealand

Student Health Information

Future Attendees - Names and dates of birth of any family members likely to attend this school

Mother / Caregiver 1 Information

(If Caregiver) - Relationship to Student

Father / Caregiver 2 Information

(If Caregiver) - Relationship to Student

Emergency Contact Other Than Parent

Family Declaration

I give permission for my son / daughter to be treated as necessary by the school designated First Aider or Staff member

I  agree to follow all  school policies / procedures / agreements

I give permission for my child to participate in school supervised activities within walking distance of the school as detailed in the Information Booklet

I give permission for my child to be videoed or photographed

1. by a parent or a visitor to the school

2.  by teachers and children for curriculum purposes within our school

3.  by the School of Education in our role as a Normal School to show trainee teachers particular aspects of how teachers manage and teach in various curriculum areas and for other educational purposes

In terms of the Privacy Act, I understand that the information on this enrolment form is collected to form part of the esential information of the school holds on my child.  The records made from this information may be viewed on request at the school.  I approve the forwarding on of the information when my child transfers to another school.  I further approve of the forwarding of my child's name and address on request to a potential next school or health and educational agencies.