Buccleuch Montessori Enrollment Form Step 1 of 5 20% Buccleuch Montessori Enrollment FormCommencement date: Program Applying for:ToddlerPreschoolPrimaryInformation about ChildChild's Name First Name Last Name Home LanguageID / Passport NoDate of Birth Present AgeSexPrevious schoolAttended fromtoSiblingsNameAgeFamily Position Information about ParentsParent #1 InformationParent #1 (Fee Payer) First Name Last Name Relationship to childCompany Name & PositionParent's Indentity NumberHome PhoneWork PhoneCell PhoneEmail Parent #2 InformationParent #2 First Name Last Name RelationshipCompany Name & PositionParent's Indentity NumberHome PhoneWork PhoneCell PhoneEmail Marital StatusPerson Responsible for payment of School feesPostal Address Street Address City ZIP / Postal Code Residential Address Same as postal Street Address City ZIP / Postal Code 2 Emergency contact persons: (in case of both parents being un-contactable)Emergency Contact Person #1 First Name Last Name RelationshipHome PhoneWork PhoneCell PhoneEmergency Contact Person #2 First Name Last Name RelationshipHome PhoneWork PhoneCell PhoneParents consent for person(s) who may collect your childI give permission for the following person(s) to collect my child from school:NameRelationship Parents SignatureDate Please note; it is essential that you inform us of any changes to this list. If you have arranged for your child to go home with a school friend, please let us know well in advance that he/she will be going home with that particular child’s caregiver. We cannot allow your child to go home with anyone not specified on this list without prior arrangement. We are concerned for your child's Safety! PLEASE NOTIFY THE SCHOOL OF ANY DETAIL CHANGES IE: CONTACT NUMBERS or EMAIL ADDRESSES. How did you learn about Buccleuch Montessori?UPLOAD THE FOLLOWING DOCUMENTS FOR ENROLEMENT TO BUCCLEUCH MONTESSORI PRESCHOOL & PRIMARYUPLOAD COPY OF YOUR CHILDS BIRTH CERTIFICATE. Drop files here or UPLOAD COPY OF BOTH PARENTS IDENTITY DOCUMENTS. Drop files here or UPLOAD COPY OF YOUR CHILDS HEALTH & IMMUNISATION RECORDS. Drop files here or UPLOAD COPY OF MOST RECENT REPORTS. Drop files here or PROOF OF RESIDENCE. Drop files here or YOUR DRIVER’S LICENCE. Drop files here or COPY OF YOUR MEDICAL AID CARD. Drop files here or REQUIREMENTS FOR ENROLEMENT TO BUCCLEUCH MONTESSORI PRESCHOOL & PRIMARY 1.COMPLETED REGISTRATION FORMS. NON-REFUNDABLE REGISTRATION FEE, EQUIVALENT TO ONE MONTH’S SCHOOL FEE. NON-REFUNDABLE TOP-UP FEE FOR EXISTING CHILDREN GRADUATING FROM OUR PRESCHOOL TO OUR PRIMARY GROUP. APPLICATION FOR SECURITY STICKERSCOMPLETED REGISTRATION FORMS. NON-REFUNDABLE REGISTRATION FEE, EQUIVALENT TO ONE MONTH’S SCHOOL FEE. NON-REFUNDABLE TOP-UP FEE FOR EXISTING CHILDREN GRADUATING FROM OUR PRESCHOOL TO OUR PRIMARY GROUP. APPLICATION FOR SECURITY STICKERS Information about Child's Medical HistorySerious IllnessesMedication RequiredAllergiesFurther information regarding your child’s healthUpload Child's Immunisation Record Drop files here or DatesDiphtheriaWhooping CoughTetanusBoosterBCG Vaccination (Tuberculosis)Mumps, Measles & Rubella (MMR)OtherBorn byNatural birthC- sectionDetails of Doctor:Name of DoctorTelephone Number of DoctorMedical Aid DetailsNamePhone Number Buccleuch Montessori Preschool & Primary Indemnity and AgreementI/We, the undersigned Father/Legal Guardian and Mother/Custodian Parent of the above mentioned child. In our capacity(ies) as parents/guardians of our child/children, hereby: 1. Indemnify Buccleuch Montessori Preschool & Primary, all assistants and/or employees of the school, shall not be held liable for any injuries sustained and/or damaged suffered by us and/or our children arising from any cause whatsoever whilst our child/children are in the care of the school, whether or not such injury and/or damages are caused by any act or omission of the school, the assistants and/or employees. 2. Expressly, indemnify Buccleuch Montessori Preschool & Primary, all assistants and/or employees against any claim, which may arise or be instituted from any cause whatsoever. 3. Expressly, indemnify Buccleuch Montessori Preschool & Primary, all assistants and/or employees against any claim, demand for costs and/or expenses arising out of the actions of our child/children or as a result of the medical or other treatment which my/our child/children receive from whosoever, whilst in the care of the school. 4. Consent to and agree that Buccleuch Montessori Preschool & Primary, all assistants and/or employees may give the required permission and sign the necessary written consent for my child/children to be subjected to surgery and/or other medical treatment in an emergency situation provided that this will be executed on the advice and under the supervision of a medical doctor and in the event of the parents of the child/children being unreachable both telephonically or otherwise at all. We agree to pay all medical costs incurred. 5. Buccleuch Montessori Toddler, Preschool & Primary undertakes to educate your child in accordance with Montessori Principles, aimed at developing a well-rounded, happy child with balanced development in the intellectual, emotional, social and physical spheres. 6. It is understood that the Montessori system ideally requires a three-year cycle, from ages three to six, six to nine and nine to twelve, and that the parents will endeavour to fulfill this cycle. It is also understood that any situation in the home, which might impact upon the child’s behaviour in the school environment, will be brought to the attention of the staff. In turn the staff will inform the parents of any behaviour at school which is outside the normal pattern. 7. Fees are to be paid with or via debit order or Internet on the 1st day of each month (in advance) with an annual price increase. A 5% interest fee will be charged on all overdue accounts. 8. A non-refundable registration fee equivalent to one month’s school fees is payable upon registration. 9. One full terms written notice is required on termination of this agreement. If the notice is not received, in writing within the first week of the term, one full term’s fees will be levied. Signature of Father/GuardianDate Mother/CustodianDate As Witnesses
