Enrolment Agreement

Child's Full Name

(Preferred names/nicknames)

Date of Birth

Staff Initials

Identification (please bring this in on your next visit to The Forest so that we can take a copy for your file, or email to theforest.ece@gmail.com)

NZ Birth Certificate Foreign Birth Certificate NZ Passport Foreign Passport Other

Male/Female

Ethnicity

Iwi

Primary Caregiver

Address

(Mobile)

(Work)

Email

example@example.com

Secondary Caregiver

Address

(Mobile)

(Work)

Email

example@example.com

Emergency Contact

Address

To be used in the event that we cannot contact you first

Ph (Home)

(Mobile)

(Email)

example@example.com

Immunisations Current? Y/N (please bring in verification on your next visit to The Forest for us to copy or email to theforest.ece@gmail.com)

Family GP

Phone

Address

Health Problems/Dietary Concerns/Allergies/Medications required: Medications must be signed for or staff cannot administer. Parents will be asked to provide all foods for children with special dietary requirements or food allergies.

Special Needs

Cultural or Religious Considerations (e.g. Languages spoken at home)

Permission to use Arnica/Bepanthan/Sunscreen/Zinc and Castor Oil Cream/Antiseptic Cream if required Y/N (signature)

Permission to excursion on farm outside licencend area Y/N

Permission to use Bepanthen/Sunscreen/Zinc and Castor Oil Cream/Topical Antihistimine/Antiseptic Cream if required? (Typed answer 'Yes' will be considered signature for permission, alternatively type No)

Permission to excursion outside licenced area (The Forest Programme - typed answer 'Yes' will be considered signature for permission, alternatively type No)

Enrolment date

Date

Enrolment days/times requested:

Hours open: 7.30am until 5.30pm Monday to Friday

Transition Dates requested (these are at least an hour long, and usually three just before your child begins with us. We will assess what your child needs as we go along, and extend this if necessary)

Monday Booking (eg: 9am to 4pm)

Tuesday Booking

Wednesday Booking

Thursday Booking

Friday Booking

Persons who may collect your child from The Forest ECE (anyone other than listed on front page:

Name

Address

Phone

Persons who may NOT collect your child from The Forest ECE:

Name

Details

Custodial arrangements: (please bring in any court orders, protection orders, or advise of any access with conditions in place for this child)

I have read the Fees and Policies information and agree to abide by the payment terms referred to in the document. I hereby declare all the information in this enrolment application is true and correct.

Signed

Clear

Booking Fee A once-only $150 fee will be payable on confirmation of enrolment. This fee is an administration fee and does not go toward attendance fees, it is non-refundable. On your child's first day of attendance, they will be given a set of wet weather gear, and a wet-bag (we discourage the use of plastic bags

Payment of fees Payment is due on invoice. Our preference for payment is Direct Debit. We do not take eftpos or credit card. If it becomes necessary to refer your account to debt collection you will be liable for any debt collection costs.

Holiday Policy Although we do not shut over the Christmas and New Year period, we understand that many families are able to take a break at this time, and offer you two weeks fee-free. Dates are confirmed by October each year. Statutory holiday dates (outside the closedown period) will be half charge. Please see the office for confirmation. All holidays outside of this time will be charged at your normal fee.

Illnesses: Days off due to illness will be charged at your normal day rate.

Permanently leaving The Forest ECE Two weeks notice is required of intention to withdraw your child from the centre, or normal payment of fees for this time. If your child is absent for three weeks, enrolment is automatically cancelled unless we have been notified and in agreement with the prolonged absence. Note: if a child does not attend the centre for 21 consecutive days then all funding from the Ministry of Education ends and full centre fees (including Ministry portion) will be charged to you for continued absence.

WINZ Subsidy: In the event of delay in payment of your subsidy, or suspension, you must pay full fees until notification of payment is received by the centre from WINZ. At this time, subsidy will be credited to your account.

Photographs: Do you give permission for your child's photo to be taken and displayed in the centre for centre related documentation (e.g. profile books/programme planning/displays?

Observations will be done on your child to complete their portfolios, and photographs taken. Sometimes these photographs may be used on the Centre's website, Facebook site or newsletters, do you give permission for this?

Teachers in Training: On occasion, your child will be in a class with a training teacher. Do you give your permission for these teachers to include your child's photograph in their assignments? These assignments are viewed only by their tutors, and your child will not be named.

B4 School Hearing and Vision Checks Vision and Hearing technicians will visit our centre to check the hearing and vision of four-year-old children who have not been seen for the above checks, or require re-checks from a previous visit. Your child's name, date of birth and National Health Index (NHI) number will be recorded by the technician and stored in the B4 School Check national information system, along with the results of the check. I consent to my child taking part in the B4 School Hearing and Vision Checks. YES/NO

Medical Care: In the event of emergency, staff will take all actions necessary to safeguard your child's wellbeing and administer treatment of any illness/injury through the necessary channels, e.g.: calling an ambulance if required. I agree that this will be at my expense.

Forest/Farm Walks and Excursions: Excursions outside the licenced area are a very important part of our programme. Any children who are not allowed to be included in these may not be enrolled. Children will be taken on excursions outside the centre with the appropriate teacher/child ratio (which will be at least the same as the ratio maintained whilst attending the Centre - 1:10 over twos), and the parents' permission. YES/NO

In signing this enrolment form, I give permission for my child to travel with the Centre staff or adults authorized by the Supervisor in a motor vehicle while in the care of the Centre. Such travel may be arranged for centre excursions, emergency medical assistance, transport to/from school or home: This written permission from parents, in advance, is required by Regulation 27 (1) of the Education (Early Childhood Centre) Regulations 1998. YES/NO

ECE Subsidy: The Forest provide up to 20 ECE hours subsidy for children from their third birthday. The Ministry of Education will subsidise up to six hours per day to a maximum of 20 hours, and this amount comes directly off your account. You may only use up to 20 hours per week, so if you have a mixed enrolment, please ensure only 20 hours per child are claimed between the two centres. I confirm that my child is not enrolled at any other centre to receive the ECE funding that I claim at The Forest. I agree to advise The Forest ECE of any changes to my enrolment that may affect my eligibility for receiving free ECE.

Clear

* To ensure your child is placed on the waiting list, please ensure that their immunisation information (photocopy of Plunket Book is acceptable) is emailed to the centre, and a $150 per child deposit is paid to The Forest (Account Number 12-3476-0023412-00).

Privacy Statement: We are collecting personal information on this enrolment form for the purposes of providing early childhood education for your child. We will use and disclose your child's information only in accordance with the Privacy Act 1993. Under that Act you have the right to access and request correction of any personal information we hold about you or your child. Details about your child's identity will be shared with the Ministry of Education so that it can allocate a national student number for your child. This unique identifier will be used for research, statistics, funding, and the measurement of educational outcomes. You can find more information about national student numbers at: www.minedu.govt.nz/parents

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I agree to the terms and conditions of enrolment and agree to pay the fees as set out in the above policy. I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at Little Einsteins

Acceptance of enrolment of my child at this service is in no way an assurance or guarantee of continued enrolment for the time indicated or under the terms and conditions effective at the time of enrolment. Management reserves the right to terminate enrolment or vary the conditions.

All About Me!

Information about me for my Forest Kaiako

We place the utmost value and importance on the knowledge you bring as your child's first teacher. Please support us in getting to know you, your whanau and your child better by filling out the questions that are applicable to you and your child. This enables us to provide your child with the best care and learning experiences possible and ensure they quickly develop a sense of belonging here as they embark on their Forest learning journey.

My date of birth is

Date

My whänau/family and special people in my life are

Any other information about my whänau/family

My whenua/Country of origin is:

I live in (if different from above):

The languages I know are:

My family's special celebrations/rituals include:

At the moment my main interests/favourite things to do/favourite places to go are:

I am allergic to:

Foods I like are:

I don't really like:

At the moment my main interests/favourite things to do/favourite places to go are

Things that comfort me when I am feeling a little sad are:

My Favourite songs to sing are:

My favourite stories to read are:

My favourite comfort object or comfort toy is:

My strengths/favourite things to do are:

At the moment I need support with:

I'm kind of scared of

My parents/whanau aspirations for me are? (examples might be, increased social competence, making good friends, being happy, resilience, numeracy, literacy, speech and language development)

Any other information that may be important for my kaiako to know

My Routine at home (if applicable)

I have (?) sleeps at (?) times?

I sleep on my back? front? side?