Hope Horizon Application Form 2023

Hope Horizon
Application Form 2023
Fill in this form from your phone, laptop or tablet.

This is an application form and does not automatically accept your child into Hope Horizon

You will be informed after we have received and reviewed the application, whether or not your child has been accepted.

Once accepted, you will need to submit your ID, birth certificate and clinic card of the child at the office as soon as possible to complete the application.

We have only limited space, please apply immediately to ensure space.

Registration fee must be paid when your application has been approved.
I have read and agree to the terms and conditions*

YES

Details of Child

Enter details of the child you want to apply for
Full name of child*

First NameLast Name
Name by which child is called *
This is also the name your child will learn to write
Date of Birth

MonthDayYear
Date
Identity Number*
Home Language
Male/Female

MaleFemale
Number of children in the household
Position in family

Only/First ChildSecond ChildThird ChildFourth ChildFifth or More
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Religion
Type of social grant (if any)
Disability (if any)
Physical or Mental or Developmental Delay
Previous School
Phone Number of Previous School
Please enter a valid phone number.
Last Grade successfully completed

Medical Information
Family Doctor/Clinic
Phone Number
Please enter a valid phone number.
Allergies (including food allergies)
Chronic Illnesses
Medical Aid
Medical Aid Number
Main Member Name
In case of Emergency*
Not parent or guardian
Phone Number*
Please enter a valid phone number.
In case of Emergency*
Not parent or guardian
Phone Number*
Please enter a valid phone number.

Parent/s Information
Parent 1
Name*

First NameLast Name
ID Number*
Occupation*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number (Home)
Please enter a valid phone number.
Phone Number (Work)
Please enter a valid phone number.
Cellphone Number*
Please enter a valid phone number.
Email*
example@example.com
Main Source of Income*

Parent/s Information
Parent 2
Name

Full NamesLast Name
ID Number
Occupation
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number (Home)
Please enter a valid phone number.
Phone Number (Work)
Please enter a valid phone number.
Cellphone Number
Please enter a valid phone number.
Email
example@example.com
Main Source of Income

General
Who will pay the fees?*
If 'Other' please specify:
When will fees be paid*

once off in January 20231st of every month15 of every month
Debit Order Details
Name on the Account*
Bank Name*
Branch Code*
Account number*
Do you allow Hope Horizon to Debit your account on a monthly basis?*

YesNo
Who does the child live with?
Phone Number of the Person the child lives with
Please enter a valid phone number.
Address of the person who the child lives with

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Who is allowed to collect the child from Hope Horizon
Name, ID number and Contact number
If any, who is NOT allowed to see or collect the child when on the premises?
Name, ID number and Contact Number
Full Day or Half Day*

Full DayHalf Day

Grade Selection
Grade in 2023*
Birth to Grade 3

It remains your choice to choose in which grade your child will be, "born in yyyy" is only a guide for each grade
Fees for 2023 are

Registration R500

R1250 per month X 11

or

R12875 once-off (10% discount)

Fees are payable on the 1st of the month for the month ahead month

Extra-Curricular Activities

What would you like your child to participate in?
Pick as many as you want

Mini RugbyMini CricketMini SoccerMini NetballLittle Divas Ballet ClassesMove it! Music & MovementClever Cats Computer ClassesTamble Bugs Gymnastics

Terms & Conditions:

By signing this document, you agree that you will uphold the following:
- All fees must be paid in full each month, for the coming month.
- If fees are not paid on time every month, you understand that your child will not be allowed in the lessons and you will be handed over to our lawyer immediately and be liable for the whole year's fees
- No refunds will be given for whatever reason
- You must still pay all the fees in case of non-attendance, illness, public holidays, school holidays, or government-instated closures.
- You will be liable for the whole year's fees if your child no longer attends and you did not fill in and sign the exit form which is available from the admin office
- You understand that if you apply for subsidy, it does not automatically grant you subsidy and if subsidy is not granted you will still be liable for all fees.
- Subsidy only exempts you for 2023 fees and not for 2022 or 2024 fees
- Please refer to the full fee structure for more
Want to apply for subsidy?

Follow the link below to apply for subsidy
https://form.jotform.com/221632257545051
Signed at Standerton on Date
Signature

Clear
Should be Empty: