Registration Form

All registrations are received and reviewed on a first come, first serve basis. Upon filling all open spots, all additional submissions will be added to our waiting list.

Registration for

PreschoolAftercare

Start date

Date

Mother ID

Father ID

Child Birth Certificate

Child immunization record

Proof of residence

Child Name

First NameLast Name

Nickname

Date of Birth

Date

Religion

Language

Gender

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Please list siblings and ages

Aftercare Only - Please provide information on the following 1. Grade, 2. Teacher & teacher's contact details, 3. Extra curricular activities/sport

Previous Daycare: Please provide provider or centre name, contact details and reason for termination.

Please tell us more about your child (e.g. Shy, moody)

Please provide us with more information regarding the following topics & what you are currently doing at home for us to better understand your child.

Meal Times- Babies: Formula/breastmilk & quantities, meal times, feeding preferences, etc.Toddlers & Pre-schoolers: Experienced difficulties with meal times, food to be avoided etc.

Nap Times When during the day, duration, certain sleeping positions etc.

Toilet, Potty Diaper Procedure followed at home

Child development history (Was child premature? Any early delays or diagnoses? Vision/hearing screenings?)

Is there any emotional/behavioural information or situation information important for us to know to better understand you child? Divorce, recent death in family, trauma, treatments or seeing a professional like a therapist etc. Kindly provide information if there is any specific ways in which we can help or things you would like us to look out for.

Custody / Legal AuthorityAre there any custody arrangements, court orders, or legal restrictions on who may pick up or communicate regarding the child?

Yes (please attach a certified copy)No

Who has legal authority to make medical/educational decisions?

Both ParentsMotherFatherLegal guardian

Medical Information (Doctor Name & Number)

Medical aid information (Medical aid, medical aid plan, medical aid number)

Medical Condition / Allergy Details (Please describe the allergy or medical condition in detail, What are the signs/symptoms to look out for? What medication do you use? How should it be administered? What should staff do in case of an allergic reaction or medical episode?

Medical Condition / Allergy Details - Parent Responsibility Statement. I acknowledge that it is my responsibility to ensure the correct medication is always available at school, clearly labeled with my child’s name and dosage instructions. I will regularly check that the medication has not expired and replace it when necessary

Yes

Emergency Medical PermissionIn the event of a medical emergency, I hereby give permission for the school to take my child to the nearest hospital or clinic and authorize medical staff to provide necessary treatment

YESNO

Billing & Payments Preferred method of receiving invoices/statements:

EmailWhatsAppPrinted

Name of person responsible for payment:

First NameLast Name

Email/number for billing communication

PARENT/GUARDIAN INFORMATION (1)

First NameLast Name

Nickname

Gender

FemaleMale

Date of birth

Date

Email

example@example.com

Phone Number

Please enter a valid phone number.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Occupation information (Occupation, Workplace, Workplace Number)

PARENT/GUARDIAN INFORMATION (2)

First NameLast Name

Nickname

Gender

FemaleMale

Date of birth

Date

Email

example@example.com

Phone Number

Please enter a valid phone number.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Occupation information (Occupation, Workplace, Workplace Number)

Emergency Contacts (Name, ID Number, Contact Nr, Relationship to child)

People allowed to collect your child (Name, ID Number, Contact Nr, Relationship to child)

Please upload the ID Photos for people allowed to collect your child

MEDIA/PHOTOGRAPHYIF YOU DO OBJECT, PLEASE ENSURE THAT YOUR CHILD IS AWARE OF THIS – IF POSSIBLE. We would appreciate it if parents completed this consent form to allow their children to be photographed during special events or normal daily activities organized at Besige Bytjie Akademie. As the parent of a child at Besige BytjieAkademie, I agree to the following: I understand that my child(ren) may bephotographed at Besige Bytjie Akademieduring normal daycare hours, field trips, or activities.I give permission for my child’s photographs to be used in school newsletters or posted on the Besige Bytjie Akademie website and facebook.I give permission for my child’s photographs to be printed off and used in classroom photo albums.I understand that by not giving permission for Media/Photography my child will not take part in the school concert as this event is photographed and recorded on video.Permission for MEDIA/PHOTOGRAPHY

GrantedDenied

TRANSPORTATION WAIVER OF LIABILITYI hereby give permission for my child to be released from school, to a Besige Bytjie Aftercare Supervisor. I hereby give permission for my child to be transported from school to the Besige Bytjie Aftercare facility.My child will be transported by Besige Bytjie Akademie in a private vehicle.I understand that the person transporting my child must meet the following conditions and that it is my responsibility to verify the driver meets these conditions: Be at least 21 years of age. Possess a valid Professional Driving Permit (PDP). Had no convictions for reckless driving or driving under the influence in the past 2 years. I understand that the Besige Bytjie Aftercare facility is not liable for any event that may occur as the result of my child being transported by a private party in a private vehicle. I understand that the policy of the school will not allow my child to be transported by any person other than the person named above.Permission for TRANSPORTATION

GrantedDenied

INSECT REPELLANT PERMISSION FORM As a parent or guardian of a child at Besige Bytjie Akademie, I understand that it will be required to apply insect /mosquito repellent on my child to maintain my child’s physical health. Therefore, I give my permission for the personnel at Besige Bytjie Akademie to apply an insect / mosquito repellent to my child when needed. Permission for INSECT REPELLANT

GrantedDenied

ANTI ITCHING CREAM PERMISSION FORMAs a parent or guardian of a child at Besige Bytjie Akademie, I understand that it will be required to apply anti itching cream on my child from time to time as specified below to maintain my child’s physical health. Therefore, I give my permission for the personnel at Besige Bytjie Akademie to apply an anti-itching cream to my child as needed.Permission for ANTI ITCHING CREAM

GrantedDenied

SUNSCREEN PERMISSION FORMAs the parent or guardian of a child at Besige Bytjie Akademie, I recognize that too much sunlight may increase my child’s risk of getting skin cancer someday. Therefore, I give my permission for the personnel at Besige Bytjie Akademie to apply a sunscreen product of SPF-15, when needed.Permission for SUNSCREEN

GrantedDenied

DIAPER OINTMENTS AND POWDERS PERMISSION FORM, As the parent or guardian of a child at Besige Bytjie Akademie, I recognize that it will be required to apply diaper ointments and powders to my child, to maintain my child’s physical health. Therefore, I give my permission for the personnel at Besige Bytjie Akademie to apply diaper ointments and powders to my child, when needed. Permission for DIAPER OINTMENTS AND POWDERS

GrantedDenied

HEALTH SCREENING PERMISSION FORMEarly childhood developmental screening includes a health and development screening, that helps detect potential problems, but is not a substitute for a comprehensive health or development exam. This screening does not replace on-going care from your health care provider or dentist. Screening data collected is private so it may only be shared with anyone listed on the release of information; school district staff with a legitimate educational need to know; by court order; or with others as required by law, including the state or legislative auditor. This Screening includes: Review of your child’s immunization record Check of your child’s growth, such as height and weight Check for possible hearing problems Check for eye health, including how well your child can see Review of factors that might interfere with your child’s health, growth, development, or learning Check of your child’s development Your report of your child’s growth and learning including emotional and behavior status Information about your child’s health care and insurance Information about community resources and programs based on your child’s or family’s needs The standards for screening are the same for every child regardless of race, income, creed, sex, national origin, or political beliefs Permission for HEALTH SCREENING

GrantedDenied

Please find our policy guide and addendum A (Fees) on our website www.bytjies.com
https://www.bytjies.com/registrasie

I,

the father/mother/guardian of

Child Name

Apply for admission at Busy Bee Learning Academy and undertake to obey the school rules and regulations. I/We the undersigned declare that I/we have read the conditions, rules, and regulations (Policy Guide / Addendum A- Fees) of Besige Bytjie Akademie and that I/We understand and accept it.
I/We also undertake to abide by it for as long as my child or children is enrolled in the pre school.

I understand that Busy Bee Academy’s school fees are yearly fees. Annual fees are payable in monthly installments from January to December. I understand that Busy Bee Academy will not accept notices in November for the month of December and the full year fee will still be payable. Furthermore I will undertake to pay the school fees on or before the 1st of each month in advance and I will give 30 days written notice to take my child out of the school. No school fees (in full or partial) will be reimbursed.

I understand that non-payment or not paying my account on time can result in penalty fees being added to my account or being handed over to the debt collector or lawyer for collecting the outstanding balance. I also understand that I will be held accountable to pay any additional fee added by the debt collector for the lawyer.
I also understand neither myself nor my preschooler will be allowed access if my account is not paid or up to date. Nonpayment will result in access being denied.

I/we will not hold the principal, neither Besige Bytjie Akademie nor anyone connected with Besige Bytjie Akademie responsible for any accident, illness or injury involving my child or for any loss.

POPIA Clause
I consent to the collection, storage, and lawful processing of my and my child’s personal information as required for educational, health, and administrative purposes, in accordance with the Protection of Personal Information Act (No. 4 of 2013). I understand this data will not be shared with third parties without my consent, except where legally required.

Observation and Developmental Assessment
I give permission for the staff of Besige Bytjie Akademie to observe and informally assess my child’s development. I understand this is for support and planning, and that any concerns will be discussed with me before referral to external professionals.

I/WE DO HEREBY DECLARE AND CERTIFY THAT I/WE HAVE READ THIS DOCUMENT AND I/WE FULLY UNDERSTAND ITS CONTENT. I AM / WE ARE AWARE THAT THIS IS AN INDEMNITY AND RELEASE OF LIABILITY.
I SIGN THIS DOCUMENT OUT OF MY OWN FREE WILL
I CONFIRM THAT I HAVE THE RIGHT TO SIGN THIS DOCUMENT.
I SIGN THIS DOCUMENT ON BEHALF OF BOTH PARENTS/GUARDIANS

Name

First NameLast Name

Date

Signature