HINDS SCHOOL ENROLMENT FORM

Please answer all required questions. If one of these questions is not relevant to you then please put N/A. Failing to fill in all the fields may mean your form will not send.

If you are not able to upload the documents asked for you will need to bring them into the school for us to view them.

Student Details

Child's Gender *

Male Female

Date of Birth *

Upload Copies of Passport or Birth Certificate

Year Level *

NE 1 2 3 4 5 6 7 8

Student Lives with *

Both Parents Mother Father Guardian

First Contacts

e.g. Mother/Father/Guardian

Contact 1 Salutation *

Mr Mrs Miss Ms Dr

Contact 2 Salutation *

Mr Mrs Miss Ms Dr

Alternative Emergency Contacts

e.g. relative/friend/neighbour

Emergency Contact 1 - Salutation *

Mr Mrs Miss Ms Dr

Emergency Contact 2 - Salutation *

Mr Mrs Miss Ms Dr

Medical Information

Immunisations up to date *

Yes No

Upload a copy of Immunisation record

Custody/Access Restrictions

Upload appropriate custody documents

Ethnicity

Student New to New Zealand

Date of entry into New Zealand

Upload Immigration document / permits

Expiry Date

Permission and Consent Details

I give permission for my child to attend local Education Outside the Classroom activities within the travel boundaries of Mid Canterbury, e.g. museum, swimming, choir, local sports activies.  I understand I will be kept informed of any events but consent will not be sought for each individual event within the mid Canterbury area.  Please let us know if you wish your child not to participate ina specific activity.  Permission will be sought for each event/actvity outside our loacl area or if the activity is deemed by the teacher as of a higher risk level.  Parents will be asked to contribute to travel costs associated to activites (where necessary).

Yes No

I give permission for staff to seek medical attention in the event of an emergency, or being unable to contact me or my alternative emergency contacts?

Yes No

I give permission for my contact details to be given to the Hinds School Board of Trustees, Hinds School Fundraising Committee and Home and School Committee *

Yes No

I give permission for my child and/or their work to be displayed publicly in our Newsletter, Facebook Page and Website *

Yes No

I would like to receive my newsletter by email. *

Yes No

Privacy Act

In terms of the Privacy Act 1993 the school needs your written consent for the following matters.  Please help us by showing Yes or No where indicated.

I agree to Hinds School collecting information relating to my child's education progress. *

Yes No

I agree to Hinds School requesting records from my child's previous school. *

Yes No

I agree to Hinds School sending records to another school should my child leave. *

Yes No

I agree to my child's records being open to access by.....

a. the School Dental Nurse *

Yes No

b. the public Health Nurse *

Yes No

Special Education Services staff *

Yes No

Please Note: The Dental Therapist periodically seeks names and classes to follow up on children who are not enrolled with the Dental Clinic.

Health Consent Forms completed by parents/caregivers are forwarded to the school's designated Public Health Nurse.

Records are made available for Hearing and Vision testing taking place within the school.

Typing your name here is equivalent of you signing this form.

Date Signed *