Student/Parent Information Form
School *
(Confirm which school your child will be/is attending)
Surname / Child Name - File Name *
(Official File name)
Your answer
Student's First Name/s *
Your answer
Student's Last Name *
Your answer
Students ID number
Your answer
Date of birth *
MM
/
DD
/
YYYY
Gender *
Home Language
Your answer
Religion
Your answer
Sibling Names and Ages
Your answer
Mom Last Name *
Can be completed by parent/guardian
Your answer
Mom First Name *
Your answer
Mom ID Number *
Your answer
Mom Cell Number
Your answer
Mom Work Number
Your answer
Mom Home Phone
Your answer
Mom Email Address
Your answer
Mom Occupation
Your answer
Mom Physical Address *
Your answer
Mom Postal Address
Your answer
Dad Last Name *
Can be completed by parent/guardian
Your answer
Dad First Name *
Your answer
Dad ID Number *
Your answer
Dad Cell Number
Your answer
Dad Work Number
Your answer
Dad Home Phone
Do not complete if same as above.
Your answer
Dad Email Address
Your answer
Dad Occupation
Your answer
Dad Physical Address
Do not complete if same as above.
Your answer
Dad Postal Address
Do not complete is same as above.
Your answer
Student Lives With:
Medical and Emergency Information
Medical Aid Provider
Your answer
Medical Aid Number
Your answer
Medical Aid Contact Number
Your answer
Doctor Name
Your answer
Doctor Contact Number
Your answer
Emergency Contact Name
Your answer
Emergency Contact - Relationship
Your answer
Emergency Contact Number 1
Your answer
Emergency Contact Number 2
Your answer
Emergency Contact Physical Address
Your answer
Medical History - Allergies
Your answer
Medical History - List any additional information you feel the school should be aware of.
Your answer
Enrollment and Billing Information
Date of Desired Enrollment *
MM
/
DD
/
YYYY
Application Fee Paid *
(R250.00 Non-Refundable)
Program Choice *
Payment Plan *
Applicable Billing Amendments *
School Fees Payment Terms and Conditions *
Acknowledgement of School Fee payment terms and conditions
Required
Outings Procedure *
Children are periodically taken on walks outside the school premises but within the complex.
Required
Applicable e-mail for Billing System and Communication *
Your answer
Optional second e-mail for Billing System and Communication
Your answer
Comments
Is there any additional information we should know?
Your answer
Date of Form Submission *
MM
/
DD
/
YYYY
PARENTAL CONSENT
Photographs *
Download/View Kids Co Constitution/Parent Handbook for all our school policies and procedures. (Open a new Tab to read)
Download/View Kids Co School fees and calendar dates (Open a new tab to read)
IMPORTANT! School Communicator - Download here.
Please complete the following *
Required
Parent Signature Mom *
By typing your name here, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.
Your answer
Parent Signature Dad *
By typing your name here, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.
Your answer
Visit our school website
D6 Communicator
School 1: Somerset Links, Jigger Avenue, Somerset West 7130
Tel 021 851 0686
School 2: 20 Electron Ave, Techno Park, Stellenbosch 7600
Tel 021 880 10 22
justine@kidscompany.co.za / www.kidscompany.co.za
2013 / 210057/ 07 Pty Ltd
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