Earlybird@TheParks Enrolment Form
Thank you for your interest in joining the Earlybird family! We are looking forward to getting to know you and your little one. This enrolment form is the second step in our four-step enrolment process. All of the information you provide below will be treated with the utmost confidentiality and is subject to our rigorous data security protocols in-line with the POPI Act.
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What is your child's full first name? (as reflected on their birth certificate) *
What is your child's surname? (as reflected on their birth certificate) *
What is the 'preferred' name your child usually goes by? (This will be used by their teacher for labeling etc.)
What is your child's date of birth? *
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What is your child's identity number as reflected on their birth certificate?
What is your child's gender identity?
Clear selection
What is the primary language your child hears spoken most at home?
Clear selection
Is there a secondary language your child hears spoken a great deal at home?
Clear selection
What is the FIRST NAME of the primary adult caregiver (parent/guardian) for this child? i.e. first point-of-contact for teachers and principal in matters related to the child? *
What is the SURNAME of the primary adult caregiver for this child? *
What is this primary caregiver's relationship to the child?
Clear selection
What is the child's primary caregiver's ID number?
What is the child's primary caregiver's email address? *
What is the child's primary caregiver's cellphone number? *
What is the child's primary caregiver's work contact number?
What is the full name and surname of the secondary adult caregiver for this child (i.e. second point-of-contact for teachers and principal in matters related to the child)?
What is this secondary caregiver's relationship to the child?
Clear selection
What is the child's secondary caregiver's ID number?
What is the child's secondary caregiver's email address?
What is the child's secondary caregiver's cellphone number?
Please indicate whether the primary or secondary caregiver will be assuming responsibility for payment of the child's school fees:
Clear selection
What is the physical address of the child's home?
What is the contact telephone number for the child's home?
Which family members does the child live with at this home on most week days?
If the child is currently enrolled at another preschool or educare centre or creche, please give us its name:
What date do you anticipate your child starting school with us at the Earlybird@TheParks Educare Centre? (Please note that this is the date we will begin invoicing you from if you complete our full enrolment process). *
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Please list any allergies your child has:
Please list any strong food preferences/intolerances your child has:
Please list any medical conditions your child has:
Please give us the name of your child's GP or Paediatrician:
Please give us a contact number for your child's GP or Paediatrician:
If your child is covered by medical aid, please give us the medical aid's name:
Medical aid membership number:
Please acknowledge that in order to complete Earlybird's enrolment process and secure your child's spot at the Earlybird@TheParks Educare Centre you will need to go through the following steps: *
Required
Thank you very much for taking the time to fill out the enrolment form. Please use the notes section below to let us know if you have any questions for us or if you want us to be aware of any additional information relating to your child (particularly if your little one has experienced any significant learning and development challenges to date):
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This form was created inside of Earlybird Educare.