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Greek Orthodox Community & Parish of St George Thebarton & Western Suburbs INC. School
STUDENT ENROLMENT FORM 2020
STUDENT DETAILS
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Indicates required field
Surname:
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Given Name:
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Middle Name:
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Place of birth:
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Date of Birth (DD/MM/YYYY)
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Age
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Gender
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Home Address:
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Suburb:
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State:
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Postcode:
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Postal Address
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Home Phone
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Work Phone
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Mobile Phone
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Email
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Language spoken at home:
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MAINSTREAM SCHOOL DETAILS (Mainstream School is the school attended on weekdays)
School Name:
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Suburb:
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Student's Year Level:
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Is this student an overseas full-fee paying student?
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yes
no
PARENT DETAILS (Parent 1)
Salutation
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Mr
Mrs
Miss
Other
Name
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Relationship to Student
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Gender
*
Home Phone
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Work Phone
*
Mobile Phone
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Email
*
Home Address
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Suburb
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State
*
Postcode
*
PARENT DETAILS (Parent 2)
Salutation
*
Mr
Mrs
Miss
Other
Name
*
Relationship to Student
*
Gender
*
Home Phone
*
Work Phone
*
Mobile Phone
*
Email
*
Home Address
*
Suburb
*
State
*
Postcode
*
EMERGENCY CONTACTS
If parents or guardians cannot be contacted or unable to collect students, the School should contact:
Person 1 Name
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Home Phone
*
Mobile Phone
*
Work Phone
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Person 2 Name
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Home Phone
*
Mobile Phone
*
Work Phone
*
MEDICAL INFORMATION
Does your child have a diagnosed medical condition which might need first aid? Please select:
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Severe Allergies
Anapbhylaxis
Food Intolerance
Asthma
Joint Condition
Heart Condition
Seizures/Epilepsy
Diabetes
Visual Impairment
Hearing Impairment
Other
For any condition a separate Medical Management Form is required. Does your child need extra routine health support? (e.g. support with medication management, continence care, psychiatric issues)
*
Yes
No
FAMILY COURT ORDERS
Are there any current Court orders relating to this student? If yes, please attach a copy of the order for the school’s records. If circumstances change, please inform the school immediately.
*
Yes
No
Upload File
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Max file size: 20MB
Details
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DECLARATION AND CONSENT
Declaration and Consent
By signing below, you declare that you have been made aware and will abide by the policies of the school. You also declare that the information provided by you in this enrolment form is true and correct and that you will inform the school of any changes to this information as they occur.
Consent is given by selecting YES to each statement.
I/we consent to the staff at this school seeking or where appropriate administering any first aid or medical treatment from a registered medical or dental practitioner, hospital, or ambulance service (including transport to a hospital) that is reasonably required and that I/we will reimburse any expense incurred by the school should this happen.
*
Yes
No
I/we consent to the staff administering medication if so requested by me/we in writing using the appropriate medication authority form (I/we recognise all medication administered at the school will only be given if the medication has been prescribed by a registered medical practitioner; from its original container; bearing the original label with the name of the child to whom the medication is to be administered; and before its expiry or use by date. I/we understand that such medication should be administered in accordance with any instructions attached to the medication or written instructions provided by a registered medical practitioner using a medical management form).
*
Yes
No
I/we agree to notify the school as soon as possible if my child will be absent.
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Yes
No
There are times when children may be photographed or filmed: e.g. special events, newspaper articles, television news items. I/we give permission for my/our child to be filmed or photographed and for photos to be used for non-profit promotional purposes.
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Yes
No
I/we consent to my child’s name in the school newsletter/website for an undefined period of time
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Yes
No
I/we give permission for my/our child's photos to be used on the St George Greek School See-Saw app.
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Yes
No
From time to time teachers will take classes on short local walks as part of the school’s educational program. These walks will take place at any time during the year. It is understood that in extreme heat or inclement weather conditions, such walks would not take place. I/we give consent for my/our child to go on short local walks. Note - major excursions involving the use of transport or whole day activities are not included in this consent. For each excursion involving financial cost a separate notice will be given and separate consent forms collected.
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Yes
No
I/we give consent for my/our child to participate in any incursions the school may organise, where people share their skills, knowledge, experiences etc. with my/our child.
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Yes
No
I certify that this is the only Ethnic School my child attends
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Yes
No
Or (if applicable) my child is also enrolled at:
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I declare that to the best of my knowledge the information contained in this form as state above is correct.
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Yes
No
SIGNATURE OF PARENT 1 (Please type full name)
*
SIGNATURE OF PARENT 2 (Please type full name) (OPTIONAL)
*
Name of person enrolling the student (PLEASE TYPE FULL NAME)
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Please note:
The ethnic school may
not be able to accept students who require extensive support without your assistance
. Ambulance and medical costs, if applicable, remain the responsibility of the parent/guardian.
PRIVACY DISCLAIMER
The school acknowledges and respects the privacy of its community. The information that is being collect by the school is to process your enrolment. By completing this form, you have consented to this information being collected. The intended recipients of this information are the school, The Ethnic Schools Association of South Australia Inc. and for interaction with the Government of South Australia who provide funding to ethnic schools. The information collected will not be released for any form of commercial gain and will be maintained in a secure location as per the requirements of the Privacy Act. You have the right to access and alter personal information concerning yourself or your child in accordance with the Privacy Act 1988 and the school’s record management policy. The contact information of students will be shared publicly only when the express permission is given to the Ethnic Schools Association of South Australia to do so or under mandatory reporting requirements.
Submit
