Northern Academy Application Form PDF Details

Embarking on the journey of education with Northern Academy requires a thorough and detailed initial step: completing the Application for Admission form. This comprehensive document, crafted by the academy and its management entities, Meridian Operations Company NPC and Campus and Property Management Company (Pty) Ltd, serves as a bridge between prospective students and a quality education. It prompts applicants to specify their desired school year and grade, including options for nursery through to grade 12, and to confirm the availability of additional services such as hostel accommodation and aftercare—highlighting the academy’s dedication to providing a holistic educational environment. A meticulous completion of this application is mandatory, necessitating signatures and the attachment of all pertinent supporting documents like identification, academic records, and proof of financial capability. Furthermore, the form delves into learners' personal details, academic history, medical information, and family background, ensuring a comprehensive understanding of the student's needs and circumstances. Notably, the application emphasizes adherence to the school’s Christian principles and policies on conduct, substance abuse, and dress code. This preparatory step underscores the academy’s commitment to fostering an informed, respectful, and inclusive community from the outset.

QuestionAnswer
Form NameNorthern Academy Application Form
Form Length7 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 45 sec
Other namesnorthern academy school fees 2021 polokwane, northern academy polokwane application forms for 2021, northern academy independent school polokwane fees 2021, northern academy school fees 2022

Form Preview Example

NORTHERN ACADEMY APPLICATION FOR ADMISSION

Meridian Operations Company NPC (RF) Reg No 2012/081855/08 / NPO Reg No 116-433NPO

Campus and Property Management Company (Pty) Ltd Reg No 2012/001821/07 / VAT Reg Number 4290261926

SCHOOL APPLIED AT

NORTHERN ACADEMY

MONTH & YEAR APPLIED FOR

GROUP OR GRADE APPLIED FOR

GROUP 1

Confirm availability at applicable school

1.5

2

2.5

3

4

5

(NURSERY SCHOOL)

GRADE R 1 2 3 4 5 6 7 8 9 10 11 12

(SCHOOL)

HOSTEL ACCOMMODATION

YES

Confirm availability at applicable school

AFTERCARE

YES

Confirm availability at applicable school

MOST IMPORTANT

NO

NO

This Application for Admission will only be processed if ALL fields are completed legibly, are signed and ALL relevant supporting documents are attached.

Ref 2013/001

REQUIRED SUPPORTING DOCUMENTS, COMPLETED SECTIONS & FORMS

CEMIS Transfer Document once available

Copy of Learner's FINAL Progress Report once available Copy of Learner's latest Progress Report

Copy of Learner's Birth Certificate / ID Document Copy of Learner's Vaccination Records if available

Copy of Learner's Residence / Study Permit, if Foreign

Copy of Parents' / Legal Guardians' ID Documents

Proof of Household Income (See Section 8) Proof of Registration Fee Payment Completed Hostel Application if applicable Completed Aftercare Application if applicable Completed Debit Order Form if applicable Subject Choice Form (FET Phase: Gr 10 - Gr 11) Sections 1 - 14 Completed & Signed

TWO RECENT

COLOUR PHOTOS

OF LEARNER

(ID SIZE)

FOR OFFICE USE

INTERVIEW DATE

NOTES

APPROVED

DATE

COMMENCEMENT DATE

GROUP / GRADE

FAMILY CODE

LEARNER NR

SIBLINGS AT

1

THE SCHOOL

2

SECTION 1 : LEARNER'S PERSONAL DETAILS

SURNAME

FULL NAMES AS ON BIRTH CERTIFICATE / ID DOCUMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PREFERRED NAME

 

 

IDENTITY NUMBER

 

DATE OF BIRTH Y Y Y Y

M M

D D

AGE

GENDER

 

 

 

 

 

 

 

MALE

FEMALE

HOME & OTHER SPOKEN LANGUAGE/S

 

HOME

 

 

OTHER

 

LANGUAGE/S OF LEARNING & TEACHING

 

FIRST

 

 

 

SECOND

 

NUMBER OF CHILDREN IN FAMILY

 

 

 

 

POSITION OF LEARNER IN FAMILY

 

NATIONALITY

 

 

COUNTRY OF ORIGIN

 

 

 

DATE OF IMMIGRATION

 

RACE

RELIGION

 

ASIAN

AFRICAN

COLOURED

 

INDIAN

 

 

WHITE

 

OTHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RESIDENCE

 

 

 

 

 

 

 

 

 

 

 

 

 

PARENTS

GUARDIANS

HOSTEL

MEANS OF TRANSPORT TO/FROM SCHOOL

LEARNER'S CELL PHONE NUMBER

MOTOR VEHICLE

MOTORBIKE

BUS

TAXI

BICYCLE

WALK

 

 

 

 

 

 

PAGE 1 OF 7

SECTION 2 : LEARNER'S EDUCATIONAL DETAILS

CURRENT SCHOOL

 

PREVIOUS SCHOOL

ADDRESS

 

 

 

ADDRESS

 

 

 

 

CODE

 

 

 

CODE

TEL NO

CODE

 

TEL NO

CODE

PRINCIPAL

 

 

 

PRINCIPAL

 

 

LAST GRADE PASSED

 

 

 

YEAR

 

 

GRADE/S REPEATED

 

 

 

HAS ADMISSION TO ANY OTHER SCHOOL/S EVER BEEN REFUSED? IF YES, PLEASE STATE REASON.

 

 

 

 

YES

NO

REASON

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACADEMIC ACHIEVEMENTS

 

 

EXTRACURRICULAR ACHIEVEMENTS

 

 

OTHER ACHIEVEMENTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION 3 : LEARNER'S MEDICAL DETAILS

BLOOD TYPE

 

 

 

 

O+

 

O-

 

A+

 

A-

AB+

 

AB-

B+

 

B-

 

UNKNOWN

FAMILY DOCTOR

NAME

 

 

 

 

 

TEL NO

 

CODE

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CODE

MEDICAL AID

NAME

 

 

 

 

 

NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

MAIN MEMBER INITIALS & SURNAME

 

 

 

 

ID NR

 

 

 

 

 

 

 

 

 

 

 

 

OPTIONS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HAS THE LEARNER RECEIVED ALL THE NECESSARY IMMUNISATIONS? IF NO, PLEASE STATE REASON.

 

 

 

 

 

 

 

 

 

 

 

YES

 

NO

REASON

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HAS THE LEARNER SUFFERED FROM ANY OF THE FOLLOWING ILLNESSES? PLEASE INDICATE WITH AN X.

 

 

 

 

 

 

ASTHMA

 

 

 

ENTERIC FEVER

 

 

 

MEASLES

 

 

 

 

 

SCARLET FEVER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CHICKEN POX

 

 

 

GERMAN MEASLES

 

 

 

MUMPS

 

 

 

 

 

TICKBITE FEVER

 

 

DIABETES

 

 

 

HEPATITIS

 

 

 

POLIO

 

 

 

 

 

TYPHOID FEVER

 

 

DIPHTHERIA

 

 

 

MALARIA

 

 

 

RHEUMATIC FEVER

 

 

WHOOPING COUGH

DOES THE LEARNER SUFFER FROM ANY ALLERGIES?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YES

 

NO

IF YES, PLEASE GIVE DETAILS.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DOES THE LEARNER HAVE ANY SPECIAL MEDICAL NEEDS?

IF YES, PLEASE GIVE DETAILS.

YES

NO

DOES OR HAS THE LEARNER SUFFERED FROM ANY OTHER ILLNESSES OR DISABILITIES?

IF YES, PLEASE GIVE DETAILS.

YES

NO

PAGE 2 OF 7

SECTION 3 : LEARNER'S MEDICAL DETAILS - CONTINUED

IS THE LEARNER RECEIVING MEDICAL TREATMENT FOR ANY CONDITION?

IF YES, PLEASE GIVE DETAILS.

YES

NO

IS OR HAS THE LEARNER SUFFERED FROM OR RECEIVED TREATMENT FOR ANY PSYCHOLOGICAL OR EMOTIONAL UPSET?

IF YES, PLEASE GIVE DETAILS.

YES

NO

HAS THE LEARNER HAD ANY OPERATIONS?

YES

NO

IF YES, PLEASE GIVE DETAILS.

PLEASE SPECIFY ANY OTHER RELEVANT MEDICAL DETAILS.

SECTION 3 : LEARNER'S MEDICAL DETAILS - CONSENT

IN A CRITICAL MEDICAL SITUATION, PLEASE BEAR IN MIND THAT THERE MAY NOT BE TIME TO REFER TO THE LEARNER'S RECORDS. THE SCHOOL THEREFORE RESERVES THE RIGHT TO UTILISE THE QUICKEST MEDICAL SERVICE AVAILABLE.

I,BEING THE PARENT / LEGAL GUARDIAN OF

HEREBY AGREE THAT A MEDICAL PRACTITIONER MAY PROVIDE EMERGENCY TREATMENT AS MAY BE NECESSARY.

SIGNATURE OF PARENT / LEGAL GUARDIAN

SECTION 4 : DETAILS OF FATHER / STEPFATHER / LEGAL GUARDIAN

COMPLETE ONLY IF NOT THE ACCOUNT HOLDER. REFER TO SECTION 8.

SURNAME

 

 

FULL NAMES AS IN ID DOCUMENT

 

 

 

 

 

 

 

 

DESIGNATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MR

MRS

MS

MISS

DR

REV

PROF

OTHER

 

 

 

 

 

IDENTITY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RELATIONSHIP

 

 

 

 

 

MARITAL STATUS

 

 

 

 

 

 

 

 

 

OCCUPATION

 

 

 

 

 

EMPLOYER

 

 

 

 

 

 

 

 

 

RESIDENTIAL ADDRESS

 

WORK ADDRESS

POSTAL ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CODE

 

CODE

CODE

TEL H CODE

 

 

 

TEL W

CODE

 

 

CELL

 

 

 

 

 

 

 

 

 

 

 

 

E-MAIL ADDRESS (PLEASE WRITE LEGIBLY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PARENTAL STATUS

LEARNER LIVING WITH

 

LEARNER'S LEGAL

ACCESS RIGHTS TO

ACCESS RIGHTS IN AN

PARENT/S

 

GUARDIAN

 

LEARNER

EMERGENCY ONLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PAGE 3 OF 7

SECTION 5 : DETAILS OF MOTHER / STEPMOTHER / LEGAL GUARDIAN

COMPLETE ONLY IF NOT THE ACCOUNT HOLDER. REFER TO SECTION 8.

SURNAME

 

 

FULL NAMES AS IN ID DOCUMENT

 

 

 

 

 

 

 

 

DESIGNATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MR

MRS

MS

MISS

DR

REV

PROF

OTHER

 

 

 

 

 

IDENTITY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RELATIONSHIP

 

 

 

 

 

MARITAL STATUS

 

 

 

 

 

 

 

 

 

OCCUPATION

 

 

 

 

EMPLOYER

 

 

 

 

 

 

 

 

RESIDENTIAL ADDRESS

 

WORK ADDRESS

POSTAL ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CODE

 

 

 

CODE

 

 

CODE

TEL H CODE

 

TEL W CODE

 

 

CELL

 

 

 

 

 

 

 

 

 

E-MAIL ADDRESS (PLEASE WRITE LEGIBLY)

 

 

 

 

 

 

 

PARENTAL STATUS

LEARNER LIVING WITH

PARENT/S

LEARNER'S LEGAL

GUARDIAN

ACCESS RIGHTS TO

LEARNER

ACCESS RIGHTS IN AN

EMERGENCY ONLY

SECTION 6 : DETAILS OF ANOTHER CONTACT IN THE CASE OF AN EMERGENCY

SURNAME

 

 

 

FULL NAMES

 

 

 

 

 

 

 

 

 

RELATIONSHIP

 

 

 

 

 

 

TEL H CODE

 

TEL W CODE

CELL

 

 

 

 

 

 

 

 

E-MAIL ADDRESS (PLEASE WRITE LEGIBLY)

 

 

 

 

 

 

SECTION 7 : DECLARATION OF PARENTS / LEGAL GUARDIANS

We the undersigned, _________________________________________________________________, hereby certify that the information given by us

in this Application for Admission is complete and accurate. We also agree to the conditions as set out herein.

We accept that the School is based on Christian principles and undertake that this will not be undermined.

We understand that the prescribed number of learners per class may be exceeded through the placing of a current learner that has to repeat a grade.

This Application for Admission will be reconsidered in the case where important relevant information, which should be brought to the School’s attention, is withheld.

We have read the Code of Conduct, Substance Abuse Policy and Dress Code and will accept an offer of placement for our child at the School in accordance with the terms and conditions as set out therein. These documents, as amended from time to time, are available on the official website of the School at www.curro.co.za.

NB: The signatures of both parents and / or legal guardians are required where applicable.

____________________________________________________

____________________________

SIGNATURE OF FATHER / STEPFATHER / LEGAL GUARDIAN

DATE

____________________________________________________

____________________________

SIGNATURE OF MOTHER / STEPMOTHER / LEGAL GUARDIAN

DATE

PAGE 4 OF 7

SECTION 8 : DETAILS OF ACCOUNT HOLDER

SURNAME

 

 

FULL NAMES AS IN ID DOCUMENT

 

 

 

 

 

 

 

 

DESIGNATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MR

MRS

MS

MISS

DR

REV

PROF

OTHER

 

 

 

 

 

IDENTITY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RELATIONSHIP

 

 

 

 

MARITAL STATUS

 

 

 

 

 

 

 

 

 

OCCUPATION

 

 

 

 

 

EMPLOYER

 

 

 

 

 

 

 

 

 

RESIDENTIAL ADDRESS

 

WORK ADDRESS

POSTAL ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CODE

 

 

 

 

 

 

 

 

 

 

 

CODE

 

 

 

 

 

CODE

TEL H CODE

 

 

 

TEL W

CODE

 

 

 

 

 

 

 

 

CELL

 

 

 

 

 

 

E-MAIL ADDRESS (PLEASE WRITE LEGIBLY)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PARENTAL STATUS

LEARNER LIVING WITH

 

 

LEARNER'S LEGAL

 

 

 

ACCESS RIGHTS TO

 

ACCESS RIGHTS IN AN

PARENT/S

 

 

 

 

 

 

 

GUARDIAN

 

 

 

 

 

LEARNER

 

 

EMERGENCY ONLY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DETAILS OF CHILDREN IN YOUR CARE WHO ARE CURRENTLY AT THIS SCHOOL

 

 

 

 

 

 

 

 

 

 

1

NAME

 

 

 

 

 

GR

 

 

 

2

NAME

 

 

 

 

 

 

 

 

GR

 

 

3

NAME

 

 

 

 

GR

 

 

4

NAME

 

 

 

 

 

 

 

GR

 

 

ANNUAL, AFTER TAX, COMBINED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LESS THAN

R 50 000 -

R100 000 -

 

R150 000 -

R200 000 -

R250 000 -

MORE THAN

HOUSEHOLD INCOME

 

 

 

 

R50 000 pa

R100 000 pa

R150 000 pa

 

R200 000 pa

R250 000 pa

R300 000 pa

R300 000 pa

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PLEASE NOTE: This is for statistical purposes only and will NOT affect your child's acceptance status.

PAYMENT OPTION

MONTHLY

DEBIT ORDER

MONTHLY IN ADVANCE BY

ELECTRONIC FUNDS TRANSFER OR CASH DEPOSIT AT THE BANK

ANNUALLY IN ADVANCE BY

ELECTRONIC FUNDS TRANSFER OR CASH DEPOSIT AT THE BANK

SECTION 9 : DECLARATION OF ACCOUNT HOLDER

We the undersigned, _________________________________________________________________, hereby certify that the information given by

the Account Holder in this Application for Admission is complete and accurate.

We accept joint and several liability to Campus and Property Management Company (Pty) Ltd and Meridian Operations Company NPC (RF) for the due and punctual payment of the annual, non-refundable registration fee, school fees, hostel fees and any other amounts which may become due and payable to the School or in respect of participation in or attendance of any extracurricular activity.

We accept the Financial Terms and Conditions of which a copy has been kept.

NB: The signatures of the account holder and that of the 2nd parent / a parent / legal guardian are required if applicable.

____________________________________________________

____________________________

SIGNATURE OF ACCOUNT HOLDER

DATE

____________________________________________________

____________________________

SIGNATURE OF 2ND PARENT / A PARENT / LEGAL GUARDIAN

DATE

____________________________________________________

____________________________

SIGNATURE OF AN AUTHORISED SCHOOL REPRESENTATIVE

DATE

PAGE 5 OF 7

SECTION 10 : FINANCIAL TERMS AND CONDITIONS

1.ACCEPTANCE OF LIABILITY

1.1The person responsible for the Account (hereafter the Account Holder) as set out in the standard Application for Admission (hereafter the Application) herewith assumes liability for the Account, alternatively binds him-/herself as co-debtor and surety for payment of all fees to the School.

1.2The legal guardian, as described in the Application, binds him-/herself as surety and co-debtor for the payment of all fees by the Account Holder or any other payments that may arise from this Agreement.

2.TERMS OF PAYMENT

2.1It is recorded that fees are determined at the beginning of the year and that the Account Holder is informed of the result in writing.

2.2The Account Holder shall immediately inform the School if he / she has not received an invoice at the start of the academic year.

2.3Fees for 11 (eleven) or 12 (twelve) months, depending on the specific School’s payment policy, are payable monthly in advance by means of debit order, electronic funds transfer or cash deposit at the bank on or before the 2nd (second) day of each calendar month or annually in advance by means of electronic funds transfer or cash deposit at the bank by 31 December, depending on the fee payment option exercised by the Account Holder in the Application for Admission.

2.4The School reserves the right to charge interest of 15% (fifteen percent) on all accounts that are in arrears by 30 (thirty) days or longer.

2.5Payment of monthly fees is not subject to presentation of a statement. Payments are made in accordance with the applicable fee structure of the School.

2.6In the event where an existing account is / has not been managed in the proper manner, no further Applications will be considered.

3.BREACH OF CONTRACT

In the event where the undersigned surety, Account Holder or legal guardian commits a breach of contract of any of the terms of this Agreement, the School may in its sole discretion:

3.1Refuse the learner entry to the School’s premises until the breach has been remedied; or

3.2Claim damages from the Account Holder and / or the surety and legal guardian; or

3.3Take whatever legal steps that may be necessary.

4.GENERAL

This Agreement constitutes the whole Agreement between the parties relating to the subject matter hereof. No amendment or consensual cancellation of this Agreement or any provision or term thereof or of any Agreement, bill of exchange or other document issued or executed pursuant to or in terms of the Agreement and no settlement of any disputes arising under this Agreement and no extension of time, waiver or relaxation or suspension of any of the provisions or terms of this Agreement or of any Agreement, bill or exchange or other document issued pursuant to or in terms of this Agreement shall be binding unless recorded in a written document signed by the parties. Any such extension, waiver or relaxation or suspension which is so given or made shall be strictly construed as relating strictly to the matter in respect whereof it was made or given.

5.JURISDICTION

This Agreement is subject to South African law.

6.CREDIT INFORMATION

The Account Holder, surety or legal guardian hereby consents to the disclosure and exchange of personal financial information to a credit bureau or financial institution in accordance with the National Credit Act.

7.DOMICILIUM

The parties choose as their domicilia citandi et executandi the addresses set out in the Application.

8.LEGAL FEES

In the event where the School takes legal action against the Account Holder, he / she will be liable for all legal fees on an attorney client scale, collection costs and commission, interest and tracing fees.

9.CANCELLATION

9.1The Account Holder undertakes to give 30 (thirty) calendar days written notice of termination of the enrolment of a learner, failing which the liability be incurred for the full amount of the following term’s fees.

9.2The School shall be entitled to terminate the enrolment of any learner under the following circumstances:

Summarily, and with immediate effect, if the learner is guilty of an offence which, in the sole opinion of the School, renders his / her continued enrolment at the School impossible, in which event the Account Holder, after deduction of all amounts otherwise owing to the School, will be refunded a pro-rata proportion of any fees already paid in advance in respect of such learner.

9.3In the event of emigration, which is a long process, the School requires 1 (one) full term’s written notice in advance.

____________________________________________________

____________________________

SIGNATURE OF ACCOUNT HOLDER

DATE

PAGE 6 OF 7

SECTION 11 : GENERAL INDEMNITY

1.The School and the Campus and Property Management Company (Pty) Ltd and Meridian Operations Company NPC (RF) Board of Directors undertake to implement reasonable and generally acceptable measures with regard to the safety and well-being of all learners, educators and visitors to the School.

2.Due to the nature of the matter, the School and the Campus and Property Management Company (Pty) Ltd and Meridian Operations Company NPC (RF) Board of Directors do not accept any responsibility for accidents that may take place in the class, on the school terrain or on the sports fields.

3.Each parent is therefore requested to complete this form as proof that you accept the position of the School and the Campus and Property Management Company (Pty) Ltd and Meridian Operations Company NPC (RF) Board of Directors as set out above as well as the risks involved therewith.

4.I, _________________________________________________, being the parent / legal guardian of

_______________________________________ who is enrolled as such and accepted by the School, subject to the terms set out herein, indemnify the School and the Campus and Property Management Company (Pty) Ltd and Meridian Operations Company NPC (RF) Board of Directors for the time being of the Campus and Property Management Company (Pty) Ltd (Reg Nr 2012/001821/07) and Meridian Operations Company NPC (RF) (Reg Nr 2012/081855/08) for any losses or damages in general, however they may occur, that I as parent / legal guardian of the above learner may suffer as a result of any occurrence whereby the learner may be involved, whether as the causing or suffering party, whilst participating in any school activity, except if such loss or damage arises as a consequence of the gross negligence or willful misconduct of the School or the Campus and Property Management Company Board of Directors or the Meridian Operations Company NPC (RF) Board of Directors or any person acting for or controlled by the School or the Campus and Property Management Company Board of Directors or the Meridian Operations Company NPC (RF) Board of Directors.

5.In particular, I authorise that the aforesaid learner may be involved in all excursions undertaken by his / her group or class during school days as part of his / her learning experience and, where applicable, I agree that he / she may utilise the transport arranged by the School for such excursions. I also indemnify the School and the Campus and Property Management Company (Pty) Ltd and Meridian Operations Company NPC (RF) Board of Directors for any damages or losses that I as parent / legal guardian of the above learner may suffer under such circumstances and voluntarily accepts the risks associated therewith, except if such loss or damage arises as a consequence of the gross negligence or willful misconduct of the School or the Campus and Property Management Company Board of Directors or the Meridian Operations Company NPC (RF) Board of Directors or any person acting for or controlled by the School or the Campus and Property Management Company Board of Directors or the Meridian Operations Company NPC (RF) Board of Directors.

6.In the event of the aforesaid learner making use of the bus service to and from the School, I acknowledge that I am aware that such service is operated by an independent contractor and that neither the School nor the Campus and Property Management Company (Pty) Ltd and Meridian Operations Company NPC (RF) Board of Directors accepts any responsibility therefore. The Campus and Property Management Company (Pty) Ltd and Meridian Operations Company NPC (RF) Board of Directors have, however, in awarding the right to operate the service, laid down certain conditions to ensure that the bus company complies with safety regulations and that the driver is sober and experienced with a proven and unblemished record.

SIGNED AT ______________________________________ ON THIS __________ DAY OF ___________________________ 20 _________.

AS WITNESSES:

1._____________________________________

2.____________________________________________________________________________

SIGNATURE OF PARENT / LEGAL GUARDIAN

SECTION 12 : PERMISSION TO USE PHOTOGRAPHS

I understand and acknowledge that, from time to time, informal photographs are taken of the School's learners, and that, insofar as these photographs are placed in the possession or control of the School and / or Curro Holdings Ltd and / or Campus and Property Management Company and / or Meridian Operations Company NPC (RF), these photographs might be used by the School and / or Curro Holdings Ltd and / or Campus and Property Management Company and / or Meridian Operations Company NPC (RF) in the electronic and / or printed media, including the Curro Holdings Ltd website, newspaper advertisements, magazine advertisements, brochures, flyers, posters, billboards, banners, flippers and signage on buildings and vehicles, which use will be solely for purposes of marketing the School and / or Curro Holdings Ltd and / or Campus and Property Management Company and / or Meridian Operations Company NPC (RF). As all marketing material of the School and / or Curro Holdings Ltd and / or Campus and Property Management Company and / or Meridian Operations Company NPC (RF) will, at all times, insofar as the use and publication of photographs are placed in the control of the School and / or Curro Holdings Ltd and / or Campus and Property Management Company and / or Meridian Operations Company NPC (RF), ensure that these photographs are used in good taste.

SIGNATURE OF PARENT / LEGAL GUARDIAN

SECTION 13 : SURVEY - SERVICES / FACILITIES REQUIRED

BUS TRANSPORT TO / FROM SCHOOL REQUIRED HOLIDAY CARE REQUIRED

YES

YES

NO

NO

FROM WHERE?

SECTION 14 : SURVEY - MARKETING

WHERE DID YOU HEAR ABOUT US? PLEASE INDICATE WITH AN X.

BILLBOARD PRESENTATION FRIEND

NEWSPAPER BROCHURE WEB

MAGAZINE FLYER

OTHER / SPECIFY

RADIO EXHIBITION

PLEASE INDICATE HOW SATISFIED YOU WERE WITH THE SERVICE RECEIVED PRE-ENROLMENT.

VERY SATISFIED

SATISFIED

UNSATISFIED

VERY UNSATISFIED

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