REDWOOD SCHOOL Application for Enrolment

Rākau pai, hua pai

Office use only:

Start date:

School Visits:

Room:

Year:

NSN:

Name of eldest child at this school:

House:

Place in family:

☐ Birthdate verification (birth certificate/passport)

☐ Internet User agreement

☐ Citizenship/Residency information

☐ Permission form

☐ Immunisation Certificate

☐ 2 documents showing proof of address (e.g. phone bill, power bill)

ELIGIBILITY Does the student live permanently in the school zone?

YES / NO

(please circle one)

If student is within the school zone we require 2 original documents confirming proof of residence. Please include these with your application. Examples of proof of residence documents: rental agreement, electricity account, landline telephone account. STUDENT Legal Surname:

Legal First Names:

Preferred Surname:

Preferred First Name:

Date of Birth:

BOY / GIRL

Student’s Citizenship: NZ Resident:

Country of Birth: Date of arrival in NZ (if applicable):

Yes

/

No

Student’s Ethnicity 1:

___________________________

Student’s Ethnicity 2:

___________________________

Student’s Ethnicity 3:

___________________________

Iwi Affiliation (Maori): Home Language: ______________________ My child also understands: ________________________

The student lives with: ☐ Both parents (same address) ☐ Mother only ☐ Father only ☐ Both parents (shared care) ☐ _________________ Previous school:

Previous class:

Learning/Behaviour Needs: Please specify any learning or behaviour needs the school should be made aware of.

PARENTS/CAREGIVERS Parent/Caregiver’s Name:

Relationship to child:

Home address:

Email:

Home phone:

Cell phone:

Work phone:

Workplace/Occupation:

Parent/Caregiver’s Name:

Relationship to child:

Home address:

Email:

Home phone:

Cell phone:

Work phone:

Workplace/Occupation:

Please nominate one primary caregiver’s email address and mobile phone number to receive important and/or emergency communication Email:

Cell phone:

CUSTODY ACCESS Court order issued?

Yes

No

N/A

please circle

one Details:

EMERGENCY CONTACTS In the event that we cannot contact a student’s primary caregiver, it may be necessary to contact another person to collect your child if they are unwell or in an emergency. This could be a relative, family friend or a neighbour. Please list below alternative contacts with at least one of them being someone who is within close proximity to the school during the day. Name of Emergency contact: 1.

2.

3.

Relationship to Student:

Home phone:

Cell phone:

EARLY CHILDHOOD EDUCATION (ECE) Did your child attend an ECE service in the six months prior to starting school?

YES

/

NO

Please circle one

If yes, please name the ECE your child attended? _____________________________________ If YES, please enter the number of hours per week for up to three services (A-F) ECE Service

Service 1 (hrs/week)

Service 2 (hrs/week)

Service 3 (hrs/week)

A. Kohango Reo B. Playcentre C. Kindergarten or Education & Care Centre D. Home based service E. Playgroup F. Correspondence School If YES, did your child regularly attend an ECE service? ‘Regularly attend’ means the child was booked into a service for sessions each week/fortnight, and generally went to those sessions unless they were sick, on holiday, or had a family occasion etc. ☐ Yes, for the last ______ years

☐ Not regularly, only occasionally with no ongoing schedule

If NO, please tick the appropriate box (G-J) G. Attended, but only outside New Zealand H. Attended, but don’t know what type of

Tick appropriate box

service I. Did not attend J. Unable to establish if attended or not MEDICAL DETAILS Doctor’s Name and/or Medical Centre:

Phone Number:

Does your child have a medical condition, or has had a medical issue, that we should be aware of? If yes, please provide details below:

YES

NO

YES

NO

Has your child ever contracted, or been in contact with, any communicable disease? (e.g. TB, Hepatitis, HIV etc)

YES

NO

Has your child been fully immunised? (please provide immunisation record & certificate with your application)

YES

NO

Does your child take any regular medication? If yes, please provide details below:

Signed:

Date:

PERMISSION FORM (This permission is asked for on an annual basis) I give permission for: __________________________________________ (child’s name) ☐ To undertake visits and trips outside the classroom, within the environs of Wellington. ☐ I give permission for my child to leave the school grounds for educational or sporting events. ☐ I give permission for my child to be transported by bus or car for educational or sporting events. • •

If there is an extra cost (outside of the Activity Fee) then a notice will be sent home. If parental transport is required then a notice will be sent home.

☐ I give permission for my child’s work to be used in school publications, understanding that the newsletter is placed on the web site. This may include the class blog where student’s first name only will be used. (This occasionally may include a local newspaper). ☐ I give permission for my child’s photo to be used in school publications. This may include our school magazine. It may include a local newspaper. ☐ I give permission for my child to be videoed. This may be used on the class blog or website or may be used by teachers for their professional development. ☐ I give permission for school staff to act on my behalf in the event of a medical emergency where the school staff are unable to contact me or any of the emergency contacts I have given for my child. I will pay any associated costs of this emergency treatment. Parent/Caregiver Name: ________________________

Signed: ____________________ Date: ______________

INTERNET USE BY STUDENTS: PARENT PERMISSION FORM AND USER AGREEMENT Redwood School makes regular use of the Internet as an integral and important part of its teaching and learning programmes. It enables our children to seek and gather information and communicate beyond the classroom. Our goal is to make this accessible to all at Redwood School. To gain access to email, the internet, and other ICT tools, all students must agree to follow the School’s cyber safety expectations and obtain the permission of their parents/caregivers. To support our use of this resource we have developed a set of digital citizenship expectations we expect all children to abide by. A copy of these expectations is attached on the following page. This form seeks your permission for your child to use this facility and acknowledges their agreement to abide by the School’s cyber safety expectations as verified by the signatures below. While most of the material on the Internet is harmless, families should be aware that the nature of some material makes it undesirable for children’s viewing. It is also possible to purchase goods and services. While the School has in place measures to make this unlikely, exceptions cannot be ruled out. Parent Declaration ☐ As Parent or Caregiver of a student at Redwood School, I have read this and the Redwood School Digital Citizenship expectations for students document. I have discussed the Cybersafety expectations with my child. ☐ I understand that school computers, the Internet and ICT equipment are used for educational purposes. ☐ I understand that failure to act as a good user will result in loss of access to the Internet and ICT resources. ☐ I understand that the School cannot be held responsible or liable for material found by students or for goods purchased. ☐ I understand that photographs of my child or a piece of their work may from time to time be published on our website or class blog site and give consent for this. ☐ I understand the signed copy of this agreement will be kept at School.

As parent or caregiver I give consent for ____________________________________ (child’s name) to have access to the Internet, ICT equipment and to be published on the Internet. Parent/Caregiver Name: _______________________ (please print)

Signed: ______________________

Date: _______________

OTHER Future enrolments: Please list any other members of your family likely to be attending Redwood School in the future: Name:

Birth date:

Name:

Birth date:

Name:

Birth date:

Communication from the School: Redwood School’s newsletter is emailed to parents and families every second Thursday. Please list the email address to receive this. Name:

Email address:

Name:

Email address:

Name:

Email address:

POLICIES & PROCEDURES / DECLARATION

☐ When he/she is absent or late I shall phone the school or provide a note of explanation. ☐ I agree to paying costs related to Activity Fee for my child. ☐ In terms of the Privacy Act, I understand that the information on this form is collected to form part of the essential information the school holds on my child. The records made from this information may be viewed on request at the school. ☐ I also agree that Redwood School may have access to information and records pertaining to my child from previous schools and agencies (if applicable) and that information about my child may be passed on to other schools or relevant agencies. ☐ I confirm that the address that I have provided to the school will be the usual place of residence of ______________________________ (child’s name) when the school is open for instruction. I will advise of any subsequent change of address. ☐ I certify that all information entered on this enrolment form is factually correct. Signed: _____________________________ Name: ___________________________ Date: __________________

FINAL CHECKLIST Please ensure you provide us with the requested documents to support your child’s application. Have you attached: ☐ A copy of student’s birth certificate (NZ Citizen) ☐ A copy of student’s passport (Citizens of other countries) ☐ A copy of student’s residence permit or student’s visa (Citizens of other countries) ☐ If your application is IN ZONE, have you attached your proof of residence documents? ☐ A copy of student’s immunisation certificate ☐ Permission form and Internet Use agreement form (both are attached, see over the page) ☐ Any documents relating to custody access ☐ Any documents relating to learning/behaviour needs

For all enquiries please contact the school office: Phone: 232 7704 (Extn 0) Email: [email protected] Address: 71A Redwood Ave, Tawa, Wellington 5028

I am a Digital Citizen at Redwood School Note for Parents/Legal Guardians/Caregivers: At Redwood School we aim to encourage students to be good digital citizens and to ensure that all children learn to use equipment appropriately and keep safe. Please read and discuss these expectations with your child. I am RESPECTFUL. I feel with my HEART. I protect mine and others’ privacy and remember that my ‘digital footprint’ should not harm others. I only use other people’s work and images online when I have their permission to do so. I am RESPONSIBLE. I think with my HEAD. I protect my private information and the information of others. I always use kind words and I think about others’ feelings when I’m writing something online. I look after the equipment at Redwood School. I am ENGAGED. I listen to my GUT. I enjoy myself while I am online and make sure that I am safe and appropriate. I visit websites that help me with my learning. If something makes me uncomfortable while I am online, I know to get advice from an adult. I am EMPOWERED. I STAND UP and say no to CYBER-BULLYING. I use STAR when I am online Stop, Think, Act, Report. I am DRIVEN to be a lifelong learner. I balance with my ARMS. I enjoy using all the digital devices that Redwood School has to offer and I use these devices to help me with my learning. I understand the need to take breaks from digital devices.