Common use of Child Details Clause in Contracts

Child Details. Child’s official given name: Child’s official surname or family name: Child’s official other names/middle name: Name your child is known by/preferred name: Surname/Family Name: Given Name: Copy of official identity verification document* collected by staff: ❑ New Zealand birth certificate ❑ Foreign birth certificate ❑ New Zealand passport ❑ Foreign passport ❑ Other Staff Initials: Child’s date of birth: dd / mm / yyyy Male ❑ Female ❑ Ethnic origin: Iwi your child belongs to: Language/s spoken at home: Child’s primary residential address: Postcode Parents / Guardians: Are parents living together ❑ or separated ❑? First Name(MOTHER): First Name(FATHER): Surname: Surname: Address:❑ (Same as Child) Address:❑ (Same as Child) Post Code: Post Code: Ph (Work): Ph (Home): Ph (work): Ph (home): Ph (Mobile): Ph (Mobile): Email: Occupation: Email: Occupation: Emergency Contacts: People you would like us to contact if we are unable to contact you & are permitted to collect your child(ren) on your behalf What is this person’s relationship to your child, i.e. Grandmother, Uncle, Family Friend? What is this person’s relationship to your child, i.e. Grandmother, Uncle, Family Friend Eg. Aunt ...................................................................................... Eg. Grandmother ......................................................................................

Child Details. ChildXxxxx’s official given name: ChildXxxxx’s official surname or family name: ChildXxxxx’s official other names/middle name: Please separate names with a comma Name your child is known by/preferred name: Surname/Family Name: Given Name: Children may be enrolled into a service even if a parent/caregiver cannot provide identity documentation. It is important to ask for identity documentation, and if a parent/caregiver can provide it, please state in the enrolment form which documentation you sighted. Copy of official identity verification document* collected by staff: ❑ New Zealand birth certificate ❑ Foreign birth certificate ❑ New Zealand passport ❑ Foreign passport ❑ Other Staff Initials: Child’s date of birth: dd / mm / yyyy Male ❑ Female ❑ Ethnic origin: Iwi your child belongs to: Language/s spoken at home: Child’s primary residential address: Postcode Parents / Guardians: Given Names Are parents living together ❑ or separated ❑? First Name(MOTHER): Name First Name(FATHER): Name Surname/Family Name: Surname/Family Name: ]Address:❑ (Same as Child) Address:❑ (Same as Child) Post Code: Post Code: Ph (Work): Ph (Home): Ph (work): Ph (home): Ph (Mobile): Ph (Mobile): Email: Occupation: Relationship to Child: Email: Occupation: Relationship to Child: Emergency Contacts: People you would like us to contact if we are unable to contact you & are permitted to collect your child(ren) on your behalf What is this person’s relationship to your child, i.e. Grandmother, Uncle, Family Friend? What is this person’s relationship to your child, i.e. Grandmother, Uncle, Family Friend Eg. Aunt ...................................................................................... Eg. Grandmother ......................................................................................

Child Details. ChildXxxxx’s official given name: ChildXxxxx’s official surname or family name: ChildXxxxx’s official other names/middle name: Please separate names with a comma Name your child is known by/preferred name: Surname/Family Name: Given Name: Copy of official identity verification document* collected by staff: ❑ New Zealand birth certificate ❑ Foreign birth certificate ❑ New Zealand passport ❑ Foreign passport ❑ Other Staff Initials: Child’s date of birth: dd / mm / yyyy Male ❑ Female ❑ Ethnic origin: Iwi your child belongs to: Language/s spoken at home: Child’s primary residential address: Postcode Parents / Guardians: Are parents living together ❑ or separated ❑? First Name(MOTHER): First Name(FATHER): Surname/Family Name: Surname/Family Name: Address:❑ (Same as Child) Address:❑ (Same as Child) Post Code: Post Code: Ph (Work): Ph (Home): Ph (work): Ph (home): Ph (Mobile): Ph (Mobile): Email: Occupation: Email: Occupation: Emergency Contacts: People you would like us to contact if we are unable to contact you & are permitted to collect your child(ren) on your behalf What is this person’s relationship to your child, i.e. Grandmother, Uncle, Family Friend? What is this person’s relationship to your child, i.e. Grandmother, Uncle, Family Friend Eg. Aunt ...................................................................................... Eg. Grandmother ......................................................................................

Child Details. Child’s official given name: Child’s official surname or family name: Child’s official other names/middle name: Please separate names with a comma Name your child is known by/preferred name: Surname/Family Name: Given Name: Copy of official identity verification document* collected by staff: ❑ New Zealand birth certificate ❑ Foreign birth certificate ❑ New Zealand passport ❑ Foreign passport ❑ Other Staff Initials: Child’s date of birth: dd / mm / yyyy Male ❑ Female ❑ Ethnic origin: Iwi your child belongs to: Language/s spoken at home: Child’s primary residential address: Postcode Parents / Guardians: Are parents living together ❑ or separated ❑? First Name(MOTHER): First Name(FATHER): Surname/Family Name: Surname/Family Name: Address:❑ (Same as Child) Address:❑ (Same as Child) Post Code: Post Code: Ph (Work): Ph (Home): Ph (work): Ph (home): Ph (Mobile): Ph (Mobile): Email: Occupation: Email: Occupation: Emergency Contacts: People you would like us to contact if we are unable to contact you & are permitted to collect your child(ren) on your behalf What is this person’s relationship to your child, i.e. Grandmother, Uncle, Family Friend? What is this person’s relationship to your child, i.e. Grandmother, Uncle, Family Friend Eg. Aunt ...................................................................................... Eg. Grandmother ......................................................................................

Child Details. ChildXxxxx’s official given name: ChildXxxxx’s official surname or family name: Child’s official other names/middle name: Name your child is known by/preferred name: Surname/Family Name: Given Name: Copy of official identity verification document* collected by staff: ❑ New Zealand birth certificate ❑ Foreign birth certificate ❑ New Zealand passport ❑ Foreign passport ❑ Other Staff Initials: Child’s date of birth: dd / mm / yyyy Male ❑ Female ❑ Ethnic origin: Iwi your child belongs to: Language/s spoken at home: Child’s primary residential address: Postcode Parents / Guardians: Are parents living together ❑ or separated ❑? First Name(MOTHER): First Name(FATHER): Surname: Surname: Address:❑ (Same as Child) Address:❑ (Same as Child) Post Code: Post Code: Ph (Work): Ph (Home): Ph (work): Ph (home): Ph (Mobile): Ph (Mobile): Email: Occupation: Email: Occupation: Emergency Contacts: People you would like us to contact if we are unable to contact you & are permitted to collect your child(ren) on your behalf What is this person’s relationship to your child, i.e. Grandmother, Uncle, Family Friend? What is this person’s relationship to your child, i.e. Grandmother, Uncle, Family Friend Eg. Aunt ...................................................................................... Eg. Grandmother ......................................................................................