Common use of Medicines Clause in Contracts

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as a way to share moments of beauty and inspiration through photographs as we learn alongside children. I do/not give my permission for my child’s photograph to be included on facebook  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool is closed on all Statutory Holidays and Public Holidays Cust Preschool is closed for a period over the Christmas holidays Excursions: I give my permission for my child to take part in planned excursions that leave Cust preschool grounds (please see excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddock. Photo/video: I give my permission for my child to be photographed for the purposes of assessment, planning and evaluation Policy Statement: Cust Preschool has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to policy review.

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Details: Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your You authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]Muddy Toes Early Learning Centre. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as a way to share moments of beauty and inspiration through photographs as we learn alongside children. I do/not give my permission for my child’s photograph to be included on facebook  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool is closed on all Statutory Holidays and Public Holidays Cust Preschool is closed for a period over the Christmas holidays Excursions: I give my permission for my child to take part in planned excursions that leave Cust preschool grounds (please see excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddock. Photo/video: I give my permission for my child to be photographed for the purposes of assessment, planning and evaluation Policy Statement: Cust Preschool has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to policy review.Optional Charges:

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Details: Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up available to six hours per daychildren 3 years and over, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: Attestation (over three) to be completed if your child is 3 years or older): Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]CAMBRIDGE EARLY LEARNING CENTRE – THE CASTLE / THE PAGODA. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as a way to share moments of beauty and inspiration through photographs as we learn alongside children. I do/not give my permission for my child’s photograph to be included on facebook  Christmas Holidays / Holidays / Sick Leave / Statutory Holidays / Term Breaks CHILDREN AGED 0-3 YEARS: Providing written notice of absence is given, either by completing our Holiday Notice form or via email one week prior, each child is entitled to up to two of their weeks at 30% of fees. Any remaining holidays will be at 50% of fees if notification is received prior to 8.30am on the day. CHILDREN AGED 3 YEARS +: Each child will be entitled to a maximum of 15 days leave at 50% of fees to cover holiday or sick absences. Please note: there will be no charge for our closedown period which is usually from 3pm Christmas Eve until the first non-statutory holiday day in January and no charge for Statutory Holidays. This enrolment agreement is inclusive of school term breaks. Cust Preschool is closed on all Statutory Holidays and Public Holidays Cust Preschool is closed for a period over the Christmas holidays Excursions: I give my permission for my child to take part in planned excursions that leave Cust preschool grounds (please see excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddock. Photo/video: I give my permission for my child to be photographed for the purposes of assessment, planning and evaluation Policy Statement: Cust Preschool has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to policy review.

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  ⧫ Enrolment Details (Under three): Date of Enrolment:____ /____ / ___ Date of EntryDetails: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  ⧫ 20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your you authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  ⧫ Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book ⧫ Optional Charges: The optional charge is for: An optional charge should only be requested for trips/Excursions if: There is a direct cost such as a way ‘entry fee’ associated with the excursion and/or Travel is required to share moments of beauty get to the destination, specifically not covered by walking. All optional charges must be only for educational excursions and inspiration through photographs as we learn alongside care for the children, and should be able to be separated out and measured. I do/not give my permission understand that if I agree to pay for my the optional charge, Little Hands Childcare and Early Learning centre may enforce payment. The agreement to pay the optional charge will last for the entire time of the child’s photograph enrolment. The rules about making changes to the agreement are you must give one – week notice in writing Changes to booked hours, if you wish to increase or decrease the hours/days your child is booked for I understand that that optional charge is not compulsory and if I choose not to pay there will be included on facebook  no penalty. I agree/do not agree (select one) to pay the optional charge for the activities/items specified in this enrolment agreement form. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ ⧫ Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool is We are closed on all Statutory Holidays and Public Holidays Cust Preschool is closed for a period over the Christmas statutory holidays Excursions: I give my permission for my child to take part in planned excursions that leave Cust preschool grounds (please see excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddock. Photo/video: I give my permission for my child to be photographed for the purposes of assessment, planning and evaluation Policy Statement: Cust Preschool has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to policy reviewif it falls on weekday.

Medicines. To This section is to be filled in only if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Date of Enrolment:____ /____ / ___ Date of EntryDetails: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]Mt Wellies Childcare Centre. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as a way to share moments of beauty and inspiration through photographs as we learn alongside children. I do/not give my permission for my child’s photograph to be included on facebook  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool Mt Wellies Childcare is open every week of the year and is only closed on all Statutory Holidays and Public Holidays Cust Preschool is closed Holidays. Normal fees are charged for a period over the Christmas holidays Excursions: I give my permission for my child to take part in planned excursions that leave Cust preschool grounds (please see excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddock. Photo/video: I give my permission for my child to be photographed for the purposes of assessment, planning and evaluation Policy Statement: Cust Preschool has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to policy reviewstatutory holidays.

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ________________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]Te Whare Whitinga o te Rā. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as a way to share moments of beauty and inspiration through photographs as we learn alongside children. I do/not give my permission for my child’s photograph to be included on facebook  Statutory Holidays / Term Breaks This enrolment agreement is inclusive inclusive/exclusive of school term breaks. Cust Preschool Te Whare Whitinga o te Rā is closed NOT open on all ANY public holiday. If your service is open on Statutory Holidays and Public Holidays Cust Preschool Holidays, parents need to confirm enrolment for each individual statutory holiday. Te Whare Whitinga o te Rā is closed for NOT open on the following public holidays if they fall on a period over weekday. Please tick the Christmas holidays Excursions: I give my permission for my child to take part in planned excursions that leave Cust preschool grounds (please see excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddock. Photo/video: I give my permission for my days you wish your child to be photographed for the purposes of assessment, planning and evaluation Policy Statementspecifically enrolled for: Cust Preschool has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to policy review.New Year’s Day Easter Monday Christmas Day Day after New Year’s Day ANZAC Day Boxing Day Waitangi Day Queen's Birthday Local Anniversary Day Good Friday Labour Day

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: created Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Manager notified Yes No Team Leader notified Yes No Qualify for a EC12/13 exemption – if yes complete forms for doctors signing Yes No Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Date of Enrolment:____ /____ / ___ Date of EntryDetails: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. If your child is absent for three weeks or more funding will cease on the fourth week and you will be liable to pay the non-funded child daily rate as per fee schedule. If your child is absent because of sickness then a medical certificate will need to be supplied for funding to continue, until normal bookings commence. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]Future Kids. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as a way  Financial Details. Please circle person to share moments of beauty and inspiration through photographs as we learn alongside children. I doinvoice: Mother/not give my permission for my child’s photograph to be included on facebook Father/Guardian/Other – Name: Email address:  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool Future Kids is closed not open on all Statutory Holidays and Public Holidays Cust Preschool is closed for the following public holidays if they fall on a period over the Christmas holidays Excursions: I give my permission for my child to take part in planned excursions that leave Cust preschool grounds (please see excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddock. Photo/video: I give my permission for my child to be photographed for the purposes of assessment, planning and evaluation week day Policy Statement: Cust Future Kids Preschool has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to in policy reviewreviews.

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as The optional charge is for: (please give details of specific activities or items) I understand that if I agree to pay for the optional charge, Caterpillars to Butterfly’s Childcare Ltd may enforce payment. The agreement to pay the optional charge will last for: the duration of your child’s stay in the centre. The rules about making changes to the agreement are: (you must give the parent a way reasonable opportunity in which to share moments of beauty change their mind): Your child’s hours change e.g. reduced (financial hardship) Your child is absent due to illness or unforeseen circumstances e.g. family death/illness I understand that that optional charge is not compulsory and inspiration through photographs as we learn alongside childrenif I choose not to pay there will be no penalty. I doagree/do not give my permission agree (select one) to pay the optional charge for my child’s photograph to be included on facebook  Statutory Holidays / Term Breaks This the activities/items specified in this enrolment agreement is inclusive of school term breaksform. Cust Preschool is closed on all Statutory Holidays and Public Holidays Cust Preschool is closed for a period over the Christmas holidays Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ Excursions: I give my permission Permission for my the child to take part in planned regular excursions that leave Cust preschool grounds (please see under the conditions stated in the service’s excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddock. Photo/video: I give my permission for my the child to be photographed for the purposes of assessment, planning and evaluation (explain clearly how the photos/videos can/can’t be used) Policy Statement: Cust Preschool Caterpillars to Butterfly’s Childcare has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to policy review.

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Date of Enrolment:____ /____ / ___ Date of EntryDetails: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as  Optional Charges and Fee Structure The optional charge is for: Supply a way to share moments box of beauty and inspiration through photographs as we learn alongside childrentissues each term Special centre excursions/lunches (written notice will be given about these planned events). I dounderstand that if I agree to pay for the optional charge, CAS Early Learning Centre may enforce payment. The agreement to pay the optional charge will last for until further notice.]. The rules about making changes to the agreement are: Parents will be notified in writing and asked to view and resign any new charges or changes. I understand that that optional charge is not compulsory and if I choose not to pay there will be no penalty. I agree/do not give agree (select one) to pay the optional charge for the activities/items specified in this enrolment agreement form. I do agree to pay to the centre fee structure and schedule for any hours used over and above the 20 Hours. These fees are: $6.00 per hour Set Weekly fee: $213.00 for a child booked in and attends over 40 hours a week and is not eligible for a WINZ subsidy or 20 ECE hours. Five percent discount will be given to all children attending 30 plus hours per week – provided that accounts are paid weekly and not on set weekly fee. Full charge of normal hourly fee for all ABSENCES. All children are entitled to three weeks annual leave per year no charge provided you inform us with two weeks’ notice. Two weeks’ notice is required if your child is leaving the centre or you wish to adjust your booked hours. I agree in the event on non-payment of my permission account that the full details of my enrolment and any relevant information may be forwarded to a collection agency for my child’s photograph to be included on facebook the purpose of collection of outstanding fees. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool CAS Early Learning Centre is closed on open Monday to Friday every weekday except all Statutory Holidays and Public Holidays Cust Preschool is closed for a period over the Christmas public holidays Excursions: I give my permission for my child to take part in planned excursions that leave Cust preschool grounds (please see excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddock. Photo/video: I give my permission for my child to be photographed for the purposes of assessment, planning and evaluation Policy Statement: Cust Preschool has a number of policies that set out the procedures that we are in place for the care and education of the children who attendclosed. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by celebrate Southland Anniversary Day on the policies of this service, and understand how you can have input to policy reviewTuesday after Easter Monday.

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Date of Enrolment:____ /____ / ___ Date of EntryDetails: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your You authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]Wonder kids Lower Hutt. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as a way to share moments of beauty and inspiration through photographs as we learn alongside children. I do/not give my permission for my child’s photograph to be included on facebook  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool Wonder Kids is closed not open on all Statutory Holidays and Public Holidays Cust Preschool public or statutory holidays if they fall on a weekday. You are still liable for fees for the days your child is closed specifically enrolled for a period over the Christmas holidays Excursions: I give my ongoing permission for my child to take part attend regular excursions of local walks around the community (under the conditions stated in planned the service’s excursions that leave Cust preschool grounds (please see excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The policy with adult:child to staff ratio is ratio’s not exceeding 1:4 Regular excursions: for over 2’s or 1:2 for under 2’s) Yes/No I give my permission for my the child to take part in spontaneous special excursions (under the conditions stated in the service’s excursions policy with adult:child ratio’s not exceeding 1:4 or 1:2 if around water for over 2’s or 1:2 for under 2’s). A permission form will be given prior to explore our surrounding preschool paddock. all excursions outlining the child/adult ratio, travel, leave and return times to and from the centre Yes/No Photo/video: I Do you give my permission for my your child to be photographed for the purposes of assessment, planning and evaluation (explain clearly how the photos/videos can/can’t be used) Yes/No I give permission for my child’s photo to be used on documentation displayed in the centre. Yes/No I give permission for my child’s photo to be uploaded to the Wonderkids Facebook page and the Wonder Kids Lower Hutt website Yes/No Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ Policy Statement: Cust Preschool Wonder Kids Lower Hutt has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to policy review.

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Details: Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Effective Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding……………………………. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Total hours Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of serviceThe Treehouse on Ranolf]. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as a way to share moments of beauty and inspiration through photographs as we learn alongside children. I do/not give my permission for my child’s photograph to be included on facebook  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool [The Treehouse on Ranolf] is closed on all Statutory Holidays and Public Holidays Cust Preschool is closed for the following public holidays if they fall on a period over the weekday. Full fees apply New Year’s Day Easter Monday Christmas holidays Day Day after New Year’s Day ANZAC Day Boxing Day Waitangi Day Queen’s Birthday Local Anniversary Day Good Friday Labour Day Excursions: I give my permission for my child to take part in planned excursions that leave Cust preschool grounds go on short walks (please see excursions policyCorrect adult: child ratios will be strictly adhered to ). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddock. Yes / no ( please circle) Photo/video: I agree to my child’s image being used for The Treehouse marketing and advertising purposes, including information booklets, The Treehouse on Ranolf Facebook page and website material (Confidentiality and security will be strictly adhered to) Yes / no (please circle) I agree to my child being observed, photographed and evaluated by the centre staff, and records kept. Yes / No (please circle). Family Photos - Any photos you or your family may take of your child may not be shared publicly on site like face book or emailed to friends, as they may include images of other children that attend The Treehouse. This is to ensure internet safety for the families and whanau. I agree__________________ I have viewed both the child health policy and the parent fees policy and agree to the terms Yes / no I give my permission for the staff to check my child for headlice Yes / no Does your child have any special needs (if yes please speak to a supervisor) Yes / no Fees Agreement – I agree to pay my fees weekly/fortnightly, with one week’s fees paid in advance on confirmation of my space at The Treehouse, before my child’s first day. I also agree for any credit checks at other centres are undertaken at the discretion of The Treehouse on Ranolf The Treehouse reserve the right to recover any debts incurred and will recover them through a debt collection agency. Any charges incurred will be photographed for passed on to the purposes of assessment, planning and evaluation Policy Statement: Cust Preschool has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to policy review.debtor

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Date of Enrolment:____ /____ / ___ Date of EntryDetails: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your You authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]Discovery Nursery and Cottage. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as a way to share moments of beauty and inspiration through photographs as we learn alongside children. I do/not give my permission for my child’s photograph to be included on facebook  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool Discovery Nursery and Cottage is closed not open on all Statutory Holidays and Public Holidays Cust Preschool public or statutory holidays if they fall on a weekday. You are still liable for fees for the days your child is closed specifically enrolled for a period over the Christmas holidays Excursions: I give my ongoing permission for my child to take part attend regular excursions of local walks around the community (under the conditions stated in planned the service’s excursions that leave Cust preschool grounds (please see excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The policy with adult:child to staff ratio is ratio’s not exceeding 1:4 Regular excursions: for over 2’s or 1:2 for under 2’s) Yes/No I give my permission for my the child to take part in spontaneous special excursions (under the conditions stated in the service’s excursions policy with adult:child ratio’s not exceeding 1:4 or 1:2 if around water for over 2’s or 1:2 for under 2’s). A permission form will be given prior to explore our surrounding preschool paddock. all excursions outlining the child/adult ratio, travel, leave and return times to and from the centre Yes/No Photo/video: I Do you give my permission for my your child to be photographed for the purposes of assessment, planning and evaluation (explain clearly how the photos/videos can/can’t be used) Yes/No I give permission for my child’s photo to be used on documentation displayed in the centre. Yes/No I give permission for my child’s photo to be uploaded to the Discovery Nursery and Cottage Facebook page and the Discovery Nursery and Cottage website Yes/No Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ Policy Statement: Cust Preschool Discovery Nursery and Cottage has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to policy review.

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc eczema, and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick Oneone: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State state time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Date of Enrolment:____ /_enrolment: ___ / ___ /___ Date of Entryentry: ___ / ___ /___ Date of exit: ___ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Mon Tues Wed Thurs Fri Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week week, at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your You authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service Tui’s Corner ELC providing relevant information to the Ministry of Education, Education and to other early childhood education services your child is enrolled at, at about the information contained in this box. Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at Tui’s Corner ELC. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ At Tui’s Corner ELC we have optional charges for Manly Park Kitchen meals. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ At Tui’s Corner ELC we are open for all school holidays. We use face book as a way to share moments of beauty and inspiration through photographs as we learn alongside children. I do/not give my permission for my child’s photograph to be included on facebook  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool is are closed on all Statutory Holidays and Public Holidays Cust Preschool is closed for the following public holidays if they are observed on a period over the weekday: - New Year’s Day - Easter Monday - Labour Day - Day After New Year’s Day - ANZAC Day - Christmas holidays Excursions: I give my permission for my child to take part in planned excursions that leave Cust preschool grounds (please see excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddock. Photo/video: I give my permission for my child to be photographed for the purposes of assessment, planning and evaluation Policy Statement: Cust Preschool has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to policy review.Day - Waitangi Day - King’s Birthday - Boxing Day - Good Friday - Matariki - Auckland Anniversary

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / /_____/____  Enrolment Details (Under three): Details: Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hoursTotal: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over threeOver 3 years) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]JeMMa’s. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face  Optional Charges: For ECE Attestation hours (Over 3 years) Refer JeMMa’s Policy 39 The optional charge of $1.50 per booked hour is directly paid to your Educarer :- (refer Policy 39) Extra exchanges of educational toys and equipment library, home book as a way library, and play groups Excursion costs I understand that if I agree to share moments of beauty pay for the optional charge, my Educarer may enforce payment. The agreement to pay the optional charge will last until written changes have been made. The rules about making changes to the agreement are: Changes can be made to this agreement by submitting them in writing to JeMMa’s XX Xxx 00-000 Xxxxxxxx 0000 or xxxxxxxx@xxxxxx.xx.xx I understand that the optional charge is not compulsory and inspiration through photographs as we learn alongside childrenif I choose not to pay there will be no penalty. I doagree/do not give my permission agree (select one) to pay the optional charge for my child’s photograph to be included on facebook the activities/items specified in this enrolment agreement form. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool If your service is closed open on all Statutory Holidays Holidays, parents need to confirm enrolment for each individual statutory holiday. JeMMa’s is open on the following public holidays if they fall on a weekday. Please tick the days you wish your child to be specifically enrolled for:  Home-Based Education and Public Holidays Cust Preschool Care Services Only Is the educator who will be providing education and care for your child a member of the child’s family? If yes, what is closed for a period over the Christmas holidays relationship of the educators to your child? Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ Excursions: I give my permission Permission for my the child to take part in planned regular excursions that leave Cust preschool grounds (please see under the conditions stated in the service’s excursions policy). A policy 25) Do you give permission slip will also come home prior for your child’s Educarer to any excursions detailing the purpose of the trip. The take your child on local outings/walks Yes/No Do you give permission for your child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part travel in spontaneous excursions to explore our surrounding preschool paddock. a car with your Educarer Yes/No Photo/video: I give my permission Permission for my the child to be photographed for the purposes of assessment, planning and evaluation Yes/No Do you give permission for your child to be photo/video for planning assessments Yes/No Do you give permission to use your child photo in any/all of the following places General Marketing Material Yes/No Newsletter Yes/No Website Yes/No JeMMa’s Expo stands Yes/No Social Media Yes/No Policy Statement: Cust Preschool JeMMa’s has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read thesethese JeMMa’s policies which are available to you and are held at your Educarer’s home. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to policy review.

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan Plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Date of Enrolment:____ /____ / ___ Date of EntryDetails: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your You authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as  Optional Charges and Fee Structure The optional charge is for: Supply a way to share moments box of beauty and inspiration through photographs as we learn alongside childrentissues each term Special centre excursions/lunches (written notice will be given about these planned events). I dounderstand that if I agree to pay for the optional charge, CAS Early Learning Centre may enforce payment. The agreement to pay the optional charge will last for until further notice. The rules about making changes to the agreement are: Parents will be notified in writing and asked to view and resign any new charges or changes. I understand that that optional charge is not compulsory and if I choose not to pay there will be no penalty. I agree/do not give agree (select one) to pay the optional charge for the activities/items specified in this enrolment agreement form. I do agree to pay to the centre fee structure and schedule for any hours used over and above the 20 Hours. These fees are: $7.00 per hour Set Weekly fee: $266.00 for a child booked in and attends over 40 hours a week and is not eligible for a WINZ subsidy or 20 ECE hours. Five percent discount will be given to all children attending 30 plus hours per week – provided that accounts are paid weekly and not on set weekly fee. Full charge of normal hourly fee for all ABSENCES. All children are entitled to three weeks annual leave per year no charge provided you inform us with two weeks’ notice. Two weeks’ notice is required if your child is leaving the centre or you wish to adjust your booked hours. I agree in the event on non-payment of my permission account that the full details of my enrolment and any relevant information may be forwarded to a collection agency for my child’s photograph to be included on facebook the purpose of collection of outstanding fees. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool CAS Early Learning Centre is closed on open Monday to Friday every weekday except all Statutory Holidays and Public Holidays Cust Preschool is closed for a period over the Christmas public holidays Excursions: I give my permission for my child to take part in planned excursions that leave Cust preschool grounds (please see excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddock. Photo/video: I give my permission for my child to be photographed for the purposes of assessment, planning and evaluation Policy Statement: Cust Preschool has a number of policies that set out the procedures that we are in place for the care and education of the children who attendclosed. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by celebrate Southland Anniversary Day on the policies of this service, and understand how you can have input to policy reviewTuesday after Easter Monday.

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Date of Enrolment:____ /____ / ___ Date of EntryDetails: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]Riverhills Early Learning Centre Ltd. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Optional Charges: The optional charge is for: Food Quality care. Stationary used. I understand that if I agree to pay for the optional charge, Riverhills Early Learning Centre may enforce payment. The agreement to pay the optional charge will last for: As long as the child is enrolled at Riverhills Early Learning Centre. The rules about making changes to the agreement are: 1 months notice if intending to change optional charges. I understand that that optional charge is not compulsory and if I choose not to pay there will be no penalty. I agree/do not agree (select one) to pay $________________ for the activities/items specified in this enrolment agreement form. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as Required Information for Licensing Purposes Excursions: Permission for the child to take part in regular excursions (under the conditions stated in the service’s excursions policy). Spontaneous Trips: ‘Spontaneous trips’ are where we may walk down the road to see something happening; for example looking at a way house being built or to share moments empty the letter box. The distance is short and within your child’s capabilities. Your child will be in the company of beauty and inspiration through photographs as we learn alongside childrena Riverhills Early Learning Centre teacher. Adult/child ratios will be maintained at all times. All planned trips will be covered by a specific form for that trip. I do/do/ do not give my permission for my child’s photograph to be included on facebook  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool is closed on all Statutory Holidays and Public Holidays Cust Preschool is closed for a period over the Christmas holidays Excursions: I give my permission for my child to take part in planned excursions that leave Cust preschool grounds (please see excursions policy)go on ‘spontaneous trips’. A permission slip will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursionsSigned:______________________________________ Date: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddock. ____/_________/_________ Photo/video: I give my permission for my child to be photographed for the purposes of assessment, planning and evaluation evaluation. To be used in the Teachers professional teaching folders. Used for Project folders, notice boards, shown to current and perspective clients. Display still photos on centre’s website and Face book* page, Use still photos in promotional materials. Parent/Guardian Signature: _____________________________ Date: ______/_____/_____ Only first names and possibly last initials (in the event of two or more children with the same first name) will be displayed on the centres website and Face book page. The focus of the photo is on the activity rather than a particular child. I understand that it is my responsibility to update this form in the event that I no longer wish to authorise one or more of the above uses. I agree that this form will remain in effect during the term of my child’s enrolment. Signed:______________________________________ Date: ____/_________/_________ Policy Statement: Cust Preschool Riverhills Early Learning Centre has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to policy review.

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Date of Enrolment:____ /____ / ___ Date of EntryDetails: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. If your child is absent for three weeks or more funding will cease on the fourth week and you will be liable to pay the non-funded child daily rate as per fee schedule. If your child is absent because of sickness then a medical certificate will need to be supplied for funding to continue, until normal bookings commence. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]Future Kids. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as a way to share moments of beauty and inspiration through photographs as we learn alongside children. I do/not give my permission for my child’s photograph to be included on facebook  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool Future Kids is closed not open on all Statutory Holidays and Public Holidays Cust Preschool is closed for the following public holidays if they fall on a period over the Christmas holidays Excursions: I give my permission for my child to take part in planned excursions that leave Cust preschool grounds (please see excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddock. Photo/video: I give my permission for my child to be photographed for the purposes of assessment, planning and evaluation week day Policy Statement: Cust Future Kids Preschool has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to in policy reviewreviews.

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: created Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Manager notified Yes No Team Leader notified Yes No Qualify for a EC12/13 exemption – if yes complete forms for doctors signing Yes No Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Date of Enrolment:____ /____ / ___ Date of EntryDetails: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. If your child is absent for three weeks or more funding will cease on the fourth week and you will be liable to pay the non-funded child daily rate as per fee schedule. If your child is absent because of sickness then a medical certificate will need to be supplied for funding to continue, until normal bookings commence. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]Future Kids. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as a way  Financial Details. Please circle person to share moments of beauty and inspiration through photographs as we learn alongside children. I doinvoice: Mother/not give my permission for my child’s photograph to be included on facebook Father/Guardian/Other – N ame: E mail address:  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool Future Kids is closed not open on all Statutory Holidays and Public Holidays Cust Preschool is closed for the following public holidays if they fall on a period over the Christmas holidays Excursions: I give my permission for my child to take part in planned excursions that leave Cust preschool grounds (please see excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddock. Photo/video: I give my permission for my child to be photographed for the purposes of assessment, planning and evaluation week day Policy Statement: Cust Future Kids Preschool has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to in policy reviewreviews.

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Date of Enrolment:____ /____ / ___ Date of EntryDetails: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your You authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]Wonder Kids Kapiti. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as a way to share moments of beauty and inspiration through photographs as we learn alongside children. I do/not give my permission for my child’s photograph to be included on facebook  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool Wonder Kids Kapiti is closed not open on all Statutory Holidays and Public Holidays Cust Preschool public or statutory holidays if they fall on a weekday. You are still liable for fees for the days your child is closed specifically enrolled for a period over the Christmas holidays Excursions: I give my ongoing permission for my child to take part attend regular excursions of local walks around the community (under the conditions stated in planned the service’s excursions that leave Cust preschool grounds (please see excursions policy). A permission slip will also come home prior to any excursions detailing the purpose of the trip. The policy with adult:child to staff ratio is 1:4 Regular excursions: ratio’s not exceeding 1:4) Yes/No I give my permission for my the child to take part in spontaneous special excursions (under the conditions stated in the service’s excursions policy with adult:child ratio’s not exceeding 1:4 or 1:2 if around water). A permission form will be given prior to explore our surrounding preschool paddock. all excursions outlining the child/adult ratio, travel, leave and return times to and from the centre Yes/No Photo/video: I Do you give my permission for my your child to be photographed for the purposes of assessment, planning and evaluation (explain clearly how the photos/videos can/can’t be used) Yes/No I give permission for my child’s photo to be used on documentation displayed in the centre. Yes/No I give permission for my child’s photo to be uploaded to the Wonder Kids Kapiti Facebook page and the Wonder Kids Kapiti website Yes/No Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ Policy Statement: Cust Preschool Wonder Kids Kapiti has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to policy review.

Medicines. To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only. For staff: Individual health plan sighted and a copy taken: Tick One: Yes No Name of medicine: Method and dose of medicine: When does the medicine need to be taken: (State time or specific symptoms) Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Enrolment Details (Under three): Details: Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  Enrolment Details (20 Hours ECE): (over three) Date of Enrolment:____ /____ / ___ Date of Entry: ____ /____ / ____ Date of Exit: ____ /____ / ____ Please Note: Bookings exceeding and outside the 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must will be no compulsory fees when a child is receiving 20 Hours ECE fundingcharged accordingly. Days Enrolled: Monday Tuesday Wednesday Thursday Friday Times Enrolled: Total hours: 20 Hours ECE at this service Total hours: 20 Hours ECE at another service Total hours: Parent/Guardian Signature: ____________________________ Date: ____ /____ / ____  20 Hours ECE Attestation: (over three) Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per week at this service? Is your child receiving 20 Hours ECE at any other services? Tick One Yes No If yes to either or both of the above, please sign to confirm that: Your child does not receive more than 20 hours of 20 Hours ECE per week across all services. Your authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE. You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box. Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____  Dual Enrolment Declaration I hereby declare that my child is/is / is not enrolled at another early childhood institution at the same times that he/she is enrolled at [insert name of service]. SUNNY SIDE EARLY EDUCARE Parent/Guardian Signature: _____________________________ Date: ____ /____ / ____ We use face book as a way to share moments of beauty and inspiration through photographs as we learn alongside children. I do/not give my permission for my child’s photograph to be included on facebook  Optional Charges - NO OPTIONAL CHARGE  Statutory Holidays / Term Breaks This enrolment agreement is inclusive of school term breaks. Cust Preschool Please note the centre is closed CLOSED on all Statutory Holidays and Public Holidays Cust Preschool is closed for a period over the Christmas holidays public holidays. Excursions: I give my permission Permission for my the child to take part in planned regular excursions that leave Cust preschool grounds (please see under the conditions stated in the service’s excursions policy). A permission slip Adult To Child Ratio: 1 adult to: 4 children for children aged between four years and five years. 2 children for children aged between two years and three years. 2 children for children under two years (in a double pram) 2 children for all children where volumes of water will also come home prior to any excursions detailing the purpose of the trip. The child to staff ratio is 1:4 Regular excursions: I give my permission for my child to take part in spontaneous excursions to explore our surrounding preschool paddockbe accessible. Photo/video: I give my permission for my the child to be photographed for the purposes of assessment, planning and evaluation SUNNY SIDE will take photos and video of children for the purposes of learning assessment, planning, evaluation and our website page. I agree for my child’s photos or video to be used for: (Please tick)  Learning Assessment  Planning  Evaluation  SUNNY SIDE Website Policy Statement: Cust Preschool Sunny Side Early Educare has a number of policies that set out the procedures that are in place for the care and education of the children who attend. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by the policies of this service, and understand how you can have input to policy review.