Enrolment

Student Enrolment Form (Years 0 - 8)

Enrolment Date *

Intended Start Date *

SECTION 1 STUDENT DETAILS

Date of Birth *

Gender *

Male Female

Ethnicity (tick all that apply)

Māori NZ European/Pākehā Samoan Tongan Cook Island Māori Niuean Chinese Indian Other - please specify in next field

NZ Citizen or Resident *

Yes No - if no answer the next question please.

Expiry Date of Visa in previous question

SECTION 2: RESIDENTAIL ADDRESS DETAILS

Is this address inside the Hillside Primary School zone? Yes No No Applicable

SECTION 3: PREVIOUS EDUCATION

Last Date Attended *

SECTION 4: PARENT / CAREGIVER DETAILS

Does the student live in more than one household? *

Yes - Shared Care (please complete both sections) No - Primary Household Only

Legal Care Arrangements *

Both parents/caregivers have full guardianship One parent/caregiver has sole guardianship Parenting Order/Court Order in place (please attach a copy in the next field)

Please attach a copy of Parenting Order / Court Order

Who has day to day care

Primary Household Shared equally Alternating weeks Other arrangement - please specify in next field

Primary Household (Student's Main Residence)

Student Lives at this address *

Full-time Most of the time Weekdays Other - Please specify in next field

Preferred method of communication Text Email Phone call School App

Receives school reports and newsletters *

Yes No

Emergency Contact? *

Yes No

Secondary Household

Preferred method of commuication *

Text Email Phone Call School App

Receives school reports and newsletters?

Yes No

SECTION 5: HEALTH INFORMATION

Medical Conditions *

None Yes- Please specify in next field

Medication required at school *

Yes - Please upload Medication Authority form in next field No

Please upload Medication Authority form

Medical Assistance Consent

In the event of illness or injury at school, and if the school is unable to contact a parent/caregiver, I authorise the school to:

Administer basic first aid

Yes No

Seek medical treatment from a doctor, medical center, or hospital if necessary

Yes No

Arrange ambulance transport if the school considers it urgent

Yes No

I understand that every reasonable effort will be made to contact a parent/caregiver or emergency contact as soon as possible.

Yes

SECTION 6: LEARNING SUPPORT / ADDITIONAL NEEDS

Has your child received learning or behaviour support? *

Yes No

Details - chose as many as are appropriate.

ORS RTLB IEP SLT Other - please specify in next field

SECTION 7: DIGITAL & MEDIA PERMISSIONS

I give permission for my child to: Check all that are appropriate

Use school digital devices and online platforms Be photographed or filmed for school use Have images published on the newsletter, school website or social media Participate in local trips and sports events

SECTION 8: DECLARATION

I declare the information provided is true and correct and may be used for lawful educational and Ministry of Education purposes.

Digital Signature - typing your name below is equal to you signing this form.

Date signed