22 Inyati str
Nelspruit
1218
PO Box 40073
The Village
Nelspruit
1218
Tel/Fax: 013 744 0101
Cel: 082 872 9189
082 893 1973
Email: liza @dinkyland.co.za
www.dinkyland.co.za
Facebook: Dinkyland
Nursery School
Application form:
Date of Admission:
Surname:
Nickname:
Position in family:
Religion:
Previous school:
Name of Family Friend:
Date of Birth:
Name:
Female/Male:
Home Language:
Tel of School:
Tel/Address of friend:
Where did you hear about Dinkyland Nursery School: .....................................
FATHER
Box:
Town:
MOTHER
Code:
H
W
MEDICAL INFORMATION:
Surname/Initials
Christian names
ID Number
Home address
Town
Postal address
Occupation
Employer
Employer number
Employer address
Cell phone
Telephone
Box:
Town:
H
Code:
W
Name of medical aid:
Medical aid no:
Family doctor:
Tel:
IN CASE OF EMERGENCY PLEASE CONTACT IF PARENT OR GUARDIAN CANNOT BE
REACHED:
Name and surname:
Relationship:
Residential address:
Tel:
NAME ANY DISEASES, ALLERGIES OR MEDICAL CONDITIONS THAT YOUR CHILD HAD OR
HAS:............................................................................................................................................................
...............................................
Who will bring the child to school?
Who will fetch the child?
AGREEMENT ENTERED INTO BY AND BETWEEN DINKYLAND NURSERY SCHOOL AND
FATHER/GUARDIAN(SURNAME):.......................................................
FULL NAMES............................................ID......................................
DOMICILLIUM ADDRESS(STREET)......................................................
MOTHER/GUARDIAN(SURNAME):.....................................................
FULL NAMES............................................ID......................................
DOMICILLIUM ADDRESS(STREET)......................................................
WHERE AS WE AS PARENTS OR GUARDIANS SUBJECT OURSELVES TO ALL THE CONDITIONS
AND TERMS OF THE ADMISSION REQUIREMENTS, TERMS AND SCHOOL RULES. NOW
THEREFOR WE UNDERTAKE THE FOLLOWING:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
We accept responsibility for the payment of tuition fees as determined from time to time.
We undertake to pay such amount monthly in advance to DINKYLAND NURSERY SCHOOL. School
fees are payable on the 1st day of the month.
Fees are to be paid in full each month even if your child was absent due to illness or school holidays
or for any other reason.
Interest of 15% will be charged if paid later than the 7 th of each month.
Should we fall in arrears, Dinkyland Nursery School setting out any money in arrears and the
interest thereon, would be prima facie proof of the amount due by their parent/guardian to
Dinkyland Nursery School and it will not be necessary to prove the appointment/or authority of the
signatory of such Certificate. This Certificate would be a liquid document for the purpose of
obtaining a judgment and provisional and or summary judgment.
We hereby consent to the recovery of attorney and client costs as well as collection commission
against us.
We choose the above address as my/our domicillium and consent that all notices and legal
documents should be delivered to such address and I/we undertake to give notice in writing to the
School within seven(7) days of any change of address.
The parties hereby consent and agree to the jurisdiction of the Magistrate’s Court in Nelspruit.
We hereby consent to giving one months written notice if we want to take our child out of
Dinkyland. Notice must be given before the 4th of the month. Please note that November is not a
notice month.
I/We cannot give verbal notice and accept that a notice letter must be handed personally to the
principal.
Please note that November is not a notice month.
We accept that a fee of R50,00 will be charged if my child is fetched after 17h30 without prior
arrangements.
We accept that application is by selection and not by sequence.
Dinkyland or its staff cannot be held responsible for the loss of any clothing or belongings or for any
injuries inquired on the school’s premises or on field trips.
15. School fees are payable over 12 months:
School fees for 2015: R19 560,00 This can be paid over 12 months or 10 months.
Babies and Toddler fee, R19 920,00
After Care fees for 2015: R9 000 This can be paid over 12 months or 10 months.
16. The parents hereby indemnify and agree to hold harmless Dinkyland, the owners, the Principal and
Staff, or the authorised agents or representatives of the aforementioned, against any and all claims,
howsoever arising, including negligence, arising out of any injury, death, loss, damage, cost or
expense, including legal costs, suffered by the learner or a third party as a result of or during the
enrolment of the learner at the school.
We undertake and accept the admission requirements, terms and conditions of
Dinkyland Nursery School.
Signed at ............................................... this ......................
Day of ............................................20...
............................................
..............................................
Mother/Guardian
Witness
.............................................
..............................................
Father/Guardian
Witness
Please attach the following to your application:
1.
2.
3.
4.
5.
6.
7.
8.
Copy of ID document of Mother/Guardian and Father/Guardian.
Copy of Child’s birth certificate.
Please supply copy of divorce settlement if applicable.
Court documentation to verify legal guardianship(where applicable)
Copy of proof of vaccination(clinic card)
Enrollment of R300,00 (not refundable)
School fee R ....................... per month
Matrass fee R200,00 this will be the property of the child.
LETTER OF ADMISSION FOR PUPIL TO GO ON TRIPS AND OUTINGS:
I ......................................... parent/guardian of .....................................................(child)
Hereby give my permission for him/her to go on excursions planned by the school. I accept that all reasonable
precautions will be taken to ensure the safety and welfare of my child and that I shall be held responsible for the
payment of medical/hospital accounts, where applicable, should an injury be sustained.
.......................................Mother/Guardian
........................................Father/Guardian