Enrolment Form

Please fill out the form below. If you experience any problems please contact the School office.

In Zone / Out of Zone

Legal Last Name

Preferred Last Name

Legal First Name

Preferred First Name

Legal Middle Name

Date of Birth

Gender

Male Female Other

Current School Year

Other Languages

Child’s Ethnicity

If Māori, please advise child’s iwi affiliations

Main Caregiver 1

Lives with Send invoices Send copy of report

Mr. Mrs. Ms. Miss

Last Name

First Name

Relationship to Student

Home Address

Post Code

Email Address

Mobile Number

Work Phone Number

Occupation

Employer

Main Caregiver 2

Lives with Send invoices Send copy of report

Mr. Mrs. Ms. Miss

Last Name

First Name

Relationship to Student

Home Address

Post Code

Email Address

Mobile Number

Work Phone Number

Occupation

Employer

Name(s) of sibling(s) currently enrolled at Shelly Park School

Place in family

Step Parent

Lives with Send invoices Send copy of report

Mr. Mrs. Ms. Miss

Last Name

First Name

Relationship to Student

Home Address

Post Code

Email Address

Mobile Number

Work Phone Number

Occupation

Employer

Non-Custodial Parent

Lives with Send invoices Send copy of report

Mr. Mrs. Ms. Miss

Last Name

First Name

Relationship to Student

Home Address

Post Code

Email Address

Mobile Number

Work Phone Number

Occupation

Employer

Emergency Contact 1: Living in Auckland (other than parent / step-parent in previous step)

Relationship to Student

Mobile Number

Work Phone Number

Emergency Contact 2: Living in Auckland (other than parent / step-parent above)

Name

Relationship to Student

Mobile Number

Work Phone Number

Students enrolling from another school

Previous Primary School

Date Left

Year Level

Reason for Leaving

Access Details: Please provide access details that impact on your child whilst attending Shelly Park School. E.g wheelchair

Child’s country of birth (name the country):

New Zealand Citizen

YES NO

New Zealand Resident

YES NO

Australian Citizen

YES NO

New Zealand Student Permit

YES NO

Birth Certificate Number

NZ Passport Number

Australian Passport Number

Date of Entry to NZ

Any relevant custody details?

Custody Details: Please provide any custody details that may impact on your child(ren) at this school. Attach relevant documentation to this form. Without this documentation the school has limited powers to assist.

Court Details

YES NO

Court Details: Please provide any Court Orders that may affect your child/ren at this school. Attach relevant documentation to this form. Without this documentation the school has limited powers to assist.

Doctor

Practice

Phone Number

All immunisations completed

YES NO

Certificate attached

YES NO

Certificate attached

YES NO

Medical: Health conditions / Allergies / Medication / Vision / Hearing: Please attach all relevant medical reports.

Learning Information: Any learning or behaviour challenges, strengths and interests. Please note any involvement with an early childhood learning support service (Ministry of Education) or health based services e.g. CAMHS, pediatrician, speech therapists, public health nurse, RTLB - Please attach all relevant medical reports.

Please list any other relevant information you wish to disclose or to be noted in support of this enrolment form: (also please advise if any family members were past or current students of Shelly Park School)

Other preschoolers whom you intend to enrol at Shelly Park School at a later date:

Name

Date of birth

Male Female

Name

Date of birth

Male Female

Did your child regularly attend an Early Childhood Education facility? E.g Kindy, kōhanga reo, daycare

Yes, for the last few year(s) Not regularly, only occasionally. No, he /she / they did not attend ECE

Name of preschool / kindergarten / kōhanga / daycare:

Policies and Procedures
I/We agree to abide by the policies and procedures of the school. View these online on our school website www.shellypark.school.nz

Attendance and Punctuality I/We agree to ensure our child attends school every day. In the event of illness/approved family commitments, we will contact the school on the morning of the first day of absence to report their non-attendance and expected return date. I/We agree our child will be at school by 8:45am each day ready for their learning and will be picked up no later than 3:10pm each afternoon unless advised.

Child’s Property I/We understand the school will take all reasonable steps to ensure the safekeeping of my child’s property. The school will not accept liability for loss or damage to personal property. All property must be named.

School Uniform I/We understand that the wearing of school uniform is a condition of enrolment at Shelly Park School. I will ensure my child is suitably dressed in regulation school uniform.

Behaviour Management Plan I/We understand that the school has a Behaviour Management Plan that aims to make our school a safe place for all students and staff. I will support the school’s behaviour initiatives.

Signed: Parent/Caregiver:

School Trips and Visits

I/We give permission for our child to attend school trips and visits during their time at Shelly Park School. I/We understand, I will be notified of any such trips/events and I understand that I have the right to send a note exempting my child from a school trip/event. I/We understand the school has in place EOTC (Education Outside The Classroom) guidelines. These include risk analysis procedures and the requirement to plan all school trips with a focus on child safety and enjoyment. Any overnight camp experiences will require additional permission procedures. All parents accompanying students on an overnight camp will be police vetted.

Signed: Parent/Caregiver:

Use of Work and Images: Please place a ✓ or do not tick in the box below.
I I/We give permission for my child’s work / image to be used:

Signed: Parent/Caregiver

Cyber Safety and IT Use

I/We give permission for our child to use the school’s IT equipment and access the internet for learning purposes, including the school Seesaw platform. We will support the school should my child engage in unsafe online behaviour that is harmful to others or our school reputation.

Signed: Parent/Caregiver:

Medical

I/We give permission for the school to take action on my behalf, in the case of sudden illness or injury, if they cannot contact me. Any medication needs to be left at the school office and will be administered from there.

Signed: Parent/Caregiver:

Privacy Learning Information

In terms of the Privacy Act, I understand that the information contained in this form is essential information the school holds on my child. I approve the forwarding of information when my child transfers to another school, including name and address on request to a potential primary or intermediate school, and that my contact telephone number and address be made available to the PTA or Board of Trustees as required.

I approve of the school making contact with my child’s previous place of education to discuss the learning needs of my child.

The information contained in this enrolment form may be shared with the Ministry of Education.

Signed: Parent/Caregiver:

Enrolment Form

Enrolment Form

In Zone / Out of Zone

Quick Links

Contact Us

Shelly Park School

Get the SchoolAppsNZ Mobile App