G a r d e n M o n t e s s o r i P r e s c h o o l

Reg Number: 2013/019355-07

53 Garden Road, Blue Hills, Midrand

Michelle 084 277 4409

Dianne 083 271 3272

Page 1 of 8

C ON TR A CT OF E NR O L M EN T

The following requirements are necessary to process the enrolment:

COPY OF BIRTH CERTIFICATE

COPY OF BOTH PARENT/ GUARDIAN’S ID DOCUMENT

CLINIC CARD

PROOF OF RESIDENCE (RECENT COPY OF RATES, LEVY, DEED OF SALE, SIGNED LEASE AGREEMENT

COPY OF MOST RECENT SCHOOL REPORT

NON-REFUNDABLE REGISTRATION FEE OF R1500

REFUNDABLE DEPOSIT EQUAL TO ONE MONTH’S TUITION

AN ANNUAL AMENITIES AND EQUIPMENT FEE OF R600

FIRST MONTHLY, TERMLY OR ANNUAL TUITION FEE

COPY OF MEDICAL AID CARD

4 COLOUR ID SIZED PHOTOGRAPHS OF THE CHILD

Please read this Enrolment Agreement and the Policies and Procedures document carefully. If you do not understand any provision, please ask the principal for clarification. This agreement, its attachments and the “Policies and Procedures” establishes your legal rights and responsibilities and those of Garden Montessori regarding your child’s participation at Garden Montessori. Throughout this agreement and attachments, the terms “you” and “parent” refer to the parent(s) or legal guardian(s) of the enrolled child. The term “we” refers to Garden Montessori. Please initial at the bottom of each page and sign in full at the end.

Please complete in block capitals.

DETAILS OF CHILD

SURNAME

FIRST NAMES

PREFERRED NAME

DATE OF BIRTH / / ID /PASSPORT #

COUNTRY OF BIRTH CITIZENSHIP

HOME LANGUAGE RELIGION

PRESENT SCHOOL

CONTACT DETAILS OF PREVIOUS SCHOOL

G a r d e n M o n t e s s o r i P r e s c h o o l

Reg Number: 2013/019355-07

53 Garden Road, Blue Hills, Midrand

Michelle 084 277 4409

Dianne 083 271 3272

Page 2 of 8

DETAILS OF CHILD

SIBLINGS NAME DATE OF BIRTH

SIBLINGS NAME DATE OF BIRTH

SIBLINGS NAME DATE OF BIRTH

TELL US A BIT MORE ABOUT YOUR CHILD (CHARACTER, LIKES, DISLIKES ETC.)

OTHER SIGNIFICANT ADULTS IN YOUR CHILD’S LIFE

SPECIAL DIETARY REQUIREMENTS

TO BE COMPLETED BY THE PARENT OR GUARDIAN WITH WHOM THE CHILD NORMALLY RESIDES:

HOME ADDRESS

CODE

POSTAL ADDRESS

CODE

HOME TELEPHONE NUMBER

FATHER/ MALE GUARDIAN

TITLE FULL NAMES

OCCUPATION

EMPLOYER

BUSINESS ADDRESS

WORK NUMBER HOME NUMBER

CELL NUMBER FAX NUMBER

E-MAIL ADDRESS

ID OR PASSPORT NUMBER

MARITAL STATUS

G a r d e n M o n t e s s o r i P r e s c h o o l

Reg Number: 2013/019355-07

53 Garden Road, Blue Hills, Midrand

Michelle 084 277 4409

Dianne 083 271 3272

Page 3 of 8

MOTHER/ FEMALE GUARDIAN

TITLE FULL NAMES

OCCUPATION

EMPLOYER

BUSINESS ADDRESS

WORK NUMBER HOME NUMBER

CELL NUMBER FAX NUMBER

E-MAIL ADDRESS

ID OR PASSPORT NUMBER

MARITAL STATUS OTHER PEOPLE AUTHORISED TO COLLECT YOUR CHILD

NAME RELATIONSHIP

NAME RELATIONSHIP

NAME RELATIONSHIP

EMERGENCY INFORMATION EMERGENCY CONTACT PEOPLE OTHER THAN PARENTS

NAME RELATIONSHIP

TEL. NUMBERS

NAME RELATIONSHIP

TEL. NUMBERS

MEDICAL AID

MEDICAL AID NUMBER

DOCTOR’S NAME

DOCTOR’S PHONE NUMBER

DETAILS OF ILLNESS OR ALLERGIES THAT SHOULD BE NOTED

G a r d e n M o n t e s s o r i P r e s c h o o l

Reg Number: 2013/019355-07

53 Garden Road, Blue Hills, Midrand

Michelle 084 277 4409

Dianne 083 271 3272

Page 4 of 8

BANKING DETAILS

Garden Montessori may check and confirm any information on the application form and may make any enquiries it deems necessary, in particular to check my credit worthiness with any credit bureau and/or the last school the pupil attended.

NAME OF PERSON RESPONSIBLE FOR ACCOUNT

NAME OF ACCOUNT HOLDER

BANK ACCOUNT NUMBER

BRANCH BRANCH CODE

TERMS AND CONDITIONS OF ENROLMENT I, / We the undersigned, do hereby agree to the following Terms and Conditions:

DEPOSIT, FEES AND PENALTIES

Upon acceptance of my child at Garden Montessori I/we agree to pay: 2014

A deposit equal to one month’s tuition. We understand and agree that the deposit is refundable upon receipt of one terms written notice. We understand and agree that the deposit is refundable upon receipt of one term’s written notice. Should we remove our child before the end of the notice period, the full fee for the notice period is payable.

An annual amenities and equipment fee of R600.00 (six hundred rand), payable upon enrolment and thereafter in January each year.

A registration fee equal to an amount of R1500.00 (one thousand five hundred rand.) We understand and agree that the registration fee is non-refundable.

2015

A deposit equal to one month’s tuition. We understand and agree that the deposit is refundable upon receipt of one terms written notice. We understand and agree that the deposit is refundable upon receipt of one term’s written notice. Should we remove our child before the end of the notice period, the full fee for the notice period is payable.

An annual amenities and equipment fee of R600.00 (six hundred rand), payable upon enrolment and thereafter in January each year.

A registration fee equal to an amount of R1700.00 (one thousand five hundred rand.) We understand and agree that the registration fee is non-refundable.

G a r d e n M o n t e s s o r i P r e s c h o o l

Reg Number: 2013/019355-07

53 Garden Road, Blue Hills, Midrand

Michelle 084 277 4409

Dianne 083 271 3272

Page 5 of 8

We elect to pay the tuition fees of Garden Montessori as follows:

2014 FEES – Please check the relevant box Half Day - 07h00 to 12h30 Full Day - 07h00 to 17h30

Monthly - 12 payments of R 2 450 Monthly - 12 payments of R 3 230

Per Term - 3 payments of R 9 800 Per Term - 3 payments of R 12 920

Annually - 1 payment of R 27 930 Annually - 1 payment of R 36 820

2015 FEES – Please check the relevant box Half Day - 07h00 to 12h30 Full Day - 07h00 to 17h30

Monthly - 12 payments of R 2 700 Monthly - 12 payments of R 3 550

Per Term - 3 payments of R 10 800 Per Term - 3 payments of R 14 200

Annually - 1 payment of R 30 780 Annually - 1 payment of R 40 470

NOTE Monthly payments are due by no later than the 7th day of the month and I/we acknowledge that if payment is not received timeously, I/we will be charged a late payment penalty fee of 10% which will be added to my/ our next invoice. Per Term fees are due no later than the end of the first week of the term and I/we acknowledge that if payment is not received timeously I/we will be charged a late payment penalty fee of 10% which will be added to my/ our next invoice. Annual fees are due before the start of the school year and are discounted by 5%. Should you wish to deposit cash into our account, please note that the cash deposit fee will be added to your next invoice.

BANK DETAILS First National Bank - Carlswald Branch Code: 25 01 17 Account Number: 624 011 89685 Account Name: Montessori Community South Africa I/we understand and agree that Garden Montessori shall have the right to withhold any and all services to the child or dismiss the child if no payment is received 30 days after the due date. Accounts in arrears may be referred to a collection agency. In the event that an account is sent to collections, I/we will be responsible for the balance of my/our account and any reasonable collection and attorney fees and costs associated with the collection of the account. PENALTY ON NOTICE OF TERMINATION I/we agree to give one full term’s written notice on the first day of the new term before withdrawing my/our child from Garden Montessori; otherwise fees in lieu of notice will be charged by Garden Montessori and paid by me/us.

G a r d e n M o n t e s s o r i P r e s c h o o l

Reg Number: 2013/019355-07

53 Garden Road, Blue Hills, Midrand

Michelle 084 277 4409

Dianne 083 271 3272

Page 6 of 8

GENERAL I /we understand and agree as follows: To comply with all the rules and regulations of Garden Montessori, which rules and regulations are incorporated in these terms and conditions as well as in the ‘Policies and Procedures’. Failure to comply with Garden Montessori rules and regulations may result in the termination of this contract without notice. Garden Montessori reserves the right to make any changes to the rules and regulations if deemed necessary. I/we will contact the school telephonically if someone other than me or my spouse or people nominated on this form will pick up my child on any day and I will provide the name, phone number and pickup time for that person. I/we understand that Garden Montessori prohibits attendance of a child during any illness. I/we agree to contact Garden Montessori when my/our child has come down with a communicable disease so that other parents can be notified that their child has been exposed. I/we agree to pay the full tuition fee even if my/our child is absent for one or more days. My/our child may have the opportunity to participate in a special program or field trip. This may result in an additional fee due before the day of the event and may require completion of a specific permission slip. In the event that Garden Montessori incurs expenses in connection with the enforcement of this contract and/or collection of monies owed to Garden Montessori, I/we will be responsible for reimbursing Garden Montessori for such expenses incurred, including attorney’s fees and costs, tracing fees and collection costs.

G a r d e n M o n t e s s o r i P r e s c h o o l

Reg Number: 2013/019355-07

53 Garden Road, Blue Hills, Midrand

Michelle 084 277 4409

Dianne 083 271 3272

Page 7 of 8

INDEMNITY

Garden Montessori shall not be liable under any circumstances whatsoever, including but not limited to any loss,

injury, death and/or damages, to the person and/or property of the Child, and/or to the person and/or property

of his/her Parent/Guardian whilst being in the care of, and/or on the premises of Garden Montessori for any

purposes whatsoever, including where such loss, injury, death and/or damages is/are caused by any third party

on and/or off the premises, unless such loss, injury, death and/or damages arise as a result of gross negligence on

the part of Garden Montessori.

I/ We shall be responsible for payment of all medical and or hospital accounts, where applicable, should an

emergency situation arise with the child stipulated above, whilst on the property of Garden Montessori.

Power is granted to the Principal or her representative to authorise whatever treatment he/she, in their sole

discretion, seems necessary for the child, and in doing so agree that the Principal and her representative shall act

in loco parentis.

This indemnity shall commence on date of signature hereof and shall remain in force and be of effect for the

duration of the pupils enrolment at Garden Montessori.

DATED THIS DAY OF 201

NAME OF FATHER/ MALE GUARDIAN SIGNATURE OF FATHER/ MALE GUARDIAN

NAME OF MOTHER/ FEMALE GUARDIAN SIGNATURE OF MOTHER/ FEMALE GUARDIAN

SIGNED ON BEHALF OF GARDEN MONTESSORI

WITNESS

G a r d e n M o n t e s s o r i P r e s c h o o l

Reg Number: 2013/019355-07

53 Garden Road, Blue Hills, Midrand

Michelle 084 277 4409

Dianne 083 271 3272

Page 8 of 8

VIDEO/ PHOTOGRAPHIC CONSENT FORM

I, hereby grant GARDEN MONTESSORI SCHOOL, MICHELLE WAREHAM and DIANNE HEART permission to use my

child’s likeness in a photograph in any and all of its publications, including website and Facebook entries, without

payment of any other consideration.

I, hereby irrevocably authorise GARDEN MONTESSORI SCHOOL, MICHELLE WAREHAM and DIANNE HEART to

edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicising GARDEN MONTESSORI

SCHOOL, MICHELLE WAREHAM and DIANNE HEART’s programmes or for any other lawful purpose.

In addition, I waive the right to inspect or approve the finished product, including written or electronic copy,

wherein my child’s likeness appears. Additionally, I waive any right to royalties or other compensation arising or

related to the use of the photograph. I hereby hold harmless and release and, forever discharge GARDEN

MONTESSORI SCHOOL, MICHELLE WAREHAM and DIANNE HEART from all claims, demands, and causes of action

which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on

behalf of my estate have or may have by reason of this authorisation.

As the child is under age 21, there must be consent by a parent or guardian, as follows:

I hereby certify that I am the parent or guardian of ________________________________

Named above, and do hereby give my consent without reservation to the foregoing on behalf of this person.

DATED THIS DAY OF 201

NAME OF FATHER/ MALE GUARDIAN SIGNATURE OF FATHER/ MALE GUARDIAN

NAME OF MOTHER/ FEMALE GUARDIAN SIGNATURE OF MOTHER/ FEMALE GUARDIAN

SIGNED ON BEHALF OF GARDEN MONTESSORI

WITNESS