Indemnity | Play Sense Micro Playschools

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Parent / Guardian Information

Please Confirm Your Address*

Street Suburb Province Zip Code Country

Please confirm your ID number*

Where applicable, please provide your child’s secondary parent / guardian details

First Name*

Last Name*

ID Number*

Email*

Phone*

Emergency Contact (In Addition to Parent / Guardian)

First Name*

Last Name*

Phone*

Relationship To Child*

Authority to Collect

Please include the details of anyone other than the Parent / Guardian who would collect your child regularly.

First Name

Last Name

Phone

Relationship To Child

Medical Information

Medical Aid Scheme*

Medical Aid Number*

Doctor

Doctor's Phone*

Dentist*

Dentist's Phone*

Allergies

Is there anything special (medical, physical or socio-emotional) that we should know about your child to help us meet their needs effectively?

Depending on the needs of your child, we may require someone (either their nanny or another appropriate caregiver) to accompany them at group. This is not to exclude your child in any way but assists us in best being able to support your little one in the group. Your teacher will advise if this is necessary after observing your little one in the group context.

Is your child seeing/have they seen a therapist?*

Please specify which type of therapist*

Acceptance of Terms and Conditions

Although all reasonable precautions will be taken for the safety and welfare of the CHILD whilst the CHILD is under the care of the TEACHER at the HOST FAMILY, the PARENTS shall have no claim, of any nature whatsoever, against the TEACHER, the HOST FAMILY and/or PLAY SENSE or any of their respective employees, directors, shareholders, members, agents and/or contractors for any loss, damages (whether specific, actual or consequential), illness, injury, delay or inconvenience sustained or suffered by the PARENTS and/or the CHILD which cannot be attributed to the wrongful acts or omissions (whether negligent or otherwise) of the TEACHER, the HOST HOME and/or PLAY SENSE or their respective employees, directors, shareholders, members, agents and/or contractors.

Terms and conditions*

I understand and agree to the above limitations of liability

Terms and conditions*

I, as the parent, confirm and agree that I intend to enrol my child into the PLAY GROUP and hereby enter into an agreement with the TEACHER, who owns the franchise operating the PLAY GROUP.

Terms and conditions*

I, as the parent, authorise the teacher to administer first aid treatment to my child in the event of injury and indemnify the TEACHER, the HOST FAMILY and/or PLAY SENSE for the payment of any medical and/or hospital expenses incurred by them should an injury be sustained by their CHILD at the PLAY GROUP.

Terms and conditions

I, as the parent, allow my child’s image to appear on social media. Play Sense never uses photos where a child’s face is visible unless with specific permission. (Optional)

Terms and conditions*

I hereby confirm that I have visited the school to see the program and premises and deem them satisfactory.

Terms and conditions*

I have read the Parent Manual and accept and will abide by all Play Sense protocols, as outlined in this manual.

Terms and conditions*

I have read the Play Sense Covid Health and Safety Policy Guidelines and Protocol and acknowledge the risks of COVID-19 and am aware of my obligations as a parent in terms of health & safety as detailed in our Health and Safety Policy Guidelines and Protocol

Terms and conditions*

I have read the Terms & Conditions and am in agreement

Terms*

I accept the processing of my information as outlined in the privacy policy

This field is for validation purposes and should be left unchanged.

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Cart

Parent / Guardian Information

Emergency Contact (In Addition to Parent / Guardian)

Authority to Collect

Medical Information

Acceptance of Terms and Conditions

Parent Details

Child Details

Address

Final Details