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Enrolment

Enrolmentvividadmin2026-09-21T09:42:54+12:00

Child's details

Child's Name(Required)
Gender(Required)
Child's primary residential address
Official indentification document(Required)

Accepted file types: jpg, png, pdf, Max. file size: 2 MB.

Parents / guardians

1st parent / guardian name(Required)
2nd parent / guardian name

Additional emergency contacts (also able to pickup child)

1st emergency contact
2nd emergency contact

Custodial statement

Are there any custodial arrangements concerning your child?(Required)
Max. file size: 16 MB.
Person/s who cannot pickup your child

Health

Medicine

Do you give permission for the product listed below to be used with your child?
Riverglow Early learning centre will provide following health-related products
Category (i) Medicines
Category (i) medicines are prescription (such as antibiotics, eye/ear drops etc) or non-prescription (such as paracetamol liquid, cough syrup etc) medicine that is used for a specific period of time to treat a specific condition or symptom, provided by a parent for the use of that child only, or in relation to Rongoa Māori (Māori plant medicines), that is prepared by other adults at the service.

I acknowledge that written authority from a parent is to be given at the beginning of each day a category (i) medicine is to be administered, detailing what (name of medicine), how (method and dose), and when (time or specific symptoms/circumstances) medicine is to be given.
Category (ii) Medicines
To be filled in if your child requires medication as part of an individual health plan, for example for an on-going condition such as asthma or eczema etc and is for the use of that child only.
For Staff
Name of medicine
Method and dose
When does the medicine need to be taken (state time or specific symptoms)
 

Enrolment details

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Days enrolled(Required)
Is your child receiving 20 hours ECE for up to six hours per day, 20 hours per week at this service?
Is your child receiving 20 hours ECE at any other place?
If yes to either or both of the above, please confirm that:(Required)
Your child does not receive more than 20 hours of 20 Hours ECE per week across all services.

You authorise the Ministry of Education to make enquiries regarding the information provided in the Enrolment Agreement Form, if deemed necessary and to the extent necessary to make decisions about your child’s eligibility for 20 Hours ECE.

You consent to the early childhood education service providing relevant information to the Ministry of Education, and to other early childhood education services your child is enrolled at, about the information contained in this box.
Dual Enrolment Declaration(Required)
I hereby declare that my child is/is not enrolled at another early childhood institution at the same times that he/she is enrolled at RiverGlow Early Learning Education.

Authorisation Agreement

Consent(Required)
RiverGlow Early Learning Centre has a number of policies that set out the procedures that are in place for the care and education of the children who attend the centre. We strongly urge you to read these. The signing of this enrolment agreement form indicates that you will abide by our policies and understand how you can have input to policy review.
Consent(Required)
I authorise a senior staff member, in the event of illness or accident, to seek medical, or other advice as deemed necessary, for my child’s best interest.
Consent(Required)
My child has my permission to participate in regular excursions to nearest Reserves with other children and appropriate staff ratios. Ratios of Adult: Child 1:4 for children over 2, Parents will be notified of any planned trip. Risk assessment of the regular excursion is available at the centre. Please sign below that you have sighted the risk assessment.
Consent(Required)

  • I understand that my child must attend the Centre for two days a week.

  • I agree to collect my child within my booking hours and understand penalty fees will be charged if I exceed these times. I will be charged a Late Fee of $30 for the first 15 minutes and then $30 per 10 minutes thereafter.

  • I understand at least two weeks advance notice in writing is required before withdrawing my child from the Centre. If I fail to do so, I agree to pay the subsequent fee/s in lieu of notice.

  • I agree to notify the centre as soon as possible if my child is going to be absent.

  • My child may only leave the centre with adults listed on the enrolment form; or I will inform the centre if anyone other than me is to collect my child, and I understand that he/she must remain at the centre until my permission has been received.

Consent(Required)
I agree that when dropping off my child/ren at RiverGlow Early Learning Centre I will escort my child into the building and advise a teacher of my arrival before leaving my child in the Centre’s custody. I will advise a teacher before taking my child from the Centre. I will sign my child in on arrival and out on departure daily. I understand and accept that this is a condition of enrolment that children driven to and from the centre must travel in a child’s seat or restraint in accordance with Traffic Regulations.
Consent
As part of the planning process and to document learning, we gather artwork and photos of all children. I agree that my child may have his/her photo taken as well as be included in

▪ StoryPark Group Stories
▪ StoryPark Community Posts

I give permission for the use of photos and names to be used on the Riverglow Early Learning Centre website, Facebook and use for RiverGlow Early Learning Centre's material.
Consent
I agree that staff may apply sunscreen to my child as per sun protection Policy.
Consent(Required)
I/We agree to pay fees as per the current fee schedule.

I acknowledge that if any fees or charges remain unpaid, my child’s enrolment may be forfeited, the debt may be passed to a Debt Collection agency or placed in the Small Claims Court, and that I will be responsible for all costs incurred in this process including interest on cumulative balance of 2% per month.

**I understand that if this does occur my personal details will be passed on to the Debt Collection agency or Small Claims Court to have the outstanding amount recovered.
Consent(Required)
This enrolment agreement is inclusive of school term breaks.
RiverGlow Early Learning Centre will not be open for any public holidays.
Consent(Required)
I declare that all the above information is true and correct to the best of my knowledge.
Consent(Required)
On behalf of RiverGlow Early Learning Centre, I declare that this form has been checked and all relevant sections have been completed.
Copyright 2026 Riverglow Early Learning Centre | All Rights Reserved
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