Early Birds ECD

Child Information

NAME AND SURNAME

AGE

GENDER

RACE

HOME LANGUAGE

DATE OF BIRTH

Parent / Guardian Information

NAME AND SURNAME

PHONE NUMBER

RELATIONSHIP TO CHILD

ID / PASSPORT NUMBER

HOME ADDRESS

Emergency Contact & Medical Information

EMERGENCY CONTACT'S FULL NAME

PHONE NUMBER

IF YOUR CHILD HAS ANY ALLERGIES, DISABILITIES OR ANY HEALTH CONDITIONS, PLEASE STATE THEM (OPTIONAL)

BIRTH CERTIFICATE NUMBER

CLINIC CARD NUMBER

Registration And Tuition

Nedbank

Mrs P Mulaudzi

1214 333 036

Reference (Your child's name and surname)

PAYMENT REFERENCE

AMOUNT PAID

PAYMENT DATE

I confirm payment has been made for enrollment.

Additional Context Fields

When Would You Like Your Child to Begin?

Legal Consent & Permissions

I commit to ensuring my child attends Early Birds ECD regularly, understanding that consistent attendance supports my child's learning and development. I will notify the school in advance of any planned absences or unexpected circumstances preventing attendance.

I understand that while Early Birds ECD maintains rigorous safety standards, some risks are inherent in childhood educational settings. I hereby agree that neither the school, its staff, nor its representatives can be held liable for any unforeseen incidents that may occur despite reasonable precautions.

I grant Early Birds ECD permission to: Photograph my child during school activities, use photographs for internal documentation, potentially feature images in school marketing materials, share group activity images (with identities obscured).