Number of students enrolling per family
*
Resides with the student?
*
Resides with the student?
Title
*
Mr
Mstr
Mrs
Ms
Miss
Other
Name
*
First Name
Last Name
Relationship to student
*
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Postal address same as residential address?
*
Home Phone
(###)
###
####
Work Phone
(###)
###
####
Mobile Phone
(###)
###
####
Email
*
Highest year level of schooling completed
*
Highest level of qualification completed
*
Occupation group
*
Occupation
Employer
Country of Birth
*
Are you a single parent/guardian?
*
Name
*
Age
*
Year level
*
Current school
*
Name
Age
Year level
Current school
Name
Age
Year level
Current school
Name
Age
Year level
Current school
Name
Age
Year level
Current school
Name
Age
Year level
Current school
Name
*
Phone
*
If landline, include area code e.g. 0749264895
(###)
###
####
Relationship to student
*
Doctor
*
Doctor's phone
*
Allergies
Asthma
Chickenpox
Convulsions
Heart Disease
Measles
Mumps
Others
Is your child a foster child?
*
Are there any custodial arrangements?
*
Has your child ever been suspended or excluded from school?
*
Does your child have a verified level of ascertainment?
*
Has your child attended a primary school integration unit or special education facility?
*
Does your child suffer from any chronic illness, e.g. asthma, chronic fatigue syndrome, glandular fever?
*
Has your child experienced any emotional difficulties or had traumatic experience that may have affected learning?
*
Has your child received support for learning programs, e.g. gifted/talented, literacy & numeracy etc.?
*
Has your child received support for any particular learning difficulties, e.g. language?
*
Has your child been assessed or supported by any specialist services?
*
e.g. Guidance officer or consultant, Occupational therapist, Child guidance centre, Speech therapist, Physiotherapist, Psychiatrist/counsellor/mental health, Specialist clinic (hospital/private), Audiology clinic, Family services, Visiting teacher service (hearing, vision, or physical)
I/We agree, subject to the conditions set out above, to the taking of photographs of my/our child during school activities, to be used by the school in educating students and promoting the school and Christian education. I/We also agree to the publication of photographs or samples of work of my/our child. I/We will notify the school if I/We decide to withdraw this consent.
*
Church Attending?
*
Father - Christian:
*
Mother - Christian:
*
I/We agree to give the School Administration a full term's notice prior to withdrawal of my/our child/ren from the school or pay a full term's fee in lieu of such notice.
*
I/We pledge to pay financial obligations to the school by the date due and understand that it may be necessary to withdraw my/our student if proper arrangements are not made on a past due account.
*
I/We agree to pay the prescribed fees for the school year for the above mentioned children.
*
I/We grant permission to access information from previous school/preschool/specialist service provider.
*
I/We authorise the Principal or his representative to seek, at his discretion, medical attention for my/out child in the event of sudden illness or serious injury, when it is not expident for the Principal or his representative to secure my/our verbal consent.
*
I/We understand that teachers at Lighthouse Christian School will act in 'loco parentis' towards my/our children. Accordingly, I/We give consent to the staff to carry out this responsibility according to Biblical principles of love, care, teaching, training, and correction. Discipline will be firm, and administered in a spirit of love.
*
I/We agree to uphold and support the high academic standard of the school by providing a place at home for my/our student to study and giving encouragement in the completion of any homework or assignments.
*
I/We appreciate the standards of the school and do not tolerate profanity, obscenity in word or action, dishonor to the Godhead and the Word of God or disrespect to the personnel of the school. I/We hereby agree to support all regulations of the school on the applicant's behalf and authorise the school to employ discipline as it deems wise and expedient for the training of my/our child.
*
I/We understand that the school reserves the right to dismiss any student who fails to comply with the established regulations and discipline or whose financial obligations remain unpaid.
*
Please indicate in the space provided of any area of the Statement of Faith you do not agree with (optional):
I/We acknowledge that the only version of the Bible to be used in the school and for school purposes is the King James version (KJV).
*
I/We have read and fully understand and agree with the Policies of Lighthouse Christian School.
*
I/We declare that the details supplied in this form are complete and accurate.
*
Please indicate by checking the relevant boxes below:
*
What is the main reason you have chosen to enrol your child at Lighthouse Christian School?
*
