Enrolment Form

Childs details

Enrolment details

Please Note: 20 Hours ECE is for up to six hours per day, up to 20 hours per week and there must be no compulsory fees when a child is receiving 20 Hours ECE funding.
For 20 Hours ECE fill out boxes below with hours attested e.g. 6 hours

20 Hours ECE Attestation

Is your child receiving 20 Hours ECE for up to six hours per day, 20 hours per day, 20 hours per week at this service?

Is your child receiving 20 Hours ECE at any other services?

If yes to either or both of the above, please sign to confirm that:

• 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

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 Kidiwise Preschool & Childcare.

Parent 1 / Guardian Details

Parent 2 / Guardian Details

Custody / Court Orders

Are there any custody / court orders relating to the child?

Learning Support

Has your child been referred to external services for learning support (i.e. Ministry of Education, Public Health Nurse etc.)

If YES do you give our Learning Co-Ordinator permission to contact the service for continuation of support to your child or whanau

If you have any further documentation about the learning support you are receiving we would appreciate a copy.

Emergency Contact Details

Contact One

Contact Two

Medical Details

Immunisation Details

Please provide a copy of your child’s immunisation schedule

Does your child suffer from Asthma? If yes, please complete an Asthma Action Plan – (See Appendix 1)

Is your child allergic to anything? If yes, please complete an Allergy Action Plan – (See Appendix 2)

Is your child on any regular medication?

Does your child have any additional needs?

(If you have any concerns regarding your child, please speak with the Centre Supervisor/Team Leader)


I give Kidiwise Early Learning Centre management and staff permission to:

Allow the people listed as Parents, Guardians and Emergency Contacts to drop
off and collect my child from the centre unless instructed otherwise

Apply sun block to my child for outside play

Apply nappy rash cream as supplied by the parent / guardian

Apply medicines which are not ingested or prescribed (arnica, antiseptic cream)
for the purpose of basic first aid. (As per Appendix 3 – Ministry of Education
Licensing Criteria for Early Childhood Education and Care Centres 2008)

To seek or administer medical assistance required by my child in the event of
an accident or emergency , and agree to pay any medical or transport costs

To allow the teacher/s to take my child on walking and van excursions within the
Tauranga area.

To use the name and images (Photo / Video) of my child in displays and
documentation that will be shared within the centre community and on the
Centre website and in marketing promotions

I give permission for my child to have a private and secure profile on Storypark

I give my child permission to be in a group stories on Storypark

I give permission for my child to participate in the water safety confidence programme

Kidiwise Van Excursions

At Kidiwise we would like to be able to take the children on spontaneous excursions in the van. This will allow us to get into the community more often and take small groups on outings based on our emergent curriculum. This will only involve trips to our local amenities we are so fortunate to have, such as: the library, parks, shops, art gallery, etc.
We ensure our van is always safe to travel in by supplying age appropriate car seats and up to date servicing, warrant and registration of the vehicle. We will also ensure there is always a qualified, registered and first aid trained teacher on board.
As a parent it is your choice if you would like your child to be involved or not. Please sign below if you’re happy for your child to travel in the Kidiwise van spontaneously.

Fee Payment

The following fee payment options are available: Direct Debit, Automatic Payment and Internet banking. We are unable to accept Cash or Cheque payments.

Payment Agreement

The following fee payment options are available: Direct Debit, Automatic Payment and Internet banking. We are unable to accept Cash or Cheque payments.

  • I understand that fees are payable one week in advance following the date of the invoice. We reserve the right to charge interest at 2.5% per month and to charge a late payment penalty of 10% on any overdue accounts. If the account is not paid within 30 days after the due date, our debt recovery agency may charge you a fee equal of 25% of the unpaid portion of the invoice amount and other legal and collection costs not covered by the fee. The minimum fee will be $25. Where the total agency, legal and other costs arising from recovery of any amount owing exceeds the debt recovery fee charged, our agent is also entitled to recover such additional costs from you. This clause is intended to be for the benefit of and be enforceable by our debt recovery agency under the contracts (Privacy) Act 1982.
  • I/We agree to indemnify you against all costs, whether commission, legal fee or otherwise incurred by you or your duly authorised agents relating to any moneys, goods and services that may be outstanding from time to time pursuant to the terms of this agreement.
  • I/We agree that the terms of trade are strictly settlement on or before the one week in advance of the invoice date and that Kidiwise Early Learning Centre will be entitled to charge interest at the rate of 30% per annum (2.5% per month) on all amounts that have not been paid in full by the week in advance of the invoice date.
  • I understand flexi hours allows me to have my child booked for set days each week and I can change these provided I give two week’s notice and do not change the hours for more than 50% of each month without charge for swapping days. Charges do apply for changing booked hours.
  • Fees will be charged for booked days my child does not attend due to illness or bereavement.
  • A 50% discount is given for holidays provided two weeks notice is given. You are entitled to 15 days holiday per annum.
  • I will be charged from the enrolment start date and will continue to be charged until I have given two weeks notice which is to be signed by the Centre Supervisor regardless of whether my child attended.
  • I understand that there is a $30.00 non refundable enrolment fee.
  • I understand that a late fee of $6.00 (30 minutes) or $12.00 (one hour) may be charged on any occasion where my child is dropped off earlier than their booked hours or collected after their booked hours. Session charges may apply to all age groups.
  • I understand a $15.00 charge will be made to any child collected after 5.30pm.
  • Full fees apply to Statutory Holidays unless two weeks notice is given to use as a holiday (a 50% discount is given for holidays provided two weeks notice is given).
  • I understand the Centre provides free 20 free ECE hours for 3+ year olds for up to six hours per day.
  • I agree that when my child leaves the Centre all fees must be paid in full prior to my child leaving.


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