Student Details

(Student Info, Mainstream School Details, Medical Information, Family Court Order)

Parent or Caregiver Details

(Parents Info, Emergency Contact)

Declaration and Consent

(Declaration and Consent Details)

Student Details

Community Language School Details

Mainstream School Details

Medical Information

Student Details - Additional Information

Special Circumstances
Students with additional learning and support needs, including disability

Family Court Orders

No file chosen

Parent Details

Parent 1

Parent 2

Emergency Contacts

Person 1

Person 2

Declaration and Consent

I/we agree to delegate my/our authority to supervising community language school staff. Such supervising staff may take whatever disciplinary action they deem necessary to ensure the safety, well-being and successful conduct of the students as a group and individually.

In the event of an accident or illness and contact with me/us being impracticable or impossible, I/we authorise community language school staff to arrange whatever medical or surgical treatment a registered medical or dental practitioner, hospital or ambulance service (including transport to a hospital) considers necessary. I/we will pay all ambulance, medical and dental expenses incurred on behalf of my/our child.

I/we consent to the staff administering medication if so requested by me/we in writing using the appropriate medication authority form (I/we recognise all medication administered at the school will only be given if the medication has been prescribed by a registered medical practitioner; from its original container; bearing the original label with the name of the child to whom the medication is to be administered; and before its expiry or use by date. I/we understand that such medication should be administered in accordance with any instructions attached to the medication or written instructions provided by a registered medical practitioner using a medical management form).

I/we agree to notify the school as soon as possible if my/our child will be absent.

I/we agree to give two weeks written notice to withdraw my/our child from the school.

There are times when children may be photographed or filmed: e.g. Special events, newspaper/newsletter articles, television news items, website articles, social media articles. I/we give permission for my/our child to be filmed or photographed and for the photos or films – together with their name – to be used for non-profit promotional purposes. This includes publication for or on behalf of The Community language Schools SA, my/our child’s community language school or the Government of South Australia and its elected members and department staff. We acknowledge that publication is generally of a permanent nature.

From time to time teachers will take classes on short local walks as part of the school’s educational program. These walks will take place at any time during the year. It is understood that in extreme heat or inclement weather conditions, such walks would not take place.I/we give consent for my/our child to go on short local walks.

Note - excursions involving the use of transport or whole day activities are not included in this consent. For each excursion involving transport and/or a financial cost, a separate notice will be provided and separate consent forms collected.

I/we give consent for my/our child to participate in any excursions the school may organise, where people share their skills, knowledge, experiences etc. with my/our child.

I/we certify that this school is the only Community language School my/our child attends.
Or My/Our child is also enrolled at (if applicable):

I/we agree to pay all charges made aware to me/us by the school that I am/we are enrolling my/our child. I/we understand that this charge is legally recoverable as a debt of the school in the event of my/our non-payment of those charges.

By signing below, I/we declare that:

  • I agree to allow the community language school staff to be responsible for supervising my child during class. The staff may take any disciplinary action within school policy to ensure the safety and well-being of all students.
  • If my child is sick or hurt, and the school staff cannot reach me, I give permission for staff to arrange medical or dental treatment that a doctor or hospital recommends. I agree to pay for any ambulance, medical, or dental expenses for my child.
  • I agree that staff may give my child medication if I request this. I understand that all medication given at school must be prescribed by a doctor, in its original container, labelled with my child’s name, and must not be expired. Medication will only be given according to the doctor’s instructions as documented on the appropriate Medication Management and Authority form.
  • I agree to tell the school as soon as possible if my child will be absent from class.
  • I agree to give the school two weeks' written notice if I decide to withdraw my child from the school.
  • I give permission for my child to be photographed or filmed during events or for school promotions. I agree that these images, along with my child’s name, may be used by the Community Language Schools SA, my child’s school, or the Government of South Australia for non-profit purposes. I understand that these publications are generally permanent.
  • I give permission for my child to go on short local walks with their class as part of the school program. These walks can happen anytime during the year unless there is bad weather. I understand that for any long trips or excursions requiring transport, the school will send me separate permission forms.
  • I give permission for my child to join any activities organized by the school, where people come to share skills or experiences with my child.
  • I confirm that this is the only community language school my child attends. (or, please identify the other community language school/s your child attends)
  • I/we certify that this school is the only Community language School my/our child attends.Or My/Our child is also enrolled at (if applicable):
  • I agree to pay all school fees and charges shared with me by the school. I understand that if I do not pay, these charges may be collected as a debt by the school.

School policies are available for viewing or download at: https://www.clssa.sa.edu.au/policies-and-procedures/

Upload your sign or add your digital signature.

I confirm that I am the person who has signed above in the box “Signature of Parent 1” and that my name is typed below as “Name of Parent 1”.

I confirm that I am the person who has signed above in the box “Signature of Parent 2” and that my name is typed below as “Name of Parent 2”.

Privacy Disclaimer

The school acknowledges and respects the privacy of its community. The information that is being collect by the school is to process your enrolment. By completing this form, you have consented to this information being collected. The intended recipients of this information are the school, The Community language Schools SA and for interaction with the Government of South Australia who provide funding to ethnic schools. The information collected will not be released for any form of commercial gain and will be maintained in a secure location as per the requirements of the Privacy Act. You have the right to access and alter personal information concerning yourself or your child in accordance with the Privacy Act 1988 and the school’s record management policy. The contact information of students will be shared publicly only when the express permission is given to The Community language Schools SA to do so or under mandatory reporting requirements.