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Reg. No. CK87/17906/23

I/We, the undersigned (insert full names) parents/guardians

………………………………………………………………………………………………

of (insert full physical address)

………………………………………………………………………………………………

Do hereby:

  • 1.

    Agree to accept and abide by all terms and conditions governing Sharonlea Child Care Centre with which I /we declare ourselves to be fully acquainted:

  • 2.

    Give further consent for my/our child to make use of the bus/car transportation of Sharonlea Child Care Centre or any other transport which Sharonlea Child Care Centre may decide upon;

  • 3.

    Give consent to the person in charge of Sharonlea Child Care Centre, or in here absence, any other responsible person connected with Sharonlea Child Care Centre at any given time, to take further steps that are necessary, in the event of injury or illness of the child and thereby pledge my credit;

  • 4.

    Give consent to the person in charge of Sharonlea Child Care Centre or in her absence, any other person connected with Sharonlea Child Care Centre to give the required permission and sign the necessary written consent for the child to be subjected to surgery or any other medical treatment if all attempts to locate either parent of guardian fail, provided that this will be executed on the advice, and under the supervision of the family doctor, or if he/she is not available, under the supervision and advice of a medical doctor selected by Sharonlea Child Care Centre;

  • 5.

    Agree that while the person in charge of Sharonlea Child Care Centre will care for the child to the best of their ability, and while reasonable precautions for the safety and welfare of the child will be taken, neither they or any persons connected to Sharonlea Child Care Centre will accept any liability for any claims arising from any accident or injury happening to them/us or the child while he/she is in the care of the supervisor, and to waive and abandon any claims, which may at any time arise as aforesaid, both in my/our personal capacity, and in my/our capacity of the parent or a legal guardian of the child, and I/we expressly indemnify the supervisor or such person against any such claim which may arise or be instituted;

  • 6.

    Ensure that the child has been properly immunized against whooping cough, diphtheria, tetanus and polio and vaccinated against tuberculoses and will furnish proof of this on request:

Signature Parent/Guardian..

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

20 Jarra Street Sharonlea Tel/Fax 011-4621810

71 Ebberhout Street Sharonlea Tel/ Fax/011-7041030 kerri@sharonleachildcare.co.za rita@sharonleachildcare.co.za

P.O.Box 527 Olivedale 2158

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