Name of Student
*
First Name
Last Name
Middle Name(Optional)
Email
*
Date of Birth
MM
DD
YYYY
Gender
*
Male
Female
Other
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Student's Australian Residency Status
*
Name of Parent/Guardian
First Name
Last Name
Relationship to Student
Phone
*
Country
(###)
###
####
Email
Emergency Contact Name
*
First Name
Last Name
Relationship to Student
*
Emergency Contact Phone
*
Country
(###)
###
####
Do you/your child suffer from any medical condition? (E.g Asthma, Epilepsy, Allergies etc)?
*
If Yes, please specify and provide a medical plan (e.g asthma, anaphylaxis etc)
Privacy
*
Privacy Collection Notice - Protecting your privacy and sharing information
The information about your child and family collected through this enrolment form will only be shared with
school staff who need to know to enable the community language school to educate or support your child,
or to fulfil legal obligations including duty of care, anti-discrimination law and occupational health and safety
law. This includes using the contact information provided if there are any emergencies or medical issues.
Residency status is checked to ensure that your child is eligible for funding. Your child’s name, date of birth
and mainstream school name/s will be shared with the Department of Education (the Department) to
confirm funding eligibility. The information collected will not be disclosed beyond the community language
school or the Department without your consent, unless such disclosure is lawful. For more about
information-sharing and privacy, see the Department’s privacy policy at:
http://www.education.vic.gov.au/Pages/privacy.aspx
If you have any queries about the handling of your information by the community language school or to
correct and update your information please contact the school.
Parent/Guardian Privacy Consent and Declaration
I confirm that the information provided on this enrolment form is true and correct and I acknowledge and
agree to the terms and conditions of enrolment accompanying this enrolment form. I consent to:
1. the collection of my child’s health and personal information by the community language school for the
purposes mentioned in this form;
2. the community language school disclosing my child’s personal information contained in this enrolment form (name, date of birth and mainstream school name), to the Department of Education for data
verification and funding purposes.
I understand that the Principal or teacher (where the Principal or teacher in charge is unable to contact me)
is allowed to disclose personal and health information to professional third parties in the event of a medical
emergency, in accordance with Victorian privacy law.
Name of parent/guardian
First Name
Last Name
Date
*
MM
DD
YYYY
Annual Photography Consent
During the school year there are many occasions and events where staff may photograph, film or record
students participating in school activities and events. We do this for many reasons including to celebrate
student participation and achievement, or to communicate with our parents and school community.
This notice applies to photographs, video or recordings of students that are collected, used and disclosed by
the school. We ask that any parents/carers or other members of our school community photographing,
filming or recording students at school events (e.g. concerts, sports events etc) do so in a respectful and safe
manner and that any photos, video or recordings (“images”) of students are not publicly posted (e.g. to a
social media account) without the permission of the relevant parent/carer.
If you do not understand any aspect of this notice, or you would like to talk about any concerns you have,
please contact the community language school.
I consent to my child being photographed or audio/visually recorded participating in class or school activities
for the use and purposes of sharing
1.with other families in the school that will only be sent to school families in my child’s class.
2. in the school newsletter.
3.marketing or CLS social media sites.
