Student Information
Date of Birth
Gender
Male
Female
Level Enrolling for
Year 7
Year 8
Do you have Siblings currently at SDBIS
Yes
No
The student is living with ..
Mother & Father
Mother
Father
Caregiver
Student is a NZ Resident or Citizen
Yes
No
If NO, date of arrival in NZ
Expiry date of Visa
Visa Status (Documents required in next field)
Work Visa
Study Visa
Other
Not Applicable
Visa Status Documents
1st Primary Parent/Caregiver Information
Title
Mr
Mrs
Miss
Ms
Dr
Prof
2nd Primary Parent/Caregiver Information
Title
Mr
Mrs
Miss
Ms
Dr
Prof
Emergency Contact Details
This is in the event of an emergency when the primary parent / caregive is not available.
These must NOT be any of the parents/caregivers or caregivers listed above.
1st Emergency Contact
2nd Emergency Contact
Previous School Information
Has your child been stood down, excluded or roll-removed from the previous school?
Yes
No
Custodial Information
(if YES to any of these questions you will need to attach information or documentation where asked)
Custody Arrangements
Yes
No
Access Restrictions
Yes
No
Court Order
Yes
No
Attach Relevant Custody Documents
Health Information
Any health concerns
Yes
No
Medication at school
Yes
No
I give permission for the school to administer medication given by the parent/caregiver
Yes
I give permission for my child's hearing and vision to be tested
Yes
I give permission for the school to use Ventolin in case of an asthma emergency
Yes
Allergies
Mild
Moderate
Severe
N/A
Medical Conditions:
My child has or had the following disabilities, allergies or medical problems which may affect his/her performance or activities at school.
Please note we no longer administer over the counter medication such as panadol / paracetamol to your child
Asthma
Yes
No
Diabetes
Yes
No
Epilepsy
Yes
No
Rheumatic Fever
Yes
No
Hepatitis A or B / HIV
Yes
No
Glandular Fever
Yes
No
Nose bleeds
Yes
No
Back/Neck Problems
Yes
No
Frequent Headaches
Yes
No
Migraines
Yes
No
Sinus
Yes
No
Hay Fever
Yes
No
Heart Conditions
Yes
No
Tuberculosis
Yes
No
Recurring abdominal pain
Yes
No
Past illness or operation
Yes
No
Asthma Sufferers Only
Does the student have an Asthma Action Plan
Yes
No
N/A
If YES, please upload a copy of it here.
If using preventers, the Asthma Society recommends having an Action plan (required to be updated every 6-12 months) See GP or Practice Nurse
In case of a serious accident or emergency, an ambulance will be called. A parent / guardian will also be called, so please ensure that the school has your most current contact details
Special Agencies That Have Supported Your Child
Please check the current educational support services/s your child receives from the Ministry of Education
ICS: In-class Support
ORS: Ongoing Resourcing School
ESOL: English for Speakers of Other Languages
SWSN: Student with Special Needs
SWSA: Student with Special Abilities
RTLB
Teacher Aide
Other
School Lunchs
Preferred Lunch Option
Standard Meal
Halal
Vegetarian
No Pork / Beef
Food allergy
Yes
No
Cyber Safety & Device Agreement
The purpose of this agreement is to ensure the safety of all users of the Sir Douglas Bader Intermediate School network. Please read this page carefully to check you understand your responsibilities in this agreement and sign the appropriate sections on this form
As a student of Sir Douglas Bader Intermediate School (SDBIS) and a member of our learning community, I will contribute to making our school a safe, respectful and fair space both on and offline, I will act in a way that displays our school values - Respect, Collaboration, Creativity, Adaptability and Integrity to shape a positive online culture and be a responsible SDBIS digital citizen.
As a SDBIS digital citizen, I understand that: (Please tick you have read and agreed to the following)
● My SDBIS Google account and password are private. I must not share them with other students.
● I am responsible for everything that happens on my account.
● I will only log into devices and websites using my account.
● Chromebooks, iPads, and other school IT equipment are for learning only.
● I must not use my school account or IT equipment to hurt, bully, mock, threaten, plagiarise, or to cheat.
● I will not view, send, or download anything inappropriate or illegal.
● I will immediately tell my teacher or staff if I see any inappropriate activities.
● I will not access blocked sites or bypass security, monitoring or filtering systems.
● I can only take videos, photos, or voice recordings for learning purposes and with my teacher's permission.
● I will ask people for permission before I film, photograph, or record them.
● I will not share pictures or videos of students or staff without their permission. This includes emailing or texting one person or posting online.
● I will only use devices or go online at school when a teacher gives permission and an adult is present.
● I will give my mobile phone to the front office at the start of the day and pick it up at the end of the day. If it is confiscated from a staff member, only my parents or caregiver can collect it from the school office.
I agree that:
● SDBIS has access to all student accounts and reserves the right to check work or data related to accounts or devices.
● SDBIS’s school cyber safety rules apply to any IT equipment brought to school such as mobile phones.
● I will treat all school equipment/devices with respect and care.
Student Declaration
Parents please go over the above information with your child and make sure they understand it.
I have read and agree to the rules of the Sir Douglas Bader Intermediate School Cyber Safety Agreement. I know that if I break this Cyber Safety Agreement, I will not be allowed to use the school's IT resources. If I break the CSA, the school can tell my parents or caregivers, and there will be consequences for my actions.
Yes
By typing your name below you are in effect signing this agreement.
Date
Parent Declaration
I have read the Cyber Safety Agreement. I believe my child has read the document and understands his/her obligations.
● I understand that any breach of the rules and conditions as set out in this agreement can Lead to my child losing privileges or being subjected to disciplinary action.
● I understand that if my child loses or damages equipment, it could result in a bill for the cost of replacement parts or repairs.
● The school will be responsible for blocking illegal, dangerous, or inappropriate material, but it's up to each student to avoid accessing or using such material.
● I understand that the school is not responsible for personal devices that are not handed into the office at the beginning of the day if they become broken, lost, or stolen during school-related activities.
By typing your name below you are in effect signing this agreement.
Date
EOTC: Education Outside the Classroom Parent Consent
This Education Outside of the Classroom (EOTC) form asks for your permission for your child to join EOTC events during the school day, either on-site or nearby, and at a low-risk level within a 8km radius of the school. Examples of these events include Sporting events, Arts, and Cultural events. These events will follow the school’s safety guidelines. We will inform you about these events, but won’t ask for separate consent each time. If you have any questions or concerns, please contact the school. For events with higher risks, like adventurous activities or overnight trips, we will need specific consent from you. When we ask for this, we will also update your child’s health and contact information.
Āokonga EOTC Contract
● I agree with my child taking part in EOTC events. I acknowledge the need for them to behave responsibly.
Yes
● I have read the EOTC activities information covered by the blanket consent, and I understand the specific risks associated and not all risks can be completely eliminated.
Yes
● I give permission for the school or emergency service to administer pain relief, as indicated on their enrolment form.
Yes
● I understand the school will identify any foreseeable risks or hazards and implement effective management procedures to eliminate or minimise those risks.
Yes
● I understand that the school will encourage all ākonga to participate to their full potential, and for some ākonga a support plan will be implemented following discussion with whānau to achieve this.
Yes
● I understand that behaviour will be monitored and support will be put in place to promote the full participation of all ākonga.
Yes
● I understand that my child will be involved in the development of safety procedures. I will do my best to ensure that my child follows these procedures.
Yes
● If my child is involved in a serious disciplinary problem, including the use of illegal substances and/or alcohol, or actions that threaten the safety of others, they will be sent home at my expense.
Yes
● I understand that the school does not accept responsibility for loss or damage to personal property
Yes
By typing your names below you are in effect signing this agreement.
Date
Date
Privacy Statement
The school collects the information on this form to:
● Enrol your child at school
● Assess the educational needs of your child
● Ensure the school gets the correct resources from the Ministry of Education for your child
The school collects and uses your child’s information in accordance with the Privacy Act. The school sends some of your child’s information to the Ministry of Education and other education and health agencies. The school will not provide your child’s information to any other people or organisations without your authorisation, except in accordance with the Privacy Act
● I have read and understood the privacy statement above
● I give permission for my child’s name, image and school work to be displayed and published where appropriate e.g. school newsletters, school website, social media, classroom/school displays, school promotions, etc.
Declaration
By signing this form, I declare that all information provided in this enrolment for my child’s application is true and correct and that it is my responsibility to make sure all information is kept up to date.
By typing your name below you are in effect signing this agreement.
Date
Documentation
Please attach the following documents to support your child’s enrolment. Your child’s enrollment will not be processed until all required documents are provided.
Keep in mind that the Max file size for this is 8MB. There are tools avalible at the top of this form that can help you compress them if they are to large.
Or if your having difficulty you can drop them into the school office.
NZ Birth Certificate or NZ Passport
Recent Proof of Address (ie Phone Bill, Electricity Bill, Rates Bill)
Previous year's school report
Immunisation Record
Custody Papers - already requested in the form above.
For non-New Zealand-born students, foreign passports showing residency or Child and Parent(s) passports with student and work visa.
These have already been asked for previously on this form.