Enrolment 2019

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25 Jan

Enrolment 2019

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Enrolment

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Please fill out the Enrolment Form below. To complete the enrolment process, a deposit of $50 per child applying to enrol is required to be transferred to the bank account provided. This amount is only refunded if the Program is booked out or cancelled, or if your child is not accepted into the Program. The deposit is not refundable if you decide to withdraw the application. Please note that we interview applicants to ascertain their commitment and the suitability of the Program for them.

Account name: AUSTRALIAN MADE (MUSLIM ADOLESCENT DEVELOPMENT & EDUCATION) INC.

BSB number: 033-397.

Account number: 316310.

Transaction reference: "please insert applicant’s SURNAME Dhikr" (e.g. "MY NAME Dhikr").

ENROLMENT FORM Dhikr and Kinder Program 2019

Online Enrolment Form

Required fields mark ( * )

I / we (Please write  down)

parent-1/

guardian-1 name in full*

parent-2/

guardian-2 name in full

wish to enrol my / our son / daughter at Australian MADE DHIKR PROGRAM.

Details of Children to be enrolled:

Child No.1
A) Name of Child(1):*
B) Date of birth(1):*
Country of birth(1):
D) Language spoken at home(1):*
E)Grade in daily school:(1)*
F) Name of daily school(1):
G) Upload a photo(1):
Child No.2
A) Name of Child (2):
B) Date of birth:(2)
Country of birth:(2)
D) Language spoken at home:(2)
E)Grade in daily school:(2)
F) Name of daily school:(2)
G) Upload a photo:(2)
Child No.3
A) Name of Child (3):
B) Date of birth:(3)
Country of birth:(3)
D) Language spoken at home:(3)
E)Grade in daily school:(3)
F) Name of daily school:(3)
G) Upload a photo:(3)
Child No.4
A) Name of Child (4):
B) Date of birth:(4)
Country of birth:(4)
D) Language spoken at home:(4)
E)Grade in daily school:(4)
F) Name of daily school:(4)
G) Upload a photo:(4)
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Family Surname:*
Home Phone:
-
Emergency Phone:
-
Do you have a home computer?*
Email for communication:*
Address:*
Details of Father:
Name of Father:*
Date of birth:(Father)*
Country of Birth(Father):
Father’s Mobile:
Occupation(Father):
Year of Arrival in Australia (if not born in Australia):(Father)
Details of Mother:
Name of Mother:*
Date of birth:(Mother)*
Country of Birth(Mother):
Mother’s Mobile:
Occupation(Mother):
Year of Arrival in Australia (if not born in Australia):(Mother)
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Are there any court orders that affect any of the children listed on this enrolment application?
If the answer is yes, custody documents must be provided as an attachment to be enforced.
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This report is intended to assist the school in case of any medical emergency and all the medical information will only be used for that purpose.

General Medical Details:
Name of family doctor:
Phone:
-
Address of Family Doctor:
Medicare Nr: Child(1)
Medicare Nr: Child(2)
Medicare Nr: Child(3)
Medicare Nr: Child(4)
Medical/Hospital Insurance Fund:
Contribution:
Ambulance Subscription Nr:
Children Medical Information:

Do any of your children take any medicine: (eg. Asthma pump)

Child:(1)
Child:(2)
Child:(3)
Child:(4)
Please identify for each child if they suffer from any of the following:
Child-Suffer:(1)
Child-Suffer:(2)
Child-Suffer:(3)
Child-Suffer:(4)
Other Suffer:
Allergies to:
Child-Allergies:(1)
Child-Allergies:(2)
Child-Allergies:(3)
Child-Allergies:(4)
Other Alergies:
Other conditions (please specify the condition and the name of the relevant child)
If your child suffers from Asthma, allergies or requires medication, please provide us with a copy of the medical management plan from his/her doctor and the medication required to be administered.
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Publication and use Permission

I understand that the intellectual property rights (including all copyrights) of any work produced or created by my child for the purpose of the Dhikr Program (including artistic and literary work such as photographs and drawings, and writings etc) vests in my child.

I GRANT on behalf of my child to Australian MADE, severally, a permanent, irrevocable, royalty-free, worldwide, non-exclusive licence to use, reproduce and adapt the intellectual property rights in my child’s work for the purpose of displaying my child’s work to the public and for providing information, promoting and marketing the Dhikr Program and the services and programs of Australian MADE.

I Agree:

Image Consent form

Australian MADE may photograph/video/interview your children, so that we may use your children’s picture/video/words in class work and activities, or in our newsletters, promotional material and website. The purpose of this is to encourage other children to participate in the Dhikr Program activities, and provide information to the public and promote Australian MADE services and programs. This material is available to the public, for example in Australian MADE newsletter, website, brochures, media releases, newspaper articles, training products, website material and television broadcasts. Australian MADE will not disclose the information for any other purpose except if required by Law.

I AGREE to have my children photographed and their images used as specified above.
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Consent & Signature:

I/we, *
>*

(PARENT/GUARDIAN) have read and understood the attached information relating to the Dhikr Program. I give permission for my children

(CHILDREN’S NAMES) to participate fully in all the activities during the workshops and Faith-Fun-Friendship days, and:

1) Authorise Australian MADE to take action such as medical or surgical treatment where this may be deemed necessary and it is impractical to communicate with me/us;

2) Understand that Australian MADE and its staff/volunteers and representatives will not be liable for loss, damage or injury to persons, property or otherwise howsoever caused, except where liability is expressly imposed by law and where such liability cannot be excluded, restricted or modified. Nothing in the Conditions is to be interpreted as excluding, restricting or modifying or having the effect of excluding, restricting or modifying the application of any State or Federal legislation applicable which cannot be excluded, restricted or modified;

3) Undertake to indemnify Australian MADE and its staff/volunteers for any expense, loss, damage or liability of whatever nature resulting from arranging such medical assistance. I will immediately inform Australian MADE in writing if my child has any pre-existing medical conditions or allergies;

4) Undertake to indemnify Australian MADE and its staff/volunteers for any loss, damage or injury caused directly or indirectly by my child.


Signing this Registration Form for the Dhikr Program means you agree to act in accordance with all the Program Rules & Regulations including the Rules and Regulations attached to this form.

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By completing the enrolment form, the children and their parents/guardians agree to act upon the following rules and regulations:

Rules and Regulations:

1)     Australian MADE reserve the right to screen applicants before confirming registration of an applicant and may refuse registration as they deem appropriate;

2)     Attendance of the Parent Information Session is essential and if you fail to attend without prior agreement with the school, then the student’s registration will be cancelled;

Parents not Happy or withdrawing their Child

3)     Where a parent is not satisfied with the performance of the Instructor or the content of the program, this should be discussed openly with the Instructor, and the Instructor shall endeavour to cater to the needs of the child and adjust the program where reasonable, provided that these requested adjustments do not conflict with the aims of the Program or impact negatively on other children;

4)     If a parent decided to withdraw their child from the program for any reason, Australian MADE must be notified in writing before the next upcoming class and fees are not refundable ;

School Conduct

5)     Children must endeavour to attend all workshops.  If a child is unable to attend due to an emergency, Australian MADE should be advised as soon as practicable;

6)     Participants must be at the workshop on time at 9.30 AM, and parents must pick up their child from their allocated classroom at the end of the workshop at 1.00 PM  Australian MADE will not be responsible for the participant before the commencement time or after the end of workshops;

7)     All staff, children and parents must display values of mutual respect, understanding and kindness;

8)     Modest clothing and conduct will be required to be displayed at all times;

9)     Male/female segregation rules will be applied during workshops;

School Property

10)  Property including books, furniture and equipment will be treated respectfully and with care and in accordance with the instructions of the Instructor.  Children and their parents/guardians will be held responsible for any damage or loss they cause;

Fees and contact details

11)  Full fees are set at $550 per child for the entirety of 2019 Dhikr Program, payable by the first day of the program on 27th April 2019.  A $50 deposit per child is required by 28th February 2019 to reserve the child’s spot.  This $50deposit is not refundable but will contribute towards the total fees for that child. Should this deposit be paid by 28th February 2019,  that child’s fees will be reduced to $500 for the entirety of the Dhikr Program 2019 (as in, only a further $450 will be payable by 27th April 2019).  If no deposit is received for a child by 28th February 2019, the full $550 fee will apply, payable in full by 27th April 2019. There is no option to attend just one term and payment of $550 for the full program is incurred at enrolment, regardless of absences due to overseas travel or any other reasons.

12)  Please note that due to the waiting list for certain age levels, payment of a deposit ($50) is required to secure your child’s spot in the Dhikr Program.  This is not withstanding that your child may not be attending for a few weeks or a whole term. 

13)  Children and parents who do not observe the rules and regulations may be suspended or expelled from the Dhikr Program at the discretion of Australian MADE with no entitlement to refund of fees, and parents will be advised in writing accordingly;

14)  Parent/guardian must inform Australian MADE of any change of contact details while enrolled, including emergency contact information and medical information;

15)  Students who are unable to attend a workshop will not be entitled to a make-up workshop or any refund of fees;

Communications

16)  Our usual form of communication is via email and WhatsApp.  Please provide us with your up-to-date email address and phone number.  If you change your address at any time, or if your child’s details change, please update management as soon as practicable.

Change to Rules

17)  Any change to these rules will be communicated at the commencement of each year and in the email updates;


Privacy Note

Australian MADE respects your privacy.  Protecting your privacy and your personal information including your children’s personal information is an important responsibility for us. We will only collect personal information from you with your prior knowledge and consent. We will only use personal information provided by you for the purposes for which it was collected and for the purpose of notifying you of upcoming events and activities of Australian MADE. We will not disclose your personal information without consent to a third party or authority except if required by law.

We have implemented a policy to protect the personal information that we have under our control from: unauthorised access, improper use, alteration, and accidental loss. You are entitled to view all your personal information held by Australian MADE.  In the event of you wishing to access this information, please contact us by email.

I Agree:(2)*
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