Application

    Application to Enroll in NSW Children Services INC Homework Programs

    Personal Details















    By completing this enrolment form, I hereby grant permission to NSW CHILDREN SERVICES INC and its representatives to use photographs and/or videos of me taken for promotional purposes, including but not limited to newsletters, websites, social media platforms, advertisements, and other marketing materials.

    1. NSW CHILDREN SERVICES INC owns all rights to the photographs and videos footage and may use them for any lawful purpose.

    2. I waive any rights to inspect or approve the finished product(s) and release NSW CHILDREN SERVICES INC and its representatives from any liability arising from the use of the photographs or videos footage now or in future, whether that use is known to me or unknown.

    3. I waive any rights to royalties or other compensation related to the use of any image or footage.

    4. If under 18 of age and my parent/s or my legal guardians are responsible for providing NSW CHILDREN SERVICES INC permission on my behalf. He/she acknowledge that they have read carefully and fully understand the terms of this release and voluntarily agree to its contents.















    What is your Postal address (if different from above)















    Parents Information

















    Next of kin/emergency contact









    General Information

    Gender


    MaleFemaleOther

    In which country where you born?



    Does the child speak a language other than English at home? If more than one language, indicate the one that is spoken most often.



    Are you of Aboriginal or Torres Strait Islander origin?



    Do you consider yourself to have a disability, impairment, or long term condition? If yes, please indicate the area of disability, impairment or log term condition (tick as many as apply)


    NoYesHearing/deafIntellectualMental illnessVisionLearningBrain injuryOther:

    Does your child have allergies?



    Does your child have dietary requirements?



    Does your child takes any medication?



    Are you attending school?



    Agreement- in signing this Enrollment form I agree:

    • That the information parent/s or legal guardian/s have provided on this form is true and correct and complete.

    • That they have been provided with appropriate and sufficient information to make an informed decision about my enrollment and consent mentioned above.

    • They have read and understand the NSW CHILDREN SERVICES INC information Privacy Policy.

    • To provide NSW CHILDREN SERVICES INC with up to date and accurate contact details and notify them if anything changes.

    • To be bound by NSW CHILDREN SERVICES INC student code of conduct, and other student policies and procedures as well as National and State legislatiion and regulations including any variations that are made from time to time.

    • Failure to do comply with result in enrolment suspension to other children a chance to have a place for this program.















    If the student is under 18 years of Age parents/legal guardians must sign.