The following declaration must be completed and signed prior to enrolment being accepted.

INTERNATIONAL STUDENT DECLARATION
(Parent Contract with Meadowbank School)

As parent(s) of                                                                   (name of student)

I / We

1. Have read, understand and agree to each of the following policies set out in the Prospectus for International Students:-

The Tuition Fees	YES / NO (delete one)
The Uniform Requirements	YES / NO (delete one)
Health & Travel Insurance	YES / NO (delete one)

i. Name of Policy Provider: ________________________
ii. Policy Number: ________________________________

The Refund Policy	YES / NO (delete one)
Termination Procedures	YES / NO (delete one)
Accommodation Provisions	YES / NO (delete one)

2. Authorise the Principal of Meadowbank School (or such other person as may be appointed by the school to carry out the Principal's duties) to:-

receive information from any person, authority or body concerning my child relating to health, education and welfare;
provide consents that may be necessary on the student's behalf in event of a medical emergency where it is not reasonably practicable to contact the parents.

YES / NO (delete one)

3. Agree that my child will comply with school rules and policies while enrolled at Meadowbank  School.   

YES / NO (delete one)

4. Understand that failure to declare prior to enrolment at Meadowbank School, any special learning needs and / or behavioural concerns which my child has experienced at previous schools, may result in contract termination procedures being enacted.  

YES / NO (delete one)

List all known Special Learning Needs / Behavioural Concerns:

_____________________________________________________________________________

_____________________________________________________________________________

5. Understand that if the school determines the student has Special Learning Needs that are not declared on this declaration, the parent will bear the cost of any extra services the student may require.  

YES / NO (delete one)

6. Understand that Meadowbank School will provide tuition in accordance with
 the National Curriculum for New Zealand Schools and
 the New Zealand Ministry of Education Code of Practice for the Pastoral Care of International Students
 use its best endeavours to ensure the safety, health and well being of the student.

YES / NO (delete one)

7. I seek enrolment at Meadowbank School for  2 / 3 / 4 term's education.

Starting ___________________________(Date)

8. I attach $___________  payment for  ___ (state number) term's tuition.

SIGNED:___________________________                          ___________  
                    (Parent)                                                            (Date)

FULL NAME: ______________________________________________________
                               (Print)

FOR SCHOOL:___________________________                 ___________  
                                        (Signed)                                     (Date)

PRINT NAME:______________________________________________________