Enrollment Form

Child Information

Child's First Names *

Child's Surname *

Child's Date of Birth

Child's Age *

Child's Gender *

Child's Residential Address *

Child's Allergies *

Child's Home Language *

Parent/Guardian Information

Enter Your Full Name *

Email *

Cellular Number *

Home Telephone Number

ID Number *

Residential Address *

Medical Aid Name

Membership Number

First Relative's Name *

First Relative's Number *

Second Relative's Name

Second Relative's Number

I agree to terms & conditions provided by Hulani Day Care. I agree that I have completed this form to the best of my ability and ensured that the information I have provided is correct.

Please note that as much as this form holds space for my child, it is incomplete without the registration fee (R500) being paid in full. Once the registration fee is paid in full, we will consider your child a member of our school.

Enrollment Form Signature *

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Enrollment Form

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