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KELMSCOTT HOMESCHOOL GROUP: Classes for home educated children (@ PIARA WATERS PAVILION, 6 MONDAYS/TERM)
About
1. TIMETABLE & CLASS INFO
2. READ - Membership agreement and policies
3. ENROLMENT FORM
4. PAYMENT
Contact
About
1. TIMETABLE & CLASS INFO
2. READ - Membership agreement and policies
3. ENROLMENT FORM
4. PAYMENT
Contact
ENROLMENT FORM- KELMSCOTT HOMESCHOOL GROUP - TERM 1, 2021
15 & 22 FEB (NONE 1 MARCH), 8, 15, 22 & 29 MAR
PIARA WATERS PAVILION
PLEASE NOTE WE HAVE LIMITED SPACES AVAILABLE (12 PER CLASS)
ENROLMENTS CLOSING FRIDAY 29 JANUARY 2021. PAYMENT EXPECTED AT TIME OF ENROLMENT.
*
Indicates required field
Parent/guardian Name
*
First
Last
Parent/guardian Email
*
Parent/guardian phone number(s)
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Emergency contact (other than yourself)
*
First
Last
Emergency contact's phone number(s)
*
Person authorised to bring your child/ren and be responsible for them at Kelmscott Homeschool Group
*
First
Last
Authorised Person 1's Phone number
*
Person authorised to bring my child/ren and have responsibilty for them whilst at Kelmscott Homeschool Group
*
First
Last
Authorised person 2's phone number
*
Please include
all
children who will accompany you to Kelmscott Homeschool Group.
Child 1 - name
*
First
Last
Child 1 - age
*
Child 1 - additional needs or allergies
*
This child needs a parent/carer present in classes
*
YES
NO
Child 1
*
ACROBATICS (AGES 7-16)
DANCE - HIP HOP (AGES 7-16)
ART - EARLY YEARS (K-2)
ART - MID-UPPER PRIMARY (YRS 3-6)
ART - HIGH SCHOOL (YRS 7-10)
RHYTHM & VOICE (AGES 7-14)
THEATRE & DRAMA (AGES 5-15)
SCIENCE - BEGINNER (K-YR 2)
SCIENCE - JUNIOR (YRS 3-6)
SCIENCE - INTERMEDIATE (YRS 5-7)
SCIENCE - SENIOR (YRS 8-10)
TECHNOLOGY - JUNIOR ELECTRONICS (YRS 1-4)
Child 2 - name
*
First
Last
Child 2 - age
*
Child 2 - additional needs or allergies
*
This child needs a parent/carer present in classes
*
YES
NO
Child 2
*
Social only (not enrolling in classes)
ACROBATICS (AGES 7-16)
DANCE - HIP HOP (AGES 7-16)
ART - EARLY YEARS (K-YR2)
ART - MID-UPPER PRIMARY (YRS 3-6)
RHYTHM & VOICE (AGES 7-14)
ART - HIGH SCHOOL (YRS 7-10)
THEATRE & DRAMA (AGES 5-15)
SCIENCE - BEGINNER (K-YR 2)
SCIENCE - JUNIOR (YR 3-6)
SCIENCE - INTERMEDIATE (YRS 5-7)
SCIENCE - SENIOR (YRS 8-10)
TECHNOLOGY - JUNIOR ELECTRONICS (YRS 1-4)
Child 3 - name
*
First
Last
Child 3 - age
*
Child 3 - additional needs or allergies
*
This child needs a parent/carer present in classes
*
YES
NO
Child 3
*
Social only (not enrolling in any classes)
ACROBATICS (AGES 7-16)
DANCE - HIP HOP (AGES 7-16)
ART - EARLY YEARS (K-YR 2)
ART - MID-UPPER PRIMARY (YRS 3-6)
ART - HIGH SCHOOL (YRS 7-10)
RHYTHM & VOICE (AGES 7-14)
THEATRE & DRAMA (AGES 5-15)
SCIENCE - BEGINNER (K-YR 2)
SCIENCE - JUNIOR (YR 3-6)
SCIENCE - INTERMEDIATE (YRS 5-7)
SCIENCE - SENIOR (YRS 8-10)
TECHNOLOGY - JUNIOR ELECTRONICS (YRS 1-4)
Child 4 - name
*
First
Last
Child 4 - age
*
Child 4 - additional needs or allergies
*
This child needs a parent/carer present in classes
*
YES
NO
Child 4
*
Social only (not enrolling in any classes)
ACROBATICS (AGES 7-16)
DANCE - HIP HOP (AGES 7-16)
ART - EARLY YEARS (K-YR 2)
ART - MID-UPPER PRIMARY (YRS 3-6)
ART - HIGH SCHOOL (YRS 7-10)
RHYTHM & VOICE (AGES 7-14)
THEATRE & DRAMA (AGES 5-15)
SCIENCE - BEGINNER (K-YR 2)
SCIENCE - JUNIOR (YRS 3-6)
SCIENCE - INTERMEDIATE (YRS 5-7)
SCIENCE - SENIOR (YRS 8-10)
TECHNOLOGY - JUNIOR ELECTRONICS (YRS 1-4)
Please complete an additional form if you have
more than 4
children attend Kelmscott Homeschool Group with you. Thank you
HOME EDUCATION WA (HEWA/HBLN) MEMBERSHIP
Do you have HEWA/HBLN membership? (Includes insurance)
*
YES
NO - I understand that my fees will have a 20% surcharge and must choose the Non-HBLN option on the hall hire contribution and classes
HEWA/HBLN membership number
*
HEWA/HBLN membership expiry date
*
PHOTOGRAPHY AND VIDEO RELEASE
The Organiser takes photos of the group in action to include in the end of Term newsletter and on in some instances for inclusion in Home Education WA (HEWA/HBLN publications). If you do not wish for your children to be photographed, please let the Organiser know.
You may take photographs of your own family for personal use.
You must seek permission from other parents if you would like to take photos that include their family prior to taking photos.
Please tick which applies
*
I give permission for Kelmscott Homeschool Group and HBLN/HEWA to use photography/video of myself or child(ren) for KHG's or HBLN/HEWA’s newsletter or other printed materials.
I give permission for Kelmscott Homeschool Group and HBLN/HEWA to use photography/video of myself or child(ren) for KHG's or HEWA/HBLN’s social networking sites, the members section of the HEWA/HBLN website and at other HEWA/HBLN organised events.
I give permission for Kelmscott Homeschool Group and HBLN/HEWA to use photography and/or video of myself and/or children in BOTH digital and printed formats
I DO NOT give permission for Kelmscott Homeschool Group or HBLN/HEWAto use photography/video of myself and/or children
ASSISTANCE IS NEEDED TO ENSURE THE SMOOTH RUNNING OF THE GROUP
Assistance I can give to the Kelmscott Homeschool Group on a weekly basis
*
09:00-09:20 SETTING UP & CLEANING BEFORE FIRST CLASSES
14:30-15:00 CLEANING UP AT END OF THE DAY
SUPERVISION AT THE SIGN IN DESK (SIGNING, SANITISING/HAND WASHING PROMPT)
COVID-19 COMPLIANCE ASSISTANCE (HAND SANITISING/HANDWASHING PROMPTS)
FIRST AID - PLEASE EMAIL COPY OF CURRENT CERTIFICATE
MEMBERSHIP AGREEMENT AND FORM SUBMISSION
MEMBERSHIP AGREEMENT
*
I understand that Kelmscott Homeschool Group is NOT a "drop and run" service. Parents/Guardians are responsible for the supervision of their child(ren) at all times. Parents/guardians or another authorised person must remain on site at all times.
I understand that HBLN/HEWA, Kelmscott Homeschool Group, its members, volunteers, and parent organisers, cannot be held liable for any accidents or injuries sustained by my child(ren) in the normal course of activities, provided that all due care has been taken.
I understand that an organiser of Kelmscott Homeschool Group will call an ambulance in my absence if it is deemed necessary for the wellbeing of my child, and I agree to pay any and all costs involved.
I understand that is is my full responsibility to advise organisers via email of any and all changes to my personal information as it changes.
I have read through the Welcome pack (membership agreement) and policies and agree to the terms and conditons of these documents.
(2. Read) Welcome pack (membership agreement) and policies
Submit
PLEASE MAKE SURE YOU ADD THE HALL HIRE CONTRIBUTION AS WELL AS ANY CLASSES. IF YOU ARE NOT A PAID MEMBER OF HOME EDUCATION WA (HEWA/HBLN) YOU WILL ALSO NEED TO ADD THE HBLN LEVY FOR THE HALL HIRE CONTRIBUTION AND CLASSES.
4. PAYMENT