Means of transport to/from school:

Do you have a medical aid?

Learner's Medical Information

Has the learner ever had any of the following diseases?

Has the learner ever been treated for any of the following?

Do you want to apply for Aftercare for this learner

How many sibling?

Would you like to upload a photo?

Photo (Upload image with maximum 200kb)
Upload Photo

Mother / Guardian

Are you employed?

Father / Guardian

Are you employed?

Marital Status of Parents

If Divorced/Spearated - children in custody of

Person Responsbile for Account

Please note that parent will be jointly and severelly liable for the account even if the account is paid by a third party / bursary.

Details of any other Contact in case of Emergency (Other than Father / Mother / Guardian)

Emergency Contact 1

Emergency Contact 2

Please upload the following documents as pdf or jpeg files. If you are not able to do his at the moment please email the documents to or submit it personally at the school. Please take note that the school cannot process your application without all the necessary documents.



Declaration and Undertaking: I declare that the particulars furnished on this form are true and correct, and I undertake to comply with the rules, regulations, decisions and policies of the school, and any amendments thereto, which may be applicable to learners and parents in general. I declare that I have perused the applicable school rules and policies and understand the contents thereof and accept it as binding on myself and the learner concerned.


Third Party Consent: I consent to the school or the school’s selected third party service provider, a) collecting and capturing my Personal Information and any other person’s Personal Information, which I supply voluntarily and have consent to supply; and b) storing such Personal Information for the period as set out in the terms and conditions, to get in contact with me, provide me with the information I have requested and/ or enter into a business relationship with me. I have read the terms and conditions, and acknowledge the Online Privacy Policy and the PAIA manual and related content.


School Fees: I declare that my child is attending a private instituion which relies on the regular monthly payment of school fees as stipulated in this agreement. I understand that non-payment of school fees is a breach of the agreement. I have taken note of the school fees as published and available from the school office. I have read, understood and accept the financial policy of the school. I accept full responsibility for all amounts due to the school and I agree to pay the school fees strictly according to due dates, failing which the account will be handed over to debt collectors and that I will be liable for the collection costs. No learner with an outstanding balance for the previous year will be re-registered unless the outstanding balance is paid in full. Should school fees be in arrears, the school reserves the right to deny learners access to aftercare, transport, trips and excursions and school functions. School fees are payable monthly in advance, on or before the 7th of each month. The school reserves the right to not accept a registration on the basis of affordability, academic and disciplinary record and incomplete application. Payment by debit order is the requisite method of payment. The school has the right to change re-registration fee annually for current learners to reserve space for the following academic year.


Photos: I hereby grant permission for my child to be photographed participating in class projects and events and for the photographs to be included on the school’s website, Facebook and other electronic and social media platforms.


Indemnity: I hereby give permission that he/she may attend any excursion organised by the school with the permission of the principal. I understand that he/she will sometimes have to travel by bus or taxi to different venues of educational value. These trips will have to be paid for when organised. The school will use the best transport available at the lowest cost. I accept that the school will take the necessary precautions to ensure the safety of my child. I will however, not hold the school responsible in case of an accident, loss of limb or life, or any other damages to her/his person or property. I also understand that this arrangement is necessary because it is sometimes difficult to get hold of parents to sign a letter of consent before a trip can take place. In such instances the child is unfairly prevented from attending a trip.


Vaal Triangle Primary School Values:
I undertake to uphold the values of the school whenever I am involved in school related functions or activities. I will also be available to attend parents meetings and functions to support the education of my child. I will respond timeously to letters, e-mails, SMS and calls made by the school. I undertake to keep all personal contact details updated at all times.


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Your Ref. No.:
Learners Details
Family Details
Responsible for Account
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