Student/Family Details - Enrolment & Annual Update

Welcome to River City Christian College. We appreciate you taking the time to complete this annual form.

To complete the form, you may need to supply copies of the below documents, but not limited to:

childrens birth certificates/change of name certificate
immunisation certificates
current concession cards
applicable student health records/reports
ambulance cover documentation
previous school records (from another school)
any applicable legal documents pertaining to the child

If you would like to and are able to volunteer at our wonderful school you will need to supply a current copy of your

working with children check

You may bring the original documents into the office for verification and scanning if you do not have spare copies to provide with the completed forms.

If you need assistance in completing this form, we are here to help. Please do not hesitate to contact the office during school hours via phone 5482 4594 or email reception@rccc.vic.edu.au.

As an Independent School based in Victoria, we are required by law to collect, record and report some information/data. These questions will be indicated with (*) Please note if you have any concerns with the reporting of the data we collect, you may discuss this with our principal or office manager.

PG1 = Parent/Guardian who is to be the first or primary contact. This is usually the person who completes the form and wants to receive all communications from our parent portal.

Do you have a new student or are you completing your Annual Family update Information?

Enrolment or Family Update *

New Student EnrolmentAnnual update of family information

Form Completed By (Full Name) *

Date form Completed *

Name of Child/ren (Students)

Name of child/ren attending *One student name per line

Child/Childrens Living arrangements

Parent/Child Living Arrangement *

Single Parent Situation lives at home with PG1 - No details for second parent to be recordedTwo Parent One HomeTwo Parent Multiple HomesOther Arrangements/Changes Often

During School Term Living Arrangement *

Child/ren usually live with PG 1Child/ren usually live with PG 2Child/ren usually live with PG 1 & PG 2Child/ren Live between both homesChild/ren usually live with other (Grandparent or other)Other arrangement

Please state the address where your child/ren normally reside during school term *

During School Holidays Living Arrangement *

Child/ren usually live with PG 1Child/ren usually live with PG 2Child/ren usually live with PG 1 & PG 2Child/ren Live between both homesChild/ren usually live with other (Grandparent or other)Other arrangement

Please state the address where your child/ren normally reside during school holidays *

Legal Matters

Do you have primary custody of your child/ren? *

NoYes

Are there any persons who are restricted from being in contact with your child/ren? *

NoYes

Please explain any relevant access restrictions in place to ensure we are aware of any security concerns where applicable

Are there any court orders in place for you or your child/ren?? *

NoYes

Court Orders PG 1: Please provide copies of any court orders or access restriction orders in place

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From time to time we like to take photos of our students, staff and guests

Photography Release for my child/ren: *

1. No restrictions - Permission granted for all school publications including newsletter, promotional material, school website and social media. When names are referenced in publications, this is usually first name only.2. Same as Option 1. excluding social media (Facebook). I understand by selecting this option my child/ren may be removed from photos and/or have their faces hidden with cartoon characters. 3. Photos of my child are not authorised for any use outside the direct school environment/classroom. I understand my child may subsequently be removed from all group photographs.4. My preferred option is not listed - please contact the office for more explanation.

Please note this release pertains to all children nominated

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PARENT/GUARDIAN INFORMATION

Default First Contact Details

PLEASE NOTE: Parent/Guardian One is and will be automatically the default first point of contact.

Please ensure this is the person/details listed on this form as Parent/Guardian One

Is there a second Parent Guardian 2 (PG 2) *

YesNo - No details are to be recorded for a second parent or guardian

Reason for only one parent record PG 1 *

Deceased Parent/GuardianVisitation restrictions for my child/ren are in effectDomestic Violence Situation or Other Security ConcernsUnknown Location or whereabouts of second parentOther - Prefer not to sayNot Applicable

Emergency Contact

Will PG1 also be an emergency contact? *

YesNo

Will there be additional emergency contacts for your child/ren? *

NoYes - Please complete below for persons other than PG2

Emergency Contact Name

Emergency Contact Phone Number

As being nominated as Parent/ Guardian One I understand that I am agreeing to be the first point of contact in the event of an emergency for my child/children, and as such I am to keep all details updated annually or if and when any changes occur.

Parent/Guardian Details

Parent/Guardian 1 Details (PG 1)

Parent/Guardian 2 Details (PG 2)

First Name PG 1 *

First Name PG 2 *

Surname PG 1 *

Surname PG 2 *

Date of Birth PG 1 *

Date of Birth PG 2 *

Home Street Address PG 1 *

Home Street Address PG 2 *

Postcode

Postcode PG 2

Is your postal address different to your home address? PG 1 *

Yes No

Is your postal address is different to your home address? PG 2 *

Yes No

Postal Address PG 1 *Street Name and Number, PO box

Postal Address PG 2 *Street Name and Number, PO Box

Postal Suburb PG 1 *

Postal Suburb PG 2 *

Postal State PG 1 *

Postal State PG 2 *

Postal Postcode PG 1 *

Postal Postcode PG 2 *

Mobile Phone PG 1 *

Mobile Phone PG 2 *

Home Phone Number PG 1

Home Phone Number PG 2

Work Phone Number PG 1

Work Phone Number PG 2

Email Address PG 1 *

Email Address PG 2 *

Country of birth PG 1 *

AustraliaOutside Australia

Country of Birth PG 2 *

AustraliaOutside Australia

Your Country of Birth if outside Australia PG 1 *

Your Country of Birth if outside Australia PG 2 *

Language Spoken at home PG 1 *

EnglishOther

Language Spoken at home PG 2 *

EnglishOther

Please list any other languages you speak PG 1 *

Please list any other languages you speak PG 2 *

Indigenous Status PG 1 *

AboriginalTorres Strait IslanderAboriginal and Torres Strait IslanderNeither Aboriginal nor Torres Strait Islander

Indigenous Status PG 2 *

AboriginalTorres Strait IslanderAboriginal and Torres Strait IslanderNeither Aboriginal nor Torres Strait Islander

Citizenship PG 1 *

I am an Australian CitizenI am NOT an Australian Citizen

Citizenship PG 2 *

I am an Australian CitizenI am NOT an Australian Citizen

Fees & Charges

Responsibility to payment of fees PG 1 *

I am solely responsible for payment of feesI am equally responsible for payment of fees with PG 2

Responsibility to Payment of Fees PG 2 *

I am solely responsible for payment of feesI am equally responsible for payment of fees with PG 1

Eligible concessions

Concession Card Held PG 1 *

Yes - PensionYes - Health CareYes - Other ConcessionNo

Concession Card Held PG 2 *

Yes - PensionYes - Health CareYes - Other ConcessionNo

Concession Card Number PG 1 *

Concession Card Number PG 2 *

Concession expiry date PG 1 *

Concession Card Expiry PG 2 *

Concession: Please upload a copy all concession cards

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Please bring in to the office for CSEF funding verification

Faith

Please note your current church if applicable PG 1

Please note your current church if applicable PG 2

Employment & Study History

Please state your Occupation or state not in paid work PG 1 *

State your Occupation or state not in paid work PG 2 *

State Name of Employer/Business or state "none" PG 1 *

State Name of Employer/Business or state "none" PG 2 *

School Level Achieved PG 1 *

Year 9 or belowYear 10Year 11Year 12

School Level Achieved PG 2 *

Year 9 or belowYear 10Year 11Year 12

Highest Qualification Completed PG 1 *

No non-school qualificationTrade or Certificate III or IVDiploma/advanced diplomaBachelor degree

Highest Qualification Achieved PG 2 *

No non-school qualificationTrade or Certificate III or IVDiploma/advanced diplomaBachelor degree

Volunteering

Volunteer PG 1 *

I would like to volunteer on occasionI am unable to volunteer due to other commitments

Volunteer PG 2 *

I would like to volunteer on occasionI am unable to volunteer due to other commitments

I understand volunteering provides many opportunities for the school children, teachers and parents to work together and I acknowledge I will provide further details such as a valid working with children's check as required by the department for all volunteers with school children of all ages. I consent to the office sending me a volunteering form to compelte and accept being added to our volunteer register.

I currently volunteer with an Emergency Service PG 1 *

I volunteer with the SESI volunteer with the CFAI do not volunteer with any emergency servicesI volunteer with another organisation within the community

I currently volunteer with an Emergency Services PG 2 *

I volunteer with the SESI volunteer with the CFAI do not volunteer with any emergency servicesI volunteer with another organisation within the community

CHILD/REN INFORMATION

General information

Child 1 General Information (CH 1)

Child 2 General lnformation (CH 2)

Child 3 General Information (CH 3)

Given Name CH 1 *

Given Name CH 2 *

Given Name CH 3 *

Middle Name CH 1

Middle Name CH 2

Middle Name CH 3

Surname CH 1 *

Surname CH 2 *

Surname CH 3 *

Preferred name CH 1

Preferred name CH 2

Preferred name CH 3

Date of Birth CH 1 *

Date of Birth CH 2 *

Date of Birth CH 3 *

Title CH 1 *

MissMasterMx

Title CH 2 *

MissMasterMx

Title CH 3 *

MissMasterMx

Birth Country CH 1 *

AustraliaOutside Australia

Birth Country CH 2 *

AustraliaOutside Australia

Birth Country CH 3 *

AustraliaOutside Australia

Country of Birth CH 1 *

Country of Birth CH 2 *

Country of Birth CH 3 *

Citizenship CH 1 *

Child is an Australian CitizenChild is NOT an Australian Citizen

Citizenship CH 2 *

Child is an Australian CitizenChild is NOT an Australian Citizen

Citizenship CH 3 *

Child is an Australian CitizenChild is NOT an Australian Citizen

Main language spoken at home CH 1 *

EnglishOther

Main language spoken at home CH 2 *

EnglishOther

Main language spoken at home CH 3 *

EnglishOther

Other Language Spoken CH 1 *

Other Language Spoken CH 2 *

Other Language Spoken CH 3 *

Child 4 General Information (CH 4)

Child 5 General Information (CH 5)

Child 6 General Information (CH 6)

Given name CH 4 *

Given name CH 5 *

Given name CH 6 *

Middle Name CH 4

Middle Name CH 5

Middle Name CH 6

Surname CH 4 *

Surname CH 5 *

Surname CH 6 *

Preferred name CH 4

Preferred name CH 5

Preferred name CH 6

Date of Birth CH 4 *

Date of Birth CH 5 *

Date of Birth CH 6 *

Title CH 4 *

MissMasterMx

Title CH 5 *

MissMasterMx

Title CH 6 *

MissMasterMx

Birth Country CH 4 *

AustraliaOutside Australia

Birth Country CH 5 *

AustraliaOutside Australia

Birth Country CH 6 *

AustraliaOutside Australia

Country of Birth CH 4 *

Country of Birth CH 5 *

Country of Birth CH 6 *

Citizenship CH 4 *

Child is an Australian CitizenChild is NOT an Australian Citizen

Citizenship CH 5 *

Child is an Australian CitizenChild is NOT an Australian Citizen

Citizenship CH 6 *

Child is an Australian CitizenChild is NOT an Australian Citizen

Main language spoken at home CH 4 *

EnglishOther

Main language spoken at home CH 5 *

EnglishOther

Main language spoken at home CH 6 *

EnglishOther

Other Language Spoken CH 4 *

Other Language Spoken CH 5 *

Other Language Spoken CH 6 *

Upload a copy of all birth certificates

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If you are unable to upload a copy, bring to the office for scanning

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School Details

Child 1 School Details (CH 1)

Child 2 School Details (CH 2)

Child 3 School Details (CH 3)

Do you have a Child Victorian Student Number (VSR) CH 1 *

No VSR KnownYes I have the VSR Yes however number unknown to me

Do you have a Child Victorian Student Number (VSR) CH 2 *

No VSR KnownYes I have the VSR Yes however number unknown to me

Do you have a Child Victorian Student Number (VSR) CH 3 *

No VSR KnownYes I have the VSR Yes however number unknown to me

CH 1 VSR if known *

CH 2 VSR if known *

CH 3 VSR if known *

Type of previous kinder/school CH 1 *

GovernmentIndependentCatholic

Type of previous kinder/school CH 2 *

GovernmentIndependentCatholic

Type of previous kinder/school CH 3 *

GovernmentIndependentCatholic

Previous Kinder/School name CH 1 *

Previous Kinder/School name CH 2 *

Previous Kinder/School name CH 3 *

Date of entry sought at RCCC CH1

Date of entry sought at RCCC CH2

Date of entry sought at RCCC CH3

Describe some of the interests and hobbies of your child CH 1 *

Describe some of the interests and hobbies of your child CH 2 *

Describe some of the interests and hobbies of your child CH 3 *

Describe your child's strengths and the things they do really well CH 1 *

Describe your child's strengths and the things they do really well CH 2 *

Describe your child's strengths and the things they do really well CH 3 *

Child 4 School Details (CH 4)

Child 5 School Details (CH 5)

Child 6 School Details (CH 6)

Do you have a Child Victorian Student Number (VSR) CH 4 *

No VSR KnownYes I have the VSR Yes however number unknown to me

Do you have a Child Victorian Student Number (VSR) CH 5 *

No VSR KnownYes I have the VSR Yes however number unknown to me

Do you have a Child Victorian Student Number (VSR) CH 6 *

No VSR KnownYes I have the VSR Yes however number unknown to me

CH 4 VSR if known *

CH 5 VSR if known *

CH 6 VSR if known *

Type of previous kinder/school CH 4 *

GovernmentIndependentCatholic

Type of previous kinder/school CH 5 *

GovernmentIndependentCatholic

Type of previous kinder/school CH 6 *

GovernmentIndependentCatholic

Previous Kinder/School name CH 4 *

Previous Kinder/School name CH 5 *

Previous Kinder/School name CH 6 *

Date of entry sought at RCCC for CH4

Date of entry sought at RCCC for CH5

Date of entry sought at RCCC for CH6

Describe some of the interests and hobbies of your child CH 4 *

Describe some of the interests and hobbies of your child CH 5 *

Describe some of the interests and hobbies of your child CH 6 *

Describe your child's strengths and the things they do really well CH 4 *

Describe your child's strengths and the things they do really well CH 5 *

Describe your child's strengths and the things they do really well CH 6 *

Medical Details

Child 1 Medical Details CH 1

Child 2 Medical Details CH 2

Child 3 Medical Details CH3

Family Medicare card number CH 1 *

Family Medicare card number CH2 *

Family Medicare card number CH3 *

Health Care Cover for this child CH 1 *

Covered by private health insurancePublic health on MedicareNot Covered (international student or other reason)

Health Care Cover for this child CH2 *

Covered by private health insurancePublic health on MedicareNot Covered (international student or other reason)

Health Care Cover for this child CH3 *

Covered by private health insurancePublic health on MedicareNot Covered (international student or other reason)

Health care provider CH1 *

Health care provider CH2 *

Health care provider CH3 *

Health cover membership number CH 1 *

Health cover membership number CH2 *

Health cover membership number CH3 *

Ambulance subscription for this child CH 1 *

Covered by a current ambulance subscriptionNo ambulance subscription

Ambulance subscription for this child CH2 *

Covered by a current ambulance subscriptionNo ambulance subscription

Ambulance subscription for this child CH3 *

Covered by a current ambulance subscriptionNo ambulance subscription

Ambulance membership number CH 1 *

Ambulance membership number CH2 *

Ambulance membership number CH3 *

Family GP/Doctor Practice Name CH 1 *

Family GP/Doctor Practice Name CH2 *

Family GP/Doctor Practice Name CH3 *

GP Contact Phone CH 1 *

GP Contact Phone CH2 *

GP Contact Phone CH3 *

GP Practice Address CH 1 *

GP Practice Address CH2 *

GP Practice Address CH3 *

Family Dental Practice Name CH 1 *

Family Dental Practice Name CH2 *

Family Dental Practice Name CH3 *

Dentist Practice Phone CH 1 *

Dentist Practice Phone CH2 *

Dentist Practice Phone CH3 *

Dental Practice Address CH1 *

Dental Practice Address CH2 *

Dental Practice Address CH3 *

If other medical condition for CH1, please describe *

If other medical condition for CH2, please describe *

If other medical condition for CH3, please describe *

Regular Medication CH 1 *

Child does not have regular medicationChild has regular medication administered at homeChild has regular medication administered at school

Regular Medication CH2 *

Child does not have regular medicationChild has regular medication administered at homeChild has regular medication administered at school

Regular Medication CH3 *

Child does not have regular medicationChild has regular medication administered at homeChild has regular medication administered at school

I understand I will need to complete the medication consent form before the school can administer any medication to my child, including on camps and excursions. *

Medication Name CH 1 *

Medication Name CH2 *

Medication Name CH3 *

Medication Dosage CH 1 *

Medication Dosage CH 2 *

Medication Dosage CH 3 *

Medication Administered Time CH 1 *

Medication Administered Time CH 2 *

Medication Administered Time CH 3 *

Child 4 Medical Details CH4

Child 5 Medical Details CH5

Child 6 Medical Details CH6

Family Medicare card number CH4 *

Family Medicare card number CH5 *

Family Medicare card number CH6 *

Health Care Cover for this child CH4 *

Covered by private health insurancePublic health on MedicareNot Covered (international student or other reason)

Health Care Cover for this child CH5 *

Covered by private health insurancePublic health on MedicareNot Covered (international student or other reason)

Health Care Cover for this child CH6 *

Covered by private health insurancePublic health on MedicareNot Covered (international student or other reason)

Health care provider CH4 *

Health care provider CH5 *

Health care provider CH6 *

Health cover membership number CH4 *

Health cover membership number CH5 *

Health cover membership number CH6 *

Ambulance subscription for this child CH4 *

Covered by a current ambulance subscriptionNo ambulance subscription

Ambulance subscription for this child CH5 *

Covered by a current ambulance subscriptionNo ambulance subscription

Ambulance subscription for this child CH6 *

Covered by a current ambulance subscriptionNo ambulance subscription

Ambulance membership number CH4 *

Ambulance membership number CH5 *

Ambulance membership number CH6 *

Family GP/Doctor Practice Name CH4 *

Family GP/Doctor Practice Name CH5 *

Family GP/Doctor Practice Name CH6 *

GP Contact Phone CH4 *

GP Contact Phone CH5 *

GP Contact Phone CH6 *

GP Practice Address CH4 *

GP Practice Address CH5 *

GP Practice Address CH6 *

Family Dental Practice Name CH4 *

Family Dental Practice Name CH5 *

Family Dental Practice Name CH6 *

Dentist Practice Phone CH4 *

Dentist Practice Phone CH5 *

Dentist Practice Phone CH6 *

Dental Practice Address CH4 *

Dental Practice Address CH5 *

Dental Practice Address CH6 *

If other medical condition for CH4, please describe *

If other medical condition for CH5, please describe *

If other medical condition for CH6, please describe *

Regular Medication CH4 *

Child does not have regular medicationChild has regular medication administered at homeChild has regular medication administered at school

Regular Medication CH5 *

Child does not have regular medicationChild has regular medication administered at homeChild has regular medication administered at school

Regular Medication CH6 *

Child does not have regular medicationChild has regular medication administered at homeChild has regular medication administered at school

I understand I will need to complete the medication consent form before the school can administer any medication to my child, including on camps and excursions. *

Medication Name CH4 *

Medication Name CH5 *

Medication Name CH6 *

Medication Dosage CH4 *

Medication Dosage CH5 *

Medication Dosage CH6 *

Medication Administered Time CH 4 *

Medication Administered Time CH 5 *

Medication Administered Time CH 6 *

Disability Support

Child 1 Disability/Support Details CH1

Child2 Disability/Support Details CH2

Child 3 Disability/Support Details CH3

Diagnosed or suspected disability CH1 *

YesNoUndergoing Review

Diagnosed or suspected disability CH2 *

YesNoUndergoing Review

Diagnosed or suspected disability CH3 *

YesNoUndergoing Review

Please state the disability (or multiple) CH1 *

Please state the disability (or multiple) CH2 *

Please state the disability (or multiple) CH3 *

Please note any further details that may help us to support your Childs learning and development CH1

Please note any further details that may help us to support your Childs learning and development CH2

Please note any further details that may help us to support your Childs learning and development CH3

Please upload a copy of any reports relating to:

Diagnosis
Psychology
Speech
Occupational Therapy
Previous school Individual Learning PLans
Other relevant reports

Or bring to the RCCC office for scanning.

Upload a copy of relevant reports CH1

Browse

Upload a copy of relevant reports CH2

Browse

Upload a copy of relevant reports CH3

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Child 4 Disability/Support Details CH4

Child 5 Disability/Support Details CH5

Child 6 Disability/Support Details CH6

Diagnosed or suspected disability CH4 *

YesNoUndergoing Review

Diagnosed or suspected disability CH5 *

YesNoUndergoing Review

Diagnosed or suspected disability CH6 *

YesNoUndergoing Review

Please detail the Disability (or multiple) CH4 *

Please detail the Disability (or multiple) CH5 *

Please detail the Disability (or multiple) CH6 *

Please upload a copy of any reports relating to:

Diagnosis
Psychology
Speech
Occupational Therapy
Previous school Individual Learning PLans
Other relevant reports

Or bring to the RCCC office for scanning.

Upload a copy of relevant reports CH4

Browse

Upload a copy of relevant reports CH5

Browse

Upload a copy of relevant reports CH6

Browse

Behaviour

Child 1 Behaviour CH 1

Child 2 Behaviour CH 2

Child 3 Behaviour CH3

Please explain the reason for each individual item, for CH1 *

Please explain the reason for each individual item, for CH2 *

Please explain the reason for each individual item, for CH3 *

Child 4 Behaviour CH4

Child 5 Behaviour CH5

Child 6 Behaviour CH6

Please explain the reason for each individual item, for CH4 *

Please explain the reason for each individual item, for CH5 *

Please explain the reason for each individual item, for CH6 *

Acknowledgement & Declaration

PG 1 Acknowledgement

PG 2 Acknowledgement

I acknowledge I am responsible for and agree to maintain the payment of my fees each term by the due date. *

I agree to abide by the school procedures and policies and support my child/ren to do the same, including privacy and safety policies and other relevant policies linked below. I give consent for supervised excursions from the school and by signing below, I acknowledge I am giving my child/ren permission to participate in these events for the duration of their time at the school. *

Signatures

PG 1 signature *

Draw signature|Type signatureClear

PG 2 signature *

Draw signature|Type signatureClear

Date Signed PG 1 *

Date Signed PG 2

Please tick if you would like more information about RCCC membership options.

Please tick if you are already a member of RCCC.

RCCC Administration Only

Add administrative items here that need completing

Is this individual/family a current student of RCCC *

YesNo

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