Admissions · Play Group · 2027

Play Group application

For children under 3 and their grown-up. Complete the application below, or download the form and email it to the school.

Download the PDF form About the playgroup

You are applying for: Play Group — under 3s

Change programme Preschool (ages 3–5) application

How to complete this form

Complete the details exactly as they appear on the child’s birth certificate. Fields marked * are required.
Each child attends with an adult — tell us who will accompany your child in section 2.
Email the documents listed in section 6 to info@bushwillowkids.co.za after you submit.

Learner details

Please fill in personal information as it appears on the learner’s birth certificate.

Full names *

Surname *

Initials *

Preferred name *

Date of birth *

Nationality *

ID number

Reason for no ID (if no ID number)

Gender *

Male Female

Dexterity

Right-handed Left-handed Not yet known

Learner’s residential address *

Brothers / sisters at Bushwillow (names and classes)

Emergency contact (someone other than the parents)

Full name *

Relationship to learner *

Mobile number *

Persons authorised to collect the learner (names and ID numbers)

Health

Allergies (food, medication, insects, other, or ‘None’) *

Immunisations up to date (Road to Health booklet) *

Yes No

I consent to the use of the learner’s photograph in school newsletters, social media and other publicity.

Anything else we should know about your child (interests, routines, strengths)

Play Group information

The playgroup takes place twice a week in the morning from February 2027 and involves a pre-planned activity as well as informal play time. Each child must be accompanied by an adult. Exact times will be communicated closer to the time. Costs are R500 per month.

Age group *

3–6 months 6–12 months 12–24 months 24–36 months

Person accompanying the child *

Mother Other relative Caretaker

If another relative, who?

Parent / guardian details

Guardian type *

Title

Initials

Preferred name

Full names *

Surname *

ID / passport number *

Gender

Male Female

Mobile number *

Email address *

The email address above is chosen as the address for all notices and letters.

Physical address *

The physical address above is chosen as the domicilium address for all legal notices.

Postal address

Accountable person & banking details

The accountable person is responsible for payment of all school fees and charges.

Accountable person *

Parent / guardian Other (complete below)

Full name (if other)

ID number (if other)

Relationship to learner

Mobile number (if other)

Email (if other)

Address (if other)

Banking details

Bank name *

Branch name

Branch code *

Account type *

Cheque / current Savings Transmission

Account number *

Account holder *

Debit order authorisation

I hereby authorise Bushwillow Kids Preschool (or its appointed bankers) to recover the following payments for the learner named in this application by debit order from my bank account, as given in the banking details in section 4, on the 1st day of each month.

Payments to be collected (tick all that apply)

Playgroup (under 3) twice per month — R500 per month

Conditions

If a debit order payment is returned unpaid, a double payment may be collected the following month, together with any bank charges for the returned payment.
If a debit order is returned unpaid for a second time, it will not be presented again, and I remain liable for the full outstanding school fees and any costs of recovery.
This authority may be cancelled by giving the school 30 days’ written notice. Cancelling it does not cancel my obligation to pay, and I am not entitled to a refund of amounts withdrawn while this authority was in force, to the extent that those amounts were legally owed to the school.
The party authorised to make withdrawals may not transfer or cede any of its rights to a third party without my written consent, and I may not delegate any of my obligations under this agreement to a third party without the written consent of the authorised party.

Full name of signatory *

Signed at (place) *

Date *

Electronic consent: by ticking this box I provide my electronic consent and signature to this debit order, with the same effect as a handwritten signature. *

Documents

Email certified copies (or clear scans) of the following to info@bushwillowkids.co.za after you submit this form. Applications without required documents cannot be finalised.

Learner’s birth certificate (unabridged) *
ID document of parent / guardian 1 *
Road to Health booklet / immunisation record *
Court order / guardianship documents (where applicable)

Consent & declaration

Permission and consent

I, the parent / guardian of the learner named in this application, confirm that:

My child may take part in all learning, play-based, outdoor, nature and cultural activities organised by the school.
I accept that all reasonable precautions will be taken for my child’s safety and wellbeing, and that I am responsible for medical and / or hospital costs in the event of an injury that is not caused by the gross negligence of the school’s staff.
In an emergency, where I cannot be reached, I authorise the Principal or her representative to obtain medical or surgical treatment for my child. To the best of my knowledge my child is in good health and able to take part in organised activities.
All medical information supplied in this form is accurate and complete and may be used in an emergency.
I will inform the school promptly if any of the information in this form changes.
I will support my child in following the school’s code of conduct and policies of Bushwillow Kids Preschool.
Personal information in this form will be processed by the school for admission, administration, safety and fee-collection purposes only, in line with the Protection of Personal Information Act (POPIA), and will not be shared with third parties except where required by law.

Indemnity

I / we, the parent(s) or guardian of the learner named in this application, indemnify Bushwillow Kids Preschool, its owners and trustees, and any person employed by or acting on behalf of the school, against any losses, claims, injury or death that may be caused to the learner through his or her use of the facilities provided by the school, except where such loss, injury or death results from the gross negligence or wilful misconduct of the school or its staff.

Declaration by parent / guardian

I, the undersigned parent / guardian, declare that the information supplied in this form is true and correct, and by my signature I authorise the Principal or her representative to verify any of the details supplied. I understand that if any information is found to be untrue, the application may be cancelled and I may be liable for a criminal offence. I understand that submitting this form does not guarantee a place and that admission is subject to space and the school’s admission policy.

I agree to the permission and consent above. *

I accept the indemnity above. *

I make the declaration above, and I give my electronic consent and signature to this application, with the same effect as a handwritten signature. *

Full name of signatory *

Signed at (place) *

Date *

You will receive a copy of your application by email. Submitting this form does not guarantee a place.

Prefer paper?

Download, print and email the form.

The play group application is also available as a PDF. Complete it, sign it, and email it with your documents to the school.

Download the play group PDF Email the school