We're about building the soil in which learning occurs.

We focus on creating the environment in which a child's development can flourish.

Registration Form Part B & C

  • Child(ren) Attendance Information

  • If this child has a medication plan (anaphylaxis and asthma) please provide Alithia with a letter from the doctor and the plan at enrolment. In case of anaphylaxis, please provide one (1) EpiPen with an ice pack for us to store during attendance.

  • Child(ren) Information & Attendance

  • If this child has a medication plan (anaphylaxis and asthma) please provide Alithia with a letter from the doctor and the plan at enrolment. In case of anaphylaxis, please provide one (1) EpiPen with an ice pack for us to store during attendance.
  • If this child has a medication plan (anaphylaxis and asthma) please provide Alithia with a letter from the doctor and the plan at enrolment. In case of anaphylaxis, please provide one (1) EpiPen with an ice pack for us to store during attendance.

  • Household Information

  • Parent/Guardian & Family Information

  • List an additional person to Guardians and Emergency Contact that may collect child.
  • Is there anyone prohibited from collecting or having contact with your child? If so, please send or submit a current photo.
  • Please e-mail or submit a copy of any court orders to the powers and responsibilities of the parents in relation to the child or access of the child, after completing this enrolment form.

Our Philosophy

Form Agreements

  • Payment & Release Forms

    Please read all the information in the forms below and once complete tick your consent for each form. In order to ensure your child's enrolment, please send payment by the beginning of the term. Account Name: Alithia Inc. BSB: 533000 Acc: 255737 Reference: Child’s full name

Alithia Waiver & Release Form

 

  • I agree for the ambulance to be called and medication to be administered in an emergency situation (such as life threatening allergic reaction, snake bite etc) after Alithia has attempted to contact a guardian.
  • I will abide to all Alithia’s policies.
  • I allow my child’s photos and videos to be used for all Alithia’s promotional material and website.
  • I allow my child’s photo’s to be printed / uploaded to be placed in their individual  secure journals (Storypark or similar).
  • I understand the risks and challenges my child might be faced with throughout the day and will work closely with Alithia mentors to achieve the best and safest outcome for my child.
  • I understand that my child will face risks and dangers associated with exploring the australian bush (such as snakes, ticks, spiders, ticks, falling branches, mosquitos, ants and other flora and fauna) and agree and understand that my child mightl go home with muddy/dirty clothes.
  • I understand the importance and will inspect my child for ticks, leeches etc. after each Alithia session.
  • I agree to dress my child in SunSmart, weatherproof clothing and provide a SunSmart hat every day.
  • I give consent for my child for being the subject for observations used for programing and behavioural monitoring.
  • I/We give permission for my child to participate in cooking activities. Please advise if otherwise:
  • I/We understand that it is mine/our to update Alithia of any changes in the details in this form.
  • I/We understand that this enrolment form must be completed with three (3) additional forms (Tick, Sunscreen and Insect repellant).
  • I/We agree to keep my/our child home when suffering from a heavy cold, fever or other contagious illness. I will inform Alithia at the start of the day. If my child has started antibiotics in the last 24 hours, I will keep my child home to rest.
  • I/We agree that Alithia mentors administer Panadol if my child has a high fever. Please note we will always attempt to call the carers and/or emergency contacts first.
  • I/We confirm that all the information given on this Enrolment Form is correct.

In consideration for being permitted for my child or I to participate in any way with Alithia, I, the undersigned, understand, acknowledge and accept that participation in Alithia activities involved the risk of personal injury, including death, due to the physical, mental and emotional challenges in the activities offered, and I agree to assume those risks. Information about those activities may be obtained from Alithia volunteers and mentors. I also understand that participation in these activities is entirely voluntary and requires participants to follow instructions and abide by all applicable rules and the codes of conduct.

 

In case of an emergency involving my child, I understand that efforts will be made to contact me. In the event I cannot be reached, permission is hereby given to the medical provider to secure proper treatment, including hospitalisation, anesthesia, surgery or injections of medication for my child.

 

With appreciation of the dangers and risks associated with programs and activities, I confirm that Alithia shall not be liable to the participants for any personal injury, death, loss or damage to personal property or for any direct, indirect, special or consequential loss or damage suffered by them or any other person.

 

On my own behalf and/or on behalf of my child, I hereby fully and completely release and waive any and all claims for personal injury, death, disability or loss that may arise against Alithia, the activity coordinators, volunteers, mentors, related parties or other organisation associated with any program or activity.

 

I will disclose any pre-existing medical or other condition that I/my child have that may affect the risk that either the participant or any other person will suffer injury, loss or damage. I acknowledge that Alithia relies on the information provided by the parent/guardian, and that the parent/guardian states that all such information is accurate and complete.

 

I also confirm Alithia has explained this document to me and I am aware of the implication, intent and effect of agreeing to signing this document virtually by ticking my consent to the Waiver & Release Forms.

Please tick your consent above.

Thank You! We will process your enrolment once payment has been received.