Euned Inlet-1
Euned Inlet-1
                                                          SCHOOL STAMP
NB: PARENT/GUARDIAN TO INDEMNIFY HIS OR HER CHILD
BELOW BY SIGNING THE INDEMNITY FORM BELOW;
I understand that he/she will take part entirely at his his/her own risk, and that
while every precaution and care will be taken by the organisers neither they nor
the Head, nor any member of the staff will be held responsible for any accident,
illness or any injury which may occur during or as a result of the visit.
Furthermore, I authorize the organisers, the Head and members of staff to act “in
loco parentis” and empower them to authorize any surgical operations or other
essential medical treatments which for any reason become necessary during the
school visits and acknowledge that, the Ministry of Primary and Secondary
Education or Government is indemnified from any legal suit which may result
from disputes or accidents involving my child.
Date………………………………………………………….. Signature …………………………………
Address ……………………………………………………………………………………………………….
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Tel: ……………………………………………………………………………………………………………..
            KEY TO GRADES (PRIMARY)
45-50 90-100 1
40-44 80-89 2
35-39 70-79 3
30-34 60-69 4
25-29 50-59 5
20-24 40-49 6
15-19 30-39 7
10-14 20-29 8
   0-9                    0-19             9
SOCIAL BACKGROUND INFORMATION
Name of child …………………………………………………………………………………………………………………………..
Date Enrolled at ECD Centre ……………………………………………………………………………………………………..
Date of birth ……………………………………………………… Birth Cert No ……………………………………………….
Sex ……………………… Race ………………………………………….                      Denomination…………………………………..
Name of Father …………………………………………………………                     Occupation ………………………………………
Name of Father …………………………………………………………                     Occupation ………………………………………
Home Address ………………………………………………………………………………………………………………………….
Telephone: Home ……………………………… Business ……………………………                       Personal ………………………
Number of Children in the Family i.e.   Males…………………………………              Females ……………………….
Position of Child in the Family …………………………………………………………………………………………………..
Is he/she physically or mentally challenged? Does he/she have other special needs? Yes/No
If Yes, Elaborate ……………………………………………………………………………………………………………………….
………………………………………………………………………………………………………………………………………………..
Child’s interests ………………………………………………………………………………………………………………………..
Staple Diet ……………………………………………………………………………………………………………………………….
Allergies …………………………………………………………………………………………………………………………………..
                            TERM 1               TERM 2                TERM 3
 WEIGHT (kg)
HEIGHT (cm)
MUAC (cm)
 COMMENTS …………………………………………………………………………………………………………………………….....
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 GROSS MOTOR CO-ORDINATION                            TERM 1 TERM 2 TERM3
                                                      YES NO YES NO YES NO
 Can balance
 Can hop on alternate legs
 Can catch with both hands
 Can throw
 Can jump
 Can name parts of his/her job
 Is confident in the water
  COMMENTS ………………………………………………………………………………………………………………………………………….……………….....
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  ………………………………………………………………………………………………………………………………………………………….………………………
POSITION …………………………………….……………………………………..OUT OF ………………………………………………………………………..…
CLASS TEACHER’S COMMENTS ………………………………………………………………………………………………………………………………..….
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CHARACTER AND CONDUCT...……………………………………………………………………………………………………………………..…………..….
……………………………………………………………………………………………………………………………………………………………………………………..
HEAD’S COMMENT ………………………………………………………………………………………………………………….        …
………………………………………………………………………………..…………………………………………………………………
NEXT TERM BEGINS ON ………………………………………………….…………………………………………..   SCHOOL STAMP
NEXT TERM FEES ……………………………………………………………………………………………………...…
PARENT GUARDIAN’S SIGNATURE…………………………………………………………………………………………..
CLASS: …………….…………………………………………………………….…… YEAR: ……………..……………………….......
TERM: ………………………………………. TERM ATTENDANCE …………..……….. OUT OF…………..………………
 EMOTIONAL AND SOCIAL DEVELOPMENT                     TERM 1 TERM 2 TERM3
                                                      YES NO YES NO YES NO
 Can play with others
 Can share
 Can control his/her feelings
 Take pride in his/her achievements
 Can relate to a group
 Can take good care of his/her apparatus
 Can take care of his/her possessions
 Can concentrate and attend for ten minutes
 Can complete tasks
 Knows his/her name and age
 Knows his/her guardian telephone number
 Knows his/her address
 COMMENTS …………………………………………………………………………………………………………………………….....
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 ……………………………………………………………………………………………………………………………………………………
 ……………………………………………………………………………………………………………………………………………………
 GROSS MOTOR CO-ORDINATION                            TERM 1 TERM 2 TERM3
                                                      YES NO YES NO YES NO
 Can balance
 Can hop on alternate legs
 Can catch with both hands
 Can throw
 Can jump
 Can name parts of his/her job
 Is confident in the water
  COMMENTS ………………………………………………………………………………………………………………………………………….……………….....
  …………………………………………………………………………………………………………………………………………………………………….……………
  ………………………………………………………………………………………………………………………………………………………….………………………
  ………………………………………………………………………………………………………………………………………………………….………………………
POSITION …………………………………….……………………………………..OUT OF ………………………………………………………………………..…
CLASS TEACHER’S COMMENTS ………………………………………………………………………………………………………………………………..….
……………………………………………………………………………………………………………………………………………………………………………..………
……………………………………………………………………………………………………………………………………………………………………………..………
CHARACTER AND CONDUCT...……………………………………………………………………………………………………………………..…………..….
……………………………………………………………………………………………………………………………………………………………………………………..
HEAD’S COMMENT ………………………………………………………………………………………………………………….        …
………………………………………………………………………………..…………………………………………………………………
NEXT TERM BEGINS ON ………………………………………………….…………………………………………..   SCHOOL STAMP
NEXT TERM FEES ……………………………………………………………………………………………………...…
PARENT GUARDIAN’S SIGNATURE…………………………………………………………………………………………..
CLASS: …………….…………………………………………………………….…… YEAR: ……………..……………………….......
TERM: ………………………………………. TERM ATTENDANCE …………..……….. OUT OF…………..………………
 EMOTIONAL AND SOCIAL DEVELOPMENT                     TERM 1 TERM 2 TERM3
                                                      YES NO YES NO YES NO
 Can play with others
 Can share
 Can control his/her feelings
 Take pride in his/her achievements
 Can relate to a group
 Can take good care of his/her apparatus
 Can take care of his/her possessions
 Can concentrate and attend for ten minutes
 Can complete tasks
 Knows his/her name and age
 Knows his/her guardian telephone number
 Knows his/her address
 COMMENTS …………………………………………………………………………………………………………………………….....
 ……………………………………………………………………………………………………………………………………………………
 ……………………………………………………………………………………………………………………………………………………
 ……………………………………………………………………………………………………………………………………………………
 GROSS MOTOR CO-ORDINATION                            TERM 1 TERM 2 TERM3
                                                      YES NO YES NO YES NO
 Can balance
 Can hop on alternate legs
 Can catch with both hands
 Can throw
 Can jump
 Can name parts of his/her job
 Is confident in the water
  COMMENTS ………………………………………………………………………………………………………………………………………….……………….....
  …………………………………………………………………………………………………………………………………………………………………….……………
  ………………………………………………………………………………………………………………………………………………………….………………………
  ………………………………………………………………………………………………………………………………………………………….………………………
POSITION …………………………………….……………………………………..OUT OF ………………………………………………………………………..…
CLASS TEACHER’S COMMENTS ………………………………………………………………………………………………………………………………..….
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……………………………………………………………………………………………………………………………………………………………………………..………
CHARACTER AND CONDUCT...……………………………………………………………………………………………………………………..…………..….
……………………………………………………………………………………………………………………………………………………………………………………..
HEAD’S COMMENT ………………………………………………………………………………………………………………….        …
………………………………………………………………………………..…………………………………………………………………
NEXT TERM BEGINS ON ………………………………………………….…………………………………………..   SCHOOL STAMP
NEXT TERM FEES ……………………………………………………………………………………………………...…
PARENT GUARDIAN’S SIGNATURE…………………………………………………………………………………………..
CLASS: …………….…………………………………………………………….…… YEAR: ……………..……………………….......
TERM: ………………………………………. TERM ATTENDANCE …………..……….. OUT OF…………..………………
 EMOTIONAL AND SOCIAL DEVELOPMENT                     TERM 1 TERM 2 TERM3
                                                      YES NO YES NO YES NO
 Can play with others
 Can share
 Can control his/her feelings
 Take pride in his/her achievements
 Can relate to a group
 Can take good care of his/her apparatus
 Can take care of his/her possessions
 Can concentrate and attend for ten minutes
 Can complete tasks
 Knows his/her name and age
 Knows his/her guardian telephone number
 Knows his/her address
 COMMENTS …………………………………………………………………………………………………………………………….....
 ……………………………………………………………………………………………………………………………………………………
 ……………………………………………………………………………………………………………………………………………………
 ……………………………………………………………………………………………………………………………………………………
 GROSS MOTOR CO-ORDINATION                            TERM 1 TERM 2 TERM3
                                                      YES NO YES NO YES NO
 Can balance
 Can hop on alternate legs
 Can catch with both hands
 Can throw
 Can jump
 Can name parts of his/her job
 Is confident in the water
  COMMENTS ………………………………………………………………………………………………………………………………………….……………….....
  …………………………………………………………………………………………………………………………………………………………………….……………
  ………………………………………………………………………………………………………………………………………………………….………………………
  ………………………………………………………………………………………………………………………………………………………….………………………
POSITION …………………………………….……………………………………..OUT OF ………………………………………………………………………..…
CLASS TEACHER’S COMMENTS ………………………………………………………………………………………………………………………………..….
……………………………………………………………………………………………………………………………………………………………………………..………
……………………………………………………………………………………………………………………………………………………………………………..………
CHARACTER AND CONDUCT...……………………………………………………………………………………………………………………..…………..….
……………………………………………………………………………………………………………………………………………………………………………………..
HEAD’S COMMENT ………………………………………………………………………………………………………………….        …
………………………………………………………………………………..…………………………………………………………………
NEXT TERM BEGINS ON ………………………………………………….…………………………………………..   SCHOOL STAMP
NEXT TERM FEES ……………………………………………………………………………………………………...…
PARENT GUARDIAN’S SIGNATURE…………………………………………………………………………………………..
CLASS: …………….…………………………………………………………….…… YEAR: ……………..……………………….......
TERM: ………………………………………. TERM ATTENDANCE …………..……….. OUT OF…………..………………
 EMOTIONAL AND SOCIAL DEVELOPMENT                     TERM 1 TERM 2 TERM3
                                                      YES NO YES NO YES NO
 Can play with others
 Can share
 Can control his/her feelings
 Take pride in his/her achievements
 Can relate to a group
 Can take good care of his/her apparatus
 Can take care of his/her possessions
 Can concentrate and attend for ten minutes
 Can complete tasks
 Knows his/her name and age
 Knows his/her guardian telephone number
 Knows his/her address
 COMMENTS …………………………………………………………………………………………………………………………….....
 ……………………………………………………………………………………………………………………………………………………
 ……………………………………………………………………………………………………………………………………………………
 ……………………………………………………………………………………………………………………………………………………
 GROSS MOTOR CO-ORDINATION                            TERM 1 TERM 2 TERM3
                                                      YES NO YES NO YES NO
 Can balance
 Can hop on alternate legs
 Can catch with both hands
 Can throw
 Can jump
 Can name parts of his/her job
 Is confident in the water
  COMMENTS ………………………………………………………………………………………………………………………………………….……………….....
  …………………………………………………………………………………………………………………………………………………………………….……………
  ………………………………………………………………………………………………………………………………………………………….………………………
  ………………………………………………………………………………………………………………………………………………………….………………………
POSITION …………………………………….……………………………………..OUT OF ………………………………………………………………………..…
CLASS TEACHER’S COMMENTS ………………………………………………………………………………………………………………………………..….
……………………………………………………………………………………………………………………………………………………………………………..………
……………………………………………………………………………………………………………………………………………………………………………..………
CHARACTER AND CONDUCT...……………………………………………………………………………………………………………………..…………..….
……………………………………………………………………………………………………………………………………………………………………………………..
HEAD’S COMMENT ………………………………………………………………………………………………………………….        …
………………………………………………………………………………..…………………………………………………………………
NEXT TERM BEGINS ON ………………………………………………….…………………………………………..   SCHOOL STAMP
NEXT TERM FEES ……………………………………………………………………………………………………...…
PARENT GUARDIAN’S SIGNATURE…………………………………………………………………………………………..
CLASS: …………….…………………………………………………………….…… YEAR: ……………..……………………….......
TERM: ………………………………………. TERM ATTENDANCE …………..……….. OUT OF…………..………………
 EMOTIONAL AND SOCIAL DEVELOPMENT                     TERM 1 TERM 2 TERM3
                                                      YES NO YES NO YES NO
 Can play with others
 Can share
 Can control his/her feelings
 Take pride in his/her achievements
 Can relate to a group
 Can take good care of his/her apparatus
 Can take care of his/her possessions
 Can concentrate and attend for ten minutes
 Can complete tasks
 Knows his/her name and age
 Knows his/her guardian telephone number
 Knows his/her address
 COMMENTS …………………………………………………………………………………………………………………………….....
 ……………………………………………………………………………………………………………………………………………………
 ……………………………………………………………………………………………………………………………………………………
 ……………………………………………………………………………………………………………………………………………………
 GROSS MOTOR CO-ORDINATION                            TERM 1 TERM 2 TERM3
                                                      YES NO YES NO YES NO
 Can balance
 Can hop on alternate legs
 Can catch with both hands
 Can throw
 Can jump
 Can name parts of his/her job
 Is confident in the water
  COMMENTS ………………………………………………………………………………………………………………………………………….……………….....
  …………………………………………………………………………………………………………………………………………………………………….……………
  ………………………………………………………………………………………………………………………………………………………….………………………
  ………………………………………………………………………………………………………………………………………………………….………………………
POSITION …………………………………….……………………………………..OUT OF ………………………………………………………………………..…
CLASS TEACHER’S COMMENTS ………………………………………………………………………………………………………………………………..….
……………………………………………………………………………………………………………………………………………………………………………..………
……………………………………………………………………………………………………………………………………………………………………………..………
CHARACTER AND CONDUCT...……………………………………………………………………………………………………………………..…………..….
……………………………………………………………………………………………………………………………………………………………………………………..
HEAD’S COMMENT ………………………………………………………………………………………………………………….        …
………………………………………………………………………………..…………………………………………………………………
NEXT TERM BEGINS ON ………………………………………………….…………………………………………..   SCHOOL STAMP
NEXT TERM FEES ……………………………………………………………………………………………………...…
PARENT GUARDIAN’S SIGNATURE…………………………………………………………………………………………..
TERM: …………….………………………GRADE ………………………….…… YEAR: ……………..………………………
ATTENDANCE …………..……………………….…….. OUT OF…………………………………………..………….DAYS
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AGRICULTURE
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SHONA SPOKEN
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AGRICULTURE
SOCIAL SCIENCES
SCIENCE
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AGRICULTURE
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SHONA SPOKEN
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AGRICULTURE
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SHONA SPOKEN
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AGRICULTURE
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