Primary Caregiver

Secondary Caregiver

1.Emergency Contacts

2.Emergency Contacts

3.Emergency Contacts

1.Family Member Details

2.Family Member Details

3.Family Member Details

1.Family Member Attending School

2.Family Member Attending School

3.Family Member Attending School

New School Entrant Health Form

If you wish to discuss any concerns with the School Public Health Nurse Please Contact

Name: Donna Miller
Phone: (06) 374 8496

Privacy Information

Information from this form will be stored in note form and on a computer and may be used for referral purposes. MidCentral Health and the Ministry of Health will use the information provided for the purposes of administration and statistical information gathering. You have the right to view any information MidCentral Health holds on your Child if you wish.

Primary Health Care Services. PO Box 924, Palmerston North, Phone (06) 355 0743, Fax (06) 355 0747, Freephone 0800 153 042

MidCentral Health Public Health Services, Public Health Unit, Community Health Village, PO Box 2056, Palmerston North Hospital. Phone (06) 350 9110, Fax (06) 350 9111

School Meal Programmes

Computer Use Agreement

Please read this sheet carefully. Keep it to remind yourself of the guidelines for computer use at school.

I understand that:

• The Huia Range School values apply at all times when using computers and the internet
• The School will do its best to keep me safe while using global information systems such as the computer and the Internet
• I know that I am not permitted to access material through the Internet which is offensive (e.g. pornographic), dangerous, inappropriate, or illegal *. I am forbidden to pass on such material by copying, storing or printing it.
• If I use e-mail at school, I am not permitted to send any messages that are offensive, dangerous, inappropriate, or illegal *.
• There may be times where I will be using the computers and the internet when there is no teacher supervising me.
• I need to take care of our computers and information technology resources, and will not damage the equipment or furniture.
• I will be considerate of other users and share available equipment. I will not deliberately disrupt the computer or the school's network, or waste computer resources e.g. colour printing.
• Should I accidentally come across dangerous, mean or rude material I will tell the teacher right away, without showing any other students.

Students: * Please ask your teacher or parent if you need any of these terms explained to you.

I will look after myself sensibly:

• I will not give anyone on the Internet information about myself or anyone else - this includes address, phone number, photograph or credit card information.
• I will tell the teacher if I come across any problem or if I am not feeling safe.

I know that if I do not stay within these guidelines my parents/caregivers may be told, I may lose the right to use school computers and the internet, and the school may take other disciplinary action against me.

I have read this Agreement and know the importance of the school guidelines for the use of computers and the internet.

I know that if I do things outside these guidelines:

• My parents/caregivers may be told.
• I may lose the right to use school computers and the internet.
• The school may take other disciplinary action against me.

Parents/Caregivers*

• I have read this agreement and understand that my child is responsible for using school equipment and the internet as outlined here.
• I have gone through the agreement with my child and explained its importance, and that there may be consequences for breaking the agreement
• I understand while the school will do its best to restrict student access to offensive, dangerous, inappropriate or illegal material on the Internet or through e-mail, it is the responsibility of my child to have no involvement in such material.
• I give my permissions for my child to be given access at school to global information systems such as the Internet or e-mail

*If you would like to discuss this document or need help with understanding it, please contact the school office.