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Version 7- December 2017 BOARDER’S PARTICULAR Name Date of Birth Age as of December 2017 Gender Female Male Duration Nationality Parents are in Malaysia Contact Number Email Address : : : : : : : : : ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ MEDICAL HISTORY Allergy : Please provide the school specific item(s) to which your child/ward is/are allergic to: 1. Food / Beverage / Other Allergies (i.e: Dust, skin contact.....): ____________________________________________________________________________ Medication : ____________________________________________________________________________ I have read and am agreeable to the following (√) : Terms & Conditions of Enrolment General Indemnity Form of Boarders Boarding House Code of Conduct Authorisation to keep Mobile Phone overnight for Weekends & Eve of Public Holiday Usage of Swimming Pool Nomination of Guardian (compulsory for students whose parents are not in Malaysia) ACKNOWLEDGEMENT ____________________ ____________________ ____________________ Parent’s Name Parent’s Signature Date WIS Boarding Application Page 1 of 5 BOARDING APPLICATION FORM ACADEMIC YEAR 2018 2. In the event that my child/ward is unwell, I authorise the school to: Give my child/ward paracetamol: maximum of 2 pills a day Send my child/ward to the nearest clinic/hospital if i am not contactable 5 days 7 days Yes No Privileges for Year 10 & Year 11 Boarders

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Version 7- December 2017

BOARDER’S PARTICULAR

Name

Date of Birth

Age as of December 2017

Gender Female Male

Duration

Nationality

Parents are in Malaysia

Contact Number

Email Address

:

:

:

:

:

:

:

:

:

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

MEDICAL HISTORY

Allergy :

Please provide the school specific item(s) to which your child/ward is/are allergic to:

1. Food / Beverage / Other Allergies (i.e: Dust, skin contact.....):

____________________________________________________________________________

Medication :

____________________________________________________________________________

I have read and am agreeable to the following (√) :

Terms & Conditions of Enrolment

General Indemnity Form of Boarders

Boarding House Code of Conduct

Authorisation to keep Mobile Phone overnight for Weekends & Eve of Public Holiday

Usage of Swimming Pool

Nomination of Guardian (compulsory for students whose parents are not in Malaysia)

ACKNOWLEDGEMENT

____________________ ____________________ ____________________Parent’s Name Parent’s Signature Date

WIS Boarding Application Page 1 of 5

BOARDING APPLICATION FORMACADEMIC YEAR 2018

2. In the event that my child/ward is unwell, I authorise the school to:

Give my child/ward paracetamol: maximum of 2 pills a day

Send my child/ward to the nearest clinic/hospital if i am not contactable

5 days 7 days

Yes No

Privileges for Year 10 & Year 11 Boarders

TERMS AND CONDITIONS OF ENROLMENT

I am aware and agreeable that my child may be required to share a room.

I am aware that the school might perform spot check on my child’s room.

I am aware that the school staff might perform spot check on my child or his/her room or bag at any point after an excursion as deemed necessary.

GENERAL INDEMNITY FORM FOR BOARDERS

I hereby declare that I shall not hold the School liable for any loss damage or injury sustained by my child / ward while he/she is on a school excursion, an extra-curriculum activity or programme.

I accept that the Principal and staff will take every reasonable precaution to ensure the safety of my child.

The following Indemnity Form, if signed, signifies your consent for your child/ward to participate in all school excursions, sports and extra-curriculum activities for the duration of the child’s stay as a boarder in the school.

If you do not want your child to go on a particular excursion, you may naturally exercise this option.

NOTE: Every care will be taken to ensure the safety of your child on any outing/excursion. I hereby give permission for my child/ward to participate (under the supervision of the school) in all excursions and/or extra-curriculum activities while he/she remains as boarder at Westlake International School.

WIS Boarding Application Page 2 of 5

I would like to register my child for boarding at Westlake International School, Kampar, Perak.

I agree to the terms and conditions as stipulated in the Westlake International School Boarding House Handbook 2018.

I confirm the medical information provided above and my child has no allergy or special medical conditions which would affect him/her medical treatment other than any disclosed separately.

I agree that there will be an additional charge of RM 60 per night for weekday boarders who would like to stay over the weekend. A rebate of RM 100 per term will be given if a boarder shares a room with another boarder.

Should I decide to withdraw my child from boarding, I will give the school 1 full term’s notice. Failing that, I understand that my Boarding Deposit will be forfeited.

I recognise that Westlake International School will take every precaution to ensure the safety of my child. I shall not hold the school liable and responsible for any injury or mishap due to unforseen circumstances.

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WIS Boarding Application Page 3 of 5

BOARDING HOUSE CODE OF CONDUCT

The code of conduct expected from our boarders and students must reflect the character values of WIS such as respect, responsibility, integrity, kindness and other good moral values.

WIS believes that every student is entitled to an environment that is safe, healthy, secure, and conducive to learning. With this in mind, WIS promotes an atmosphere of mutual respect among students. Bullying of any kind is unacceptable at our Boarding House.

Boys are strictly forbidden from entering the girls’ Boarding House.

Girls are strictly forbidden from entering the boys’ Boarding House.

Boarders are not permitted to enter another room without permission from Boarding House Parents.

Communal areas must be kept tidy and the rights of others to share communal facilities must be respected.

All properties at the Boarding House must be used in a responsible manner without damage or waste.

Boarders must ask for permission before going out of the house.

Boarders must inform Boarding House Parents immediately when not feeling well.

Boarders must be willing to learn certain aspects of life skills such as cleaning up after themselves, making their own beds, tidying their own wardrobes and putting laundry in the bag for washing.

Boarders must attend all meal times except Year 10 to Year 13 boarders who are granted the privilege to opt out of certain meals.

Boarders must adhere strictly to the scheduled boarding routine, check-in and check-out time, bedtime, reporting time and any other schedule as advised by Boarding House Parents.

Boarders must attend supervised study where homework/revision will be done diligently and quietly.

Boarders are strictly not allowed to bring the following items into the Boarding Houses: tobacco, e-cigarette, alcohol, betel nuts, illegal items, offensive items, weapons, cigarette lighters, matches, joss sticks, candles, pets, explosives, etc. Items considered dangerous and detrimental to their well-being and that of other boarders will be confiscated.

Boarders are not allowed to bring electrical items such as multi-purpose cooker, kettles, iron, juicer, printer or any gaming devices. Only hair-dryers and electrical shavers are allowed. All electrical items must be approved by Boarding House Parents.

Each boarder is allowed to bring only 1 mobile phone and 1 laptop or tablet.

Boarders are expected to develop character traits and adhere to the Code of Conduct. Otherwise, they might face the following consequences:• Community service in increasing hours• Confiscation of electronic gadgets• Scheduled counselling • Being grounded from after school activities (school projects, games) and excursions

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AUTHORISATION TO KEEP MOBILE PHONE OVERNIGHT FOR WEEKENDS & EVE OF PUBLIC HOLIDAY

I hereby:

I am aware that by allowing my child to keep his / her phone overnight, my child will have to use the phone responsibly whichincludes charging the phone in a safe manner and visiting only permitted websites.

I understand that each boarder is allowed to have only 1 handphone and 1 laptop or tablet.If my child is found to have more than the allowed number of gadgets, all his / her devices will be confiscated and kept by the school for 1 term.

WIS Boarding Application Page 4 of 5

USAGE PF SWIMMING POOL

PARENTAL CONSENT AND INDEMNITY FORM

I allow my child/ward to use the swimming pool facility at the appointed time.

I confirm that he/she is fit and without medical problems.

I hereby indemnify and agree to keep the Westlake International School, its management and staff fully indemnified against all claims, loss or damage whatsoever arising from my child/ward’s participation in this activity.

PRIVILEGES FOR YEAR 10 & YEAR 11 BOARDERS

Year 10/11 boarders are allowed to extend their study time till 10:30pm everyday with permission of Boarding House Parents.

Year 10/11 boarders are allowed to keep their phone overnight.

For Year 11 weekend boarders, they are allowed to leave the school campus unsupervised between 8am to 8pm on Saturdays with proper check-in & check-out procedures.

The conditions for losing the privileges are as follow:

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Not meeting the minimum requirements of 5 credits of school examinationFailure to submit assignments on time Frequent tardiness to scheduled eventsPoor attitudeDiscipline issue(s) occur(s)

The privileges may be withheld or withdrawn if they are misused.

Allow my child to keep his / her phone overnight during weekends (Friday & Saturday night) and Eve of Public Holidays.

Do not allow my child to keep his / her phone overnight during weekends and Eve of Public Holiday.

GUARDIAN NOMINATION FORM

COMPULSORY FOR STUDENTS WHOSE PARENTS ARE NOT STAYING IN MALAYSIA

*Note: Please attach a passport photo of your child’s Guardian

Name of Boarder

Name of Guardian

Address

Contact No. (Home) (Mobile)

Signature of Guardian

:

:

:

:

:Email Address

:

I hereby give consent for the above nominated person to act as Guardian for my child.

Relationship :

____________________ ____________________ ____________________Name of Parent Parent’s Signature Date

WIS Boarding Application Page 5 of 5

A guardianship is a legal relationship between a minor and a guardian. That gives the guardian certain rights and obligations regarding the child. It is very important that your child has an appointed a local guardian if your child is a non-Malaysian. A qualified guardian has the permission and authority to make decisions on the child’s behalf in the absence of his/her parents if parents are uncontactable.

A guardian must fulfil the following requirements: • Must be a Malaysian Citizen/resident/holder of Malaysian working visa (Representative of the parents)• Must be 25 years old and above• Must be able to communicate with parents and school• Must be contactable at all times

The School must always have the guardian's current phone numbers, email address as well as residential address.