NCS Declaration Form

School

Burrow National School

Malahide/Portmarnock Educate Together NS

Pope John Paul II National Catholic School

St. Andrews National School

St. Fintan's National Catholic School

St. Helen's Junior School

St. Marnock's National School

St. Oliver Plunkett School

St. Sylvesters Infant Catholic School

This will be the premise attended by your child:
Malahide Village

This will be the premise attended by your child:
Malahide Marina

This will be the premise attended by your child:
Portmarnock

This will be the premise attended by your child:
Sutton

This will be the premise attended by your child:
MPETNS

This will be the premise attended by your child:
Cricket Club

Time you intent to collect your child:

Child/Children Information

Please fill the following items with the child information.

How many children is this application for?

Child 1 Information

Child 1: Full Name

Child 1: Day of Birth

Child 1: CHICK Number

Child 1: NCS Start Date

Child 1: NCS Expiry Date

Child 2 Information

Child 2: Full Name

Child 2: Day of Birth

Child 2: CHICK Number

Child 2: NCS Start Date

Child 2: NCS Expiry Date

Child 3 Information

Child 3: Full Name

Child 3: Day of Birth

Child 3: CHICK Number

Child 3: NCS Start Date

Child 3: NCS Expiry Date

Parent/Guardian Information

Please fill the following items with the Parent/Guardian information.

Parent/Guardian Full Name

Mobile Phone Number

I understand that there are rules associated with the NCS scheme, such as the requirement to give one month’s notice if I intend to leave the service or reduce my child’s attendance. I have familiarized myself with these rules through the official government scheme websites and am happy to comply with them.

Yes

I understand that if my child is absent for 4 consecutive weeks, my NCS hours must be reduced to reflect actual attendance levels. Continuous absence of 4 or more consecutive weeks will be notified, except in cases of prolonged illness or exceptional circumstances. Additionally, if reduced attendance continues for 8 or more consecutive weeks (i.e., fewer hours are used each week for eight weeks), the provider will notify me accordingly.

Yes

I understand that I can only claim NCS funding for the hours my child actually attends, not for the hours allocated, unless they are the same.

Yes

By enrolling my child in this service, I agree to all the policies and procedures of Hi5 Childcare. I have informed myself of these policies and procedures, which are detailed in the Parents’ Handbook I received.

Yes

The NCS is calculated based on the hours of childcare actually used, not the hours allocated. If there is a pattern of regular under-attendance, the NCS hours and the associated discount will unfortunately, need to be adjusted. Pobal, the organization that administers the NCS, has strict rules regarding attendance, which must be monitored weekly. Therefore, please claim only for the hours you plan to use the service.

Yes

I understand that it is my responsibility to complete the CHICK number renewal process and to provide the new number to Hi5. Failure to do so will result in the loss of the discount and the requirement to pay the full monthly fee.

Yes

Signature

Sign Here