School Registration Form
School Profile

Type of School

Contact Details

Physical Address

Additional information

Do you have Internet Connectivity?

Is an ESSP coach available at your school?

 Yes No

Principal Details

Gender:
 Male Female

Principals must undertake to support the programme by:

a. Appointing a Wellness Champion, preferably a Life Skills and/or Life Orientation teacher to take accountability for the implementation of the programme.
b. Releasing the Wellness Champions to attend at least 3 days of training.
c. Allowing an external Wellness Warrior access to the school to support the Wellness Champion with their activities.
d. Allowing a UJ Mentor to access the school and assist an monitor the Wellness Warrior.
e. Allowing the children to wear tags for tracking learner participation.
f. Log the tablet issued to the school (to capture activities) onto the school's asset register.
g. Ensuring that the school grounds are maintained to support activities.
h. Acquiring equipment using the vouchers of the rewards system.
i. Maintaining acquired equipment.

 I Accept!

Wellness Champion

Please provide the details of your school’s Wellness Champion below. For assistance in selecting your Wellness Champion please see the suggestions laid out in the ‘Checklist for a great Wellness Champion’ which can be found on www.cojhealthyschools.co.za or at a registration day desk. Only two wellness warriors are required at a comprehensive school.

Wellness Champion 1




Gender:
 Male Female

Wellness Champion 2 (only required for comprehensive schools)



Gender:
 Male Female

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