IT’S A KIDS WORLD LONG DAY CARE CENTRE PTY LTD

CHILD ENROLMENT FORM

To enable us to correctly enrol your child into our centre and to allow you to receive the full benefits available from the government, we ask that you complete and provide the following information:

Complete all questions on the child enrolment form (attached)

Contact the Family Assistance Office on 136 150 to be assessed for the Child Care Benefit and Child Care Rebate schemes (see the Director for more information on how these schemes operate)

Provide the Director with the following documentation to secure your child’s placement:

  • Completed enrolment form
  • Type of payments ( Cash, cheque or direct debit)
  • Copy of Medicare card
  • Copy of Immunisation Details or Conscientious Objector Letter
  • Copy of Birth Certificate

If applicable:

  • Completed Asthma Plan
  • Completed Allergy Plan
  • Copy of Court Order (restricted access)
Centre Fee Structure: Room Name: Ages 1-3
Room Name: Ages 3-6		 $75.00 per Day
$75.00 per Day
Important: Until the correct child care benefit information has been determined, the full daily fee will be charged

Step One

Child's Details

Child's Given Name:
Child's Family Name:
Child's Preferred Name:
Gender:



Date of Birth:
Address:
Town/Suburb:
Postcode:
Home Phone:

Legal Guardian:

Legal Guardian Email:
Primary Language:
Cultural Background:
Religion:
Is there anyone prohibited from having contact with or collecting your child?
Are there any court orders affecting the custody of your child?


If Yes, a photocopy must be attached and the director needs to be notified if circumstances change.
Days of Care Required (Please Tick):



Date to Commence Care:

Mother's Details:

Given Name:
Family Name:
Home Phone:
Mobile Phone:
Email:
Address:

  

Town/Suburb:

  
Postcode:
Employer:
Work Phone:
Occupation:
Hours:
Date of Birth:


Father's Details

Given Name:
Family Name:
Home Phone:
Mobile Phone:
Email:
Address:

  

Town/Suburb:

  
Postcode:
Employer:
Work Phone:
Occupation:
Hours:
Date of Birth: