Enrolment Form | Kidztime

Parent/Guardian 1

Full Legal Name*

Address*

Suburb*

Postcode*

Email*

Mobile Phone*

Home Phone

Work Phone

Parent/Guardian 2

Full Legal Name*

Address*

Suburb*

Postcode*

Email*

Mobile Phone*

Home Phone

Work Phone

Emergency Contact Details

It is required that you list TWO alternative/emergency contacts different to that of the parent/caregiver listed prior.

Emergency Contact Name*

Emergency Contact Mobile Phone*

Emergency Contact Home Phone

Emergency Contact Work Phone

Emergency Contact 2 Name*

Emergency Contact 2 Mobile Phone*

Emergency Contact 2 Home Phone

Emergency Contact 2 Work Phone

Best Contact

Please specify the best contact for you. An email address, cellphone, etc.

Best Contact Method*

Best Invoicing Email*

Medical Information

Family Doctor*

Medical Centre*

Phone*

Child Details

Child's Full Name (As per birth certificate)*

Child Known As (Nickname)

Child Date of Birth*

Gender*
MaleFemaleOther

Ethnicity

Language(s) Spoken at Home

School Attending*

Village Name*

Year*

Teachers Name*

Allergies and/or Medical Conditions*

Medication that your child will take during their time at Kidz Time*

Confirmation of Attendance

Intended Start Date*

Before School Care
MondayTuesdayWednesdayThursdayFriday
After School Care
MondayTuesdayWednesdayThursdayFriday

Additional Information

This may include any custodial arrangements concerning your child or the names of person(s) not permitted to collect your child. We must have a copy of applicable Court documents such as parenting order etc.

Important Information

WINZ Client Number (“N/A” if not applicable)*

Permissions

My child's photo may be used on the Kidz Time website, social media and/or our Newsletter*

I agree to all of the Kidz Time Terms and Conditions*
I agree