Enrol your child

Registration form

To register your child on the waiting list, please complete and submit this form. When your child has been offered a place you can complete our enrolment details.

* Required

Title

First Name *

Last Name *

Email Address *

Child's first names *

Child's family name *

Child's gender *
Female
Male

Child's date of birth *

Which Kindergarten would you like your child registered at? *

Does your child have extra learning or development needs? Please give details.

Name any support people or organisations that are currently working with your child (eg speech therapist).

Enrolling more than one child? Please supply each child's details (full name, gender and date of birth)

Parent/Guardian/Caregiver 1 - Full name *

Parent/Guardian/Caregiver 1 - Relationship to child *

Parent/Guardian/Caregiver 1 - email *

Parent/Guardian/Caregiver 1 - Daytime phone number *

Parent/Guardian/Caregiver 1 - Evening phone number

Parent/Guardian/Caregiver 1 - Mobile phone number

Parent/Guardian/Caregiver 1 - Address *

Parent/Guardian/Caregiver 2 - Full name *

Parent/Guardian/Caregiver 2 - Relationship to child *

Parent/Guardian/Caregiver 2 - email

Parent/Guardian/Caregiver 2 - Daytime phone number *

Parent/Guardian/Caregiver 2 - Evening phone number

Parent/Guardian/Caregiver 2 - Mobile phone number

Parent/Guardian/Caregiver 2 - address

Child lives mainly with: *
Parent/guardian 1
Parent/guardian 2
Both

Alternate Caregiver’s name (if the child is regularly cared for by someone other than the above)

Alternate Caregiver’s address

Alternate caregiver’s daytime phone number

Alternate caregiver’s evening phone number

Alternate caregiver’s mobile phone number

To comply with the privacy act, I give permission for the following to be made available: (please check each box) *
Parent/s name/s and telephone number to the committee
Parent/s name/s and telephone number to health authorities
Child’s name and date of birth to the school your child is likely to attend.

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2009 Term Dates

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Registration form