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* 2. Year of Enrolment

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* 3. Service Type: Please tick all that apply

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* 4. Child Details:

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* 5. Date of Birth:

If your child will turn 6 in 2019 you must seek an 'Exemption from school due to attendance in kindergarten program' from Department of Education and Early Childhood Development. Please contact us and we will provide an exemption form.

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* 6. Gender:

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* 7. Is the child of Aboriginal and/or Torres Strait Islander origin?

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* 8. Health and Wellbeing

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* 9. Ambulance cover

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* 10. Private health insurance

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* 11. Do you think your child may need some extra help to take part in the program?

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* 12. Medical conditions and allergies

Please provide a Medical Management Plan completed and signed by your medical practioner (Upload at the end of form)

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* 13. Has the child been immunised? (You must provide your child's Immunisation History Statement from Medicare,  we will be unable to process your application without this document. Upload available at the end of form)

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* 14. Parent/Guardian 1:

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* 15. Does the child live with this parent/guardian?

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* 16. Interpreter required?

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* 17. Parent/Guardian 2:

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* 18. Does the child live with this parent/guardian?

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* 19. Interpreter required?

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* 20. Siblings: Names and ages of the child’s siblings:

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