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Centre Details:
Campbell Street
Luddenham 2745
Tel: (02) 47733224
Mob: 0423678170
Fax: (02) 47733228
A.B.N: 311 562 51907

About this form: This form is designed to collect critical information in regards to your child's enrolment at out service. Please answer all questions

Our Fees: 
Vacation Care: $67.00

* CCS Subsidy is available. Please ensure you have filled in the appropriate forms with Centrelink. Once we recieve your enrolment and provided you with your acceptance your child will be enrolled. You will then need to accept the enrolment through your "my enrolments" tab on your centrelink account. We look forward to having you at our service. 

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* 1. Child Information

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* 2. Please provide staff with information regarding your child’s family circumstances, including information affecting residence and contact with parents.

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* 3. Child Gender

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* 4. Please provide below your Childs CRN Number

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* 5. Child Birth Place

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* 6. Parent 1

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* 7. Parent 2 

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* 8. What is your family Cultural Background

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* 9. Please provide your Family CRN and appropriate parents DOB

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* 10. December Sessions Required (All sessions are subject to numbers)

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* 11. January Sessions Required (All sessions are subject to numbers)

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* 12. Does your child/ren have anaphylaxis, allergies or asthma? 

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* 13. Please attach any appropriate medical plans

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* 14. Please attach you Childs Birth Certificate

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* 15. Please attach your Childs Immunisation history

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* 16. Agreements

  Yes No
I give consent for staff at the centre to apply SPF30+ broad spectrum, water resistant suncream on my child’s face, arms, neck and ears.
I consent to my child accompanying staff on local excursions and walks in the immediate vicinity of the centre.
I give consent for my child’s photo to be taken and displayed at the centre
I give consent for my child’s photo to be used for media purposes (facebook, promotional purposes)
Students from TAFE and University come to the centre for practical experience regularly. Please tick if you agree or disagree for your child to be involved in the studies of the students.
My child has been immunised in accordance with the NSW Health Department routine.
If my child has a temperature higher than 38.5*c whilst in Schoolies, a staff member may administer a single dose of paracetamol mixture (such as Panadol) to your child. Please note that an attempt to contact you before paracetamol is administered will be made.
Do you understand that fees must be kept up to date at all times preferably 2 weeks in advance. If fees fall behind and no payment plan is made your child's position will be ceased until the time accounts are brought up to date.
Do you understand that you are liable for all fees until you CCS subsidy is approved through Centrelink.

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* 17. Please provide any other information that you feel will help us get to know your family and that will help you settle into our service.

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