Kamo Kidzone Afterschool Care Enrolment Form

Children

Child Name 1 *

Child 1 Age *

Children2

Child Name 2

Child 2 Age

Children3

Child Name 3

Child 3 Age

Children4

Child Name 4

Child 4 Age

Email *

Home Address

Postcode

Contacts

People authorised to collect your child/ren

Parent/Caregiver 1 *

Caregiver 1 Phone *

Parent/Caregiver 2

Caregiver 2 Phone

After Hours Phone

Emergency Contacts *

Doctor

I give permission to administer first aid and to seek emergency treatment if necessary.

Is there anything else we should know about in order to take good care of your child/ren?

Start Date

Day

Month

Year

Privacy Act 1993: The information that you have provided is necessary for the safe and effective operation of the programme and will be used for the sole purpose of emergencies, birthdays and health and safety of the children as set out in the Policies and Procedures. If you have any questions regarding the programme, Complaints, Code of Behaviour and/or the Prevention of Child Abuse Policies etc please refer to the Programmes Policies and Procedures, which are available upon request. All information about individuals is available to them for review at any time. As the monitoring agency for OSCAR services, Child Youth and Family may require access to this enrolment information

Permissions

Click here>> to read the Kidzone Contract

Permission

I give permission for staff to administer first aid and to seek emergency treatment if necessary.

I have read and agree with Kidzone Contract.

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Kamo Kidzone Afterschool Care Enrolment Form