Enrolment Form 2024

Enrolment Form - 2024
Child's Details

Education and Care Services National Regulations - Regulation 160 (3a, e)
*Only one child's details can be added to this form. Please submit a new form for each additional child.
Service you would like to enrol your child in*

Kids Biz Mother Teresa - Mother Teresa SchoolKids Biz Holy Trinity - Holy Trinity Primary SchoolKids Biz Holy Family - Holy Family SchoolKids Biz St Joseph's - St Joseph's School
Child's Name*

First NameLast Name
Perferred Name
If applicable, please enter the child's preferred name
Child's Gender*

FemaleMale
Date of Birth*

DayMonthYear
Date
Child's Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child's Primary School*
Full Name of person child lives with*

First NameLast Name
Child Care Subsidy

This will be paid directly to the Service to reduce the fees families pay. To claim Child Care Subsidy (CCS) Families must meet eligibility requirements. Please check your eligibility requirements with the Australian Government if you are unsure.
I would like to claim the Child Care Subsidy (CCS) for this child - please note to claim you must provide the CRNs and dates of birth for both the child and their CCS linked person.*

YesNo
Child's CRN
this must be different to the linked parent / carer

	Authorisations
an emergency contact
an authorised nominee to collect this child
an authorised nominee to make medical decisions on behalf of this child
an authorised nominee for this child's permissions and excursion authorisation
to authorise this child being transported by theservice or on transportation arranged by the service

	Authorisations
an emergency contact
an authorised nominee to collect this child
an authorised nominee to make medical decisions on behalf of this child
an authorised nominee for this child's permissions and excursion authorisation
to authorise this child being transported by theservice or on transportation arranged by the service

Cultural Considerations

Education and Care Services National Regulations - Regualtion 160 (f, g, h)
Is the child of Aboriginal or Torres Strait Islander Decent?*

YesNoPrefer not to sayOther
Language spoken at home*
Ethnicity*
Religion*
You can enter prefer not to say or none if this is appropriate
Please advise any important family or religious celebrations your family observes

	I understand and agree to this
Medication will only be administered if itis in the origianl container / packaging with the original label and instructions that cna be clearly read and before the expiry or use by date. Additionally, if the medication has been prescribed by a medical practitioner:- The lable must contain the child's name; and- Parents must provide any verbal or written instructions for administration provided by the medical practitioner.
I authorise the Nominated Supervisor or another educator of the service to seek medical treatment form a registered medical practitioner, hospital or ambulance service.
I authorise the Nominated Supervisor or another educator facilitate transport of the child an ambulance in the event of an emergency.
I authorise that if the Child is diagnosed with asthma or anaphylaxis and an emergency occurs, the Nominated Supervisor or other educators may administer emrgency first aid without making contact. Educators will notify the child's parents and/or emergency services as soon as possible.

Developmental Information
If the child is undertaking or has undergone assessment to support any particular developmental areas such as speech therapy, occupational therapy, Autism spectrum disorder? Please detail below:
Please upload any relevant developmental information / medical notes

Cancelof
Family Information
If the child has any siblings please provide the names and ages below. Please note that a new form will need to be completed for each additional child.

Court Orders

Education and Care Services Regulations - Regulation 160 (3c, d)
Are there any court orders, parenting orders or official parenting plans in place relating to the powers, duties and responsibilities or authorities or any person in relation to the child or access to the child?*

YesNo
Are there any other court orders relating to the child's residence or the child's contact with a parent or other person?*

YesNo
Please upload relevant Court Orders / Parenting Plans

Cancelof

First Emergency Contact

Education and Care Services National Regulations - Regulation 160 (3b, ii, iii, iv, v) 161 (1a, l, ii, 1b)
There may be times orsituations where your child has had a small accident, injurry, trauma or illness and Parents / Carers cannot be reached or are unableto collect their child. For this reason we require you provide at least one emergency contact in addition to named parents or carers already named in this form. Emergency contacts must live a maximum of 30 minutes from the Service and may be required to provide identification when collecting the child.

(Please obtain the person's consent before listing them as an emergency contact)
Full Name*

First NameLast Name
Relationship to Child*
Address*

Street Address

Street Address Line 2

CityState / Territory

Post Code
Home Phone
Please enter a valid phone number.
Mobile Phone
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Email
example@example.com
I confirm this person can be contacted to give consent for medical treatment or to authorise for a Nominated Supervisor or educator to administer medical to the child in the even that a Parent/Guardian cannot be contacted.*

YesNo

Authorisations*

	Not Satisfied
I confirm this person can authorise the service to transport the Child or arrange the for transportation of the Child
I consent for this person to be an emergency contact
I consent for this person to be an authorised nominee to collect this child
I consent for this person to be an authorised nominee for this child's permissions and excursions
I consent for this person to be to authorise this child being transported by the service or on transportation arranged by the service.

Additional Emergency Contact

Education and Care Services National Regulations - Regulation 160 (3b, ii, iii, iv, v) 161 (1a, l, ii, 1b)
Full Name

First NameLast Name
Relationship to Child
Address

Street Address

Street Address Line 2

CityState / Territory

Post Code
Home Phone
Please enter a valid phone number.
Mobile Phone
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Email
example@example.com
I confirm this person can be contacted to give consent for medical treatment or to authorise for a Nominated Supervisor or educator to administer medical to the child in the even that a Parent/Guardian cannot be contacted.

YesNo

Authorisations

	Not Satisfied
I confirm this person can authorise the service to transport the Child or arrange the for transportation of the Child
I consent for this person to be an emergency contact
I consent for this person to be an authorised nominee to collect this child
I consent for this person to be an authorised nominee for this child's permissions and excursions
I consent for this person to be to authorise this child being transported by the service or on transportation arranged by the service.

Enrolment Agreement

PLEASE READ THE FOLLOWING AGREEMENT CAREFULLY BEFORE SIGNING. PLEASE ASK IF THERE IS ANYTHING IN THIS DOCUMENT THAT YOU ARE UNSURE OF.
- I consent for the service to seek medical treatment for my child from a medical practitioner, hospital or ambulance service.
- I consent for my child to be transported by an ambulance service.
- I agree that if my child has been injured, or becomes ill whilst at the service or otherwise in care, for a service representative to seek medical treatment for the child from a registered medical practitioner, hospital or ambulance service and transportation of the child by ambulance service.
- I consent to the carrying out of appropriate medical, dental or hospital treatment.
- I consent for the service to provide first aid and medication, including administering Ventolin & / or Epipen, to my child.
- I agree to accurately record the time of arrival and departure of my child at the service in accordance with service requirements.
- I consent to provide my child with a sun safe hat for outdoor activities and apply sunscreen prior to their arrival where there is a UV measure above 2.
- I consent for the service to provide sunscreen to my child as required - if my child requires specific sunscreen I will provide this to the service.
- I consent to my child using / viewing devices and electronic technologies (i.e. tablets, TV, iPads etc.)
- I consent to the service taking photographs and videos of my child during normal activities and excursion during care.
- I consent for photos and videos of my child to be displayed at the service and included in service newsletters.
- I agree to notify the service when my child will be collected by any person not listed on this enrolment form, I will provide the full name, contact number and full address (to support an ID check) to enable my child to be signed out of the service.
- I consent to the collection, use and display of my child’s information by the service on the OWNA App in accordance with OWNA’s Privacy Policy: www.owna.com.au/privacy-policy.html
- I have read and understood the services policies, procedures (available at: https://www.kidsbizoshc.com.au/policies).
- I agree to collect or make arrangements for the collection of my child from the service if they are unwell, are or could be contagious, or display any symptom that could be considered contagious.
- I consent for my child to participate in regular evacuation drills or an actual evacuation when necessary. I understand that my child will be relocated from the service under the supervision of service educators and team members to a safety zone for evacuation purposes.
- I am aware that I am required to pay my service fees in accordance with policies, I understand that non-payment of my account could result in cancellation of my child's enrolment and recovery action may be undertaken at my expense.
- I understand that fees are charged fortnightly and non-payment could result in cancellation of my child's enrolment and recovery action may be undertaken at my expense.
- I agree that I may be charged fees for bookings I have made before I have accessed my statement for the attendances.
- I confirm that I am listed as a parent of guardian on this enrolment form, I am authorised to complete this form for the Child and that all information and documents provided as part of this form are true and correct.
- I understand that I may need to pay the full fee for booked care where government does not provide payment of the child care subsidy directly to the service.
- I understand that I may need to arrange payment of any eligible child care subsidy entitlements directly with the Australian Government, particularly where the correct CRN and date of birth information is not provided in this enrolment form submission.
First NameLast Name
Signature

Clear
Date*

DayMonthYear
Date
Should be Empty:

Enrolment Form - 2024

Child's Details

Child Care Subsidy

Primary Parent / Carer

Second Parent / Carer

Cultural Considerations

Medical Information

Developmental Information

Family Information

Court Orders

First Emergency Contact

Additional Emergency Contact

Enrolment Agreement