Inspire Program Australia: Re-Enrolment (Boronia Park)

Re-Enrolment 2025

Inspire Boronia Park
Please only complete this form for the children who will be re-enrolling for 2025. If your child/ren will not be returning for 2025 you must complete a cancellation form.
Your Name*

First NameLast Name
Email*
Number of Children*
Child 1's Name*

First NameLast Name
Child 2's Name*

First NameLast Name
Child 3's Name*

First NameLast Name
Child 4's Name*

First NameLast Name

Child 1

Re Enrolment
Child 1's Name*

First NameLast Name
Current School Year*
Please upload an updated/up to date photograph of your child*

Cancelof
Have there been any changes to their details in the last 12 months (see below)*
These changes may relate to any of the following
- Anaphylasxis / Allergies - New illness or no longer present?
- Asthma - New illness or no longer present?
- Any medical conditions, e.g. diabetes
- Speech / Language delays or concerns
- Physical / Gross Motor delays
- Behavioural concerns including diagnosed behavioral conditions
- Any regular medication your child is taking
- Any dietary requirements
- Any cultural requirements
- Living arrangements
- Current doctor
- Custody details
Please provide the details of any changes here*
Does your child require an updated action plan?*
Please attach the updated action plan*

Cancelof
Have there been any changes to court orders relating to the child's residence or child's contact with a parent or other person?*
Please attach the updated court order*

Cancelof
Do you wish to make a request to update your child's enrolled days for 2025?*
Please request the days that you require for 2025 (*please note all change of day requests are subject to availability*)*

MondayTuesdayWednesdayThursday

Child 2

Re Enrolment
Child 2's Name*

First NameLast Name
Current School Year*
Please upload an updated/up to date photograph of your child*

Cancelof
Have there been any changes to their details in the last 12 months (please see below)*
These changes may relate to any of the following
- Anaphylasxis / Allergies - New illness or no longer present?
- Asthma - New illness or no longer present?
- Any medical conditions, e.g. diabetes
- Speech / Language delays or concerns
- Physical / Gross Motor delays
- Behavioural concerns including diagnosed behavioral conditions
- Any regular medication your child is taking
- Any dietary requirements
- Any cultural requirements
- Living arrangements
- Current doctor
- Custody details
Please provide details of any changes here*
Does your child require an updated action plan?*
Please attach the updated action plan*

Cancelof
Have there been any changes to court orders relating to the child's residence or child's contact with a parent or other person?*
Please attach the updated court order*

Cancelof
Do you wish to make a request to update your child's enrolled days for 2025?*
Please request the days that you require for 2025 (*please note all change of day requests are subject to availability*)*

MondayTuesdayWednesdayThursday

Child 3

Re Enrolment
Child 3's Name*

First NameLast Name
Current School Year*
Please upload an updated/up to date photograph of your child*

Cancelof
Have there been any changes to their details in the last 12 months (please see below)*
These changes may relate to any of the following
- Anaphylasxis / Allergies - New illness or no longer present?
- Asthma - New illness or no longer present?
- Any medical conditions, e.g. diabetes
- Speech / Language delays or concerns
- Physical / Gross Motor delays
- Behavioural concerns including diagnosed behavioral conditions
- Any regular medication your child is taking
- Any dietary requirements
- Any cultural requirements
- Living arrangements
- Current doctor
- Custody details
Please provide details of any changes here*
Does your child require an updated action plan?*
Please attach the updated action plan*

Cancelof
Have there been any changes to court orders relating to the child's residence or child's contact with a parent or other person?*
Please attach the updated court order*

Cancelof
Do you wish to make a request to update your child's enrolled days for 2025?*
Please request the days that you require for 2025 (*please note all change of day requests are subject to availability*)*

MondayTuesdayWednesdayThursday

Child 4

Re Enrolment
Child 4's Name*

First NameLast Name
Current School Year*
Please upload an updated/up to date photograph of your child*

Cancelof
Have there been any changes to their details in the last 12 months (please see below)*
These changes may relate to any of the following
- Anaphylasxis / Allergies - New illness or no longer present?
- Asthma - New illness or no longer present?
- Any medical conditions, e.g. diabetes
- Speech / Language delays or concerns
- Physical / Gross Motor delays
- Behavioural concerns including diagnosed behavioral conditions
- Any regular medication your child is taking
- Any dietary requirements
- Any cultural requirements
- Living arrangements
- Current doctor
- Custody details
Please provide details of any changes here*
Does your child require an updated action plan?*
Please attach the updated action plan*

Cancelof
Have there been any changes to court orders relating to the child's residence or child's contact with a parent or other person?*
Please attach the updated court order*

Cancelof
Do you wish to make a request to update your child's enrolled days for 2025?*
Please request the days that you require for 2025 (*please note all change of day requests are subject to availability*)*

MondayTuesdayWednesdayThursday

Contact Details

Re Enrolment
Primary Contact*

First NameLast Name
Do you wish to update your primary contact's details?*
Email*
Mobile Number*
Date of Birth*

DayMonthYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Secondary Contact*

First NameLast Name
Do you wish to update your secondary contact's details?*
Email*
Mobile Number*
Date of Birth*

DayMonthYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Authorised Nominees

Re Enrolment
Authorised nominee's are premitted to collect your child/ren from the centre. At collection, if a person is not known to staff, photo ID will be required. When we are unable to contact you (parent/guardian) in the first instance in the event of an emergency, we will notify the authorised nominee/s. Your authorised nominee/s are authorised to consent to the medical treatment of, or the administration of medication to your children. Your authorised nominee/s may also provide consent for Inspire to take your child/ren out of our service premises.
Do you wish to update your authorised nominees?*
Authorised Nominee 1*

First NameLast Name
Relationship to Child*
Mobile*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you wish to add another authorised nominee?*
Authorised Nominee 2*

First NameLast Name
Relationship to Child*
Mobile*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you wish to add another authorised nominee?*
Authorised Nominee 3*

First NameLast Name
Relationship to Child*
Mobile*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Terms & Conditions of Enrolment (2025)
Applicable to AFTER SCHOOL CARE only, effective for care commencing in Term 1 of 2025:-
- All change of day/s request are subject to availability, are not guaranteed
- Our policy requires you to provide us 2 weeks noticed before cancelling your child/ren's enrolment. However please note once your re-enrolment has been confirmed for 2025, any changes or cancellations will only come into effect from week comencing 17th February 2025, and the charges for any bookings until the 14th February 2025 are NON-REFUNDABLE.
Annexure A
Transportation Authority
Re Enrolment Declaration
I HEREBY declare that:-
- I have read, understood and agreed to the terms & conditions of 2025 enrolment, the Annexure A, and transportation authority.
- The information provided is true and correct to the best of my knowledge.
- I undertstand that if I submit this form after Sunday 3rd November 2024 I will be charged the $30.00 administration fee.
Sign here*

Clear

Re-Enrolment 2025

Child 1

Child 2

Child 3

Child 4

Contact Details

Authorised Nominees

Terms & Conditions of Enrolment (2025)

Annexure A

Transportation Authority

Re Enrolment Declaration

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