2025 APPLICATION FOR OUTSIDE SCHOOL HOURS CARE

Child Full Name*

Given NamesStudents Surname

Child CRN

Date of Birth*

Date

Gender*

FemaleMale

Class/ Year Level*

Child Full Name

First NameLast Name

Child CRN

Date of Birth

Date

Gender

FemaleMale

Class/ Year Level

Child Full Name

First NameLast Name

Child CRN

Date of Birth

Date

Gender

FemaleMale

Class/ Year Level

Parent Full Name*

Parent 1 First NameParent 1 Surname

Relationship to Child*

Residential Address*

Postcode

Email Address*

example@example.com

Date of Birth

Date

Telephone (Work / Home)

Mobile*

Parents Customer Reference Number

Parent Full Name

Parent 2 First NameParent 2 Surname

Relationship to Child

Residential Address

Postcode

Email Address

example@example.com

Date of Birth

Date

Telephone (Work/Home)

Mobile

Parents Customer Reference Number

Parents are*

Student lives with**

* NB: If a Court Order exists in relation to custody, or limiting access or dissemination of information to a parent, a copy of that Court Order MUST be provided

Priority of Access*

Child at RiskChild of Single Parent, working and/or studyingChild of parents who are both working and/or studyingAny other children

Additional Authorised Pick Up/Emergency Contact

I authorise this contact to:

Collect my child. I will attempt to contact the servce prior to their arrival.
Be contacted, if all attempts to contact myself fail, in case of accident or emergency.
Collect my child from the service should my child become ill whilst in care.

Emergency Contact Name 1

First NameLast Name

Relationship to Child

Mobile Phone

Please enter a valid phone number.

Email

example@example.com

Emergency Contact Name 2

First NameLast Name

Relationship to Child

Mobile Phone

Please enter a valid phone number.

Email

example@example.com

Emergency Contact Name 3

First NameLast Name

Relationship to Child

Mobile Phone

Please enter a valid phone number.

Email

example@example.com

Emergency Contact Name 4

First NameLast Name

Relationship to Child

Mobile Phone

Please enter a valid phone number.

Email

example@example.com

Medicare Number

Are vaccinations up to date?*

YesNo

Doctors Name

Please email a copy of the immunisation records to OSHC@sthildas.qld.edu.au

Surgery Address

Doctor's Phone Number

Allergies or illnesses

Treatment or medication

Special Needs eg hearing visual physical

Does your child require special management strategies

Cultural Background Country of Birth

Country of Birth

Primary Language

Any cultural or religious requirements that must be observed eg Diet or religious practice

Publicity You agree that images, videos & testimonials of your child may be used in St Hilda's OSHC publications (including websites) and for promotional and publicity purposes, including social media.*

YesNo

Fees

1. All fees must be paid in full - Charges are as follows:

Before School Care $20.00

After School Care $35.00

Casual After School Care $40.00

2. Please be aware that refunds for non-attendance will only be given if notice is received 48 hours prior to the scheduled booking. Please contact OSHC on 0428 639 706 or email OSHC@sthildas.qld.edu.au.

3. Collection of children after 6 pm will incur a LATE FEE of $50.00 until 6.15 pm and a fee of $1.00 per minute thereafter.

4. We encourage reserving places Vacation Care as soon as possible as some days may be unavailable. Vacation care fees are to be paid at time of booking.

Behaviour Management

St Hilda's OSHC staff have a Duty of Care to all who attend and work within the service. Any inappropriate behaviour or actions (such as inappropriate language/actions, deliberate harm to another person or facilities, disrespectful behaviour towards staff or their instructions), or behaviour which threatens the safety and/or wellbeing of any persons within St Hilda's OSHC will be addressed immediately. An incident report will be written and signed by the attending staff member and provided to the parent for their signature.

Confirmation of a place in the Outside School Hours Care Program is at the discretion of the St Hilda's Director of Pre-Prep.

Behaviour Guidance in Anglican Education and Care Services

OSHC ACTIVITY - Activities in St Hilda's School Grounds

Throughout the course of the year, children enrolled in OSHC may be escorted by OSHC Educators to activities within the St Hilda's School grounds. Locations include: Junior School Buildings and grounds including - Multi-Purpose Centre, Gymnasium, Junior School Library, Caedmon Centre, Junior School Grass Field, Junior School Playgrounds.

To view the Terms & Conditions, please read the Terms & Conditions - Terms & Conditions - Risk Identification and Management OSHC Activities.

By signing below you accept the associated Terms & Conditions to enable your child to participate in the activities.

Safe Travel Agreement

I agree to contact OSHC as soon as possible to advise of any changes to routines, activities or attendance at OSHC. I understand the service staff will follow the Safe Arrival and Departure of Children in Anglican Education and Care Services Policy and Procedure in the event my child does not arrive at the predetermined time, including contacting parents, emergency nominees or emergency services/police if the child's' location is unknown.

Please read relevant policy:

Safe Arrival and Departure of Children in Anglican Education and Care Services Policy and Procedure.

Movies Authorisation*

I give permission for my child to watch age-appropriate PG rated children's movies during Vacation Care.I do not give permission for my child to watch age-appropriate PG rated children's movies during Vacation Care.

Sunscreen Authorisation

Each day your child must arrive at OSHC with sunscreen already applied. Sunscreen will be available at the sign in desk. Sunscreen will be reapplied prior to outdoor play and activities. This form authorises St Hilda's School OSHC Educators to reapply sunscreen on your child. Please fill out ONE of the sections below.

OPTION 1: Allow educators to apply sunscreen provided by OSHC.

I, First Name ,give permission for the educators at St. Hilda's Pre-Preparatory/OSHC to apply, as appropriate, SPF30+ or higher, broad-spectrum, water-resistant sunscreen to all exposed parts of my Childs body.
Signature Date

OPTION 2: Provide your own sunscreen and authorise educators to apply it (use this option if your child has a sunscreen allergy or for other reason needs to wear a specific sunscreen)

I,   First Name   Last Name   , give permission for the educators at St. Hilda's OSHC to apply, as appropriate, to all exposed parts of my Childs body. The sunscreen that I have supplied and labelled with my child/rens name. This sunscreen is an SPF30+ or higher, broad-spectrum, water-resistant sunscreen. I understand this sunscreen will be kept at the service.
Signature   Date

Permission to Give Medication

I give permission for the listed medication below to be administered should my child suffer from a fever that has reached or exceeded 38 degrees.

Please choose only if your child has previously been given this medication without any adverse reaction.

Medication

ParacetamolIbuprofen e.g. Nurofen

Permission to seek Medical Attention

In the event of an accident or illness, where it is impractical to communicate with me, I authorise the teacher in charge to seek such medical treatment deemed necessary.

Signature of Parents

Parent 1

Parent 1 Full Name*

Signature*

Date

Parent 2 Full Name*

Signature*

Date

Please return to St Hilda's Junior School Reception/ Enrolment Department/OSHC Office

Bookings can be made via email: OSHC@sthildas.qld.edu.au

APPLICATION FOR OUTSIDE SCHOOL HOURS & VACATION CARE