Event Childcare

1
The Setting you will be attendingPreschool, Kindy (preschool/P1 wrap around), Wrap around for p2-p7
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2
Which school will your child attend? Please keep us informed of P1 start times.
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3
Parents Name* This field is required.
First Name
Last Name
4
Child's Name* This field is required.Please enter your child's name
First Name
Last Name
5
Preferred Name Please enter your preferred name for your child
First Name
Last Name
6
Child's DOB* This field is required.
Date
Day
Month
Year
7
Home telephone
Area Code
Phone Number
8
Mobile telephone* This field is required.
Area Code
Phone Number
9
Email
example@example.com
10
Email address* This field is required.
Area Code
Phone Number
11
Likes
12
Dislikes
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13
Please tick the term time days you require afterschool childcare.* This field is required.Minimum of 2 days. This booking must be for term time and school holidays. We are unable to provide term time only childcare.
Monday
Tuesday
Wednesday
Thursday
Friday
No days just preschool
14
I confirm that the information I have supplied is correct to the best of my knowledge.* This field is required.
First Name
Last Name
15
I confirm that the information I have supplied is correct to the best of my knowledge:* This field is required.Signature:
Clear
16
Date* This field is required.
Date
Day
Month
Year
Should be Empty: