Crèche and Kids Club Enrolment Form

Please complete this form in preparation for your child’s first visit to the crèche or Kids Club.

For more information, please call 9400 4600.

Program

Please select a program.

Parent / Guardian Details

Please enter your first name.
Please enter your last name.
Please enter your address.
Please enter your post code.
Please enter your phone number.
Please enter your mobile number.
Please enter your email address

Child Details

Please enter your child's first name.
Please enter your child's last name.
Please enter your child's date of birth.
Please enter your child's age.
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Please select a gender.
Please select yes or no.
Please select a severity.
Please select yes or no.

Please note: An action plan must be provided upon enrolment for children with severe allergies or medical conditions and those requiring medication.

Please enter child's medical conditions.
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Second Child Details

Please enter your child's first name.
Please enter your child's last name.
Please enter your child's date of birth.
Please enter your child's age.
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Invalid Input
Please select a gender.
Please select yes or no.
Please select a severity.
Please select yes or no.

Please note: An action plan must be provided upon enrolment for children with severe allergies or medical conditions and those requiring medication.

Please enter child's medical conditions.
Invalid Input

Third Child Details

Please enter your child's first name.
Please enter your child's last name.
Please enter your child's date of birth.
Please enter your child's age.
Invalid Input
Invalid Input
Please select a gender.
Please select yes or no.
Please select a severity.
Please select yes or no.

Please note: An action plan must be provided upon enrolment for children with severe allergies or medical conditions and those requiring medication.

Please enter child's medical conditions.

Emergency Contact Details

Please enter your emergency contact's first name.
Please enter your emergency contact's last name.
Please enter your emergency contact's phone number.
Please enter your emergency contact's mobile number.

Parent Declaration

Please agree to continue.
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Craigie Leisure Centre staff will make every effort to ensure that the highest standards of care are offered to the children enrolled in each program and agree for my child to participate in all activities offered. Organisers however, will not be liable for loss, damage or injury to property or person, occasioned as a consequence of the enrolment of any child or children in the Craigie Leisure Centre – crèche and Kidz Club program or participation in that program and as a parent you acknowledge the exclusion of liability accordingly.