Family Composition and History
- Start Enrolment
- Enrolment Information
- Family Composition and History
- Childs Health
- Enrolment Agreement
Enter your email address to start.
Enter Your Email
Year of Enrolment
Childs Christian Name
Date of birth
Place of Birth
Is there a court order affecting custody of or access to the child?
If yes please provide details.
Please upload any relevent documentation (PDF Format)
Parent/Guardian 1 Full Name
Parent/Guardian 1 Email
Work Phone - Parent/Guardian 1
Mobile Phone - Parent/Guardian 1
Address Is the same as my child's
Place of work
Hours of work
Language spoken at home
Parent/Guardian 2 - Details
Parent/Guardian 2 - Full Name
Parent/Guardian 2 Email
Address same is the same as Child's
Work Phone - Parent/Guardian 2
Mobile Phone - Parent/Guardian 2
Place of work
Hours of work
Language spoken at home
Number of children at home
Authorised Nominee 1 - Details
Authorised Nominee 1 - Full Name
Authorised Nominee 1 - Address
Authorised Nominee 1 - Home Number
Authorised Nominee 1 - Mobile Number
Authorised Nominee 1 - Relationship to Child
I authorise Nominee 1 to be notified in case of emergency involving my child if I cannot be contacted. In addition, they can collect my child from the service and consent to medical treatment or authorise administration of medication to my child during time of illness of emergency.
Authorised Nominee 2 - Details
Authorised Nominee 2 - Full Name
Authorised Nominee 2 - Address Name
Authorised Nominee 2 - Home Number
Authorised Nominee 2 - Mobile Number
Authorised Nominee 2 - Relationship to Child
I authorise Nominee 2 to be notified in case of emergency involving my child if I cannot be contacted. In addition, they can collect my child from the service and consent to medical treatment or authorise administration of medication to my child during time of illness of emergency.
Childs Health Information
Child's Medical Practitioner / Service
Doctor's Telephone Number
Child's Medicare Number
Immunisation Record (Attach in PDF Format)
Has your child had any communicable diseases? (German Measles/Mumps/Chicken Pox/Whooping Cough/Measles/Others)
If yes please provide details
Select any of the below statements that may apply to your child
If any of the above have been selected please provide details.
Please provide any further information that will help us better understand your child.
I am willing for my child to be photographed as part of the programming.
I am willing for my child to take part in walks or excursions planned as part of the programme.
I agree to have my child examined by any medical or dental person who may visit the kindergarten on any advisory or educational nature only.
In case of an accident or illness requiring emergency treatment, the educator in charge will call an ambulance if required and administer life saving medication (e.g. Epipen or Ventolin) if required. Every effort will be made to contact the parents or those listed as an authorised nominee to inform them of the situation.
I give permission and consent to the educators of Canossa Kindergarten to administer/apply Panadol Bandaid Herodoid (bumps and bruises) Savlon Ice packs Stop Itch Stingose
I/We authorise the staff of the centre to seek/provide urgent medical, dental, hospital treatment or ambulance service for my child should this be considered necessary. I/We authorise transportation of my child by ambulance if required. Furthermore, I have read, and agreed to abide by the conditions of the use of the centre and to accept such responsibility as enrolment at the centre imposes.
1. I understand that in the case of sudden illness or an accident, staff will administer immediate first aid & if parents are unable to be contacted, the Nominated Supervisor and educators, as agents for the parents shall have discretionary power to seek further medical attention, but shall be under no obligation to do so.
2. I agree to notify the Nominated Supervisor promptly for the reason of any absences, and I understand that unless the Nominated Supervisor is notified of prolonged absences (holidays, illness, etc.) my child will automatically lose their place at the Kindergarten.
3. I understand and accept that fees must be paid by the due date and a late fee of $20 will apply. In the event of my child being collected after closing time (2.45pm), a fee of $15 per 15 minutes will be charged.
4. I agree to notify the Kindergarten if anyone other than the person stated on the enrolment form is to pick up my child from Kindergarten. I will either give them a note of authorisation or ring the Kindergarten and advice them of who will be collecting my child.
5. I agree to keep my child home from Kindergarten when suffering from a bad cold or other infectious or contagious illnesses for the period of time recommended by my doctor. I understand a doctor’s clearance letter will be required.
6. The Kindergarten takes responsibility for the children between its opening hours of 8.30am and 2.45pm. NOT BEFORE OR AFTER. Prior to or following these times, a parent or guardian is completely accountable for their child/ren.
7. I have been provided with the ‘Parents Information Booklet’ and agree to accept the policies and guidelines set down by the Centre and agree to abide by these conditions.
8. As some children attending have Peanut Allergies, the Centre discourages the use of peanut butter or peanut based snacks and I agree to advise staff if my child has been provided with these products so that they can take appropriate precautions.
9. I give permission for my child to participate in fire rehearsals and am aware that the Emergency Assembly Areas are off premises.
By clicking submit you agree to that the information you have provided is true and accurate and has been completed to best of your knowledge.