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    Location*

    Would you consider another Centre?*

    Guardian Details

    First name*

    Last name*

    Phone*

    Email*

    Address*

    Child Details

    is this registration for a child that is currently enrolled at the Centre OR for a sibling of an enrolled child?

    Is this registration for a child who is not yet born? Please tick if yes.

    First name*

    Last name*

    Date of birth*

    Gender*

    Preferred commencement date*

    Number of days required*

    Wil you accept less days?*

    Please Note : priority is given to families requesting Mondays and/or Fridays.

    What days could you accept?*

    Flexibility comment

    Does your child have any medical or special needs that we need to be aware of in order to provide the best possible care and education for your child at our Centre?

    Special needs details

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    Please describe your Childcare/Kinder arrangements*