Pre-Kindy Early Learning Centre for 2.5-4 year olds

Miranda Selman (0408 601 273)
miranda@tiddlywinksprekindy.com.au
Home Information Typical day Enrolment form

Enrolment FormDownload Form as Printable PDF


Child's Name: ____________________________________________ (M/F)
Date of Birth: ________________________________________________
Parents Name: ________________________________________________
Address: ________________________________________________
Telephone:            Home: _________________________________________
  Work: _________________________________________
  Mobile:_________________________________________
Email: ________________________________________________
 

Are you happy to receive correspondence by email? Yes / No (please circle)

Please nominate people and provide their full name and telephone number who are authorised to drop off and collect your child other than yourself:
  ________________________________________________
  ________________________________________________
Person to be contacted in case of emergency other than yourself:
Name: ________________________________________________
Address: ________________________________________________
Telephone: Home: _________________________________________
  Mobile: _________________________________________
  Work: _________________________________________
Please provide details of your child's Medical Practitioner:
Name: ________________________________________________
Telephone: ________________________________________________
Address: ________________________________________________
Please list any allergies your child has:
  ________________________________________________
Please advise us of any other information you feel is relevant in regard to the care and wellbeing of your child:
______________________________________________________________________
Principle Language Spoken: ________________________________________________
Cultural, Religious, Dietary Needs: ________________________________________________
Custody, Guardianship or Access Provisions: ________________________________________________
Other Family Members: ________________________________________________
Please list 3 of your child's main interests/ favourite things.
______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
Please list 2 activities your family enjoy doing most together.
______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
Please list any thing special about your child that will help us make sure that their interests are catered for in the program.
______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
Please let us know if there is any special health, religious and cultural considerations we need to be aware of so that we can cater this into your child's program.
______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________
Please advice us of how many sessions you would like to enrol and list your day preferences:
Sessions required: ___________
Session Morning Morning Afternoon Double
Monday: _________      
Tuesday:   _________ _________ _________
Wednesday:   _________ _________ _________
Thursday:   _________ _________ _________
Friday: _________      

We authorize Tiddlywinks to seek medical attention if required in case of an emergency and pay for any associated costs.

I give / do not give permission for photographs to be taken of my child________________________ at Tiddlywinks Pre Kindergarten. These photos will only be used for display in the centre and in the children's personal portfolio's. They will not be put on any forum accessible by the internet.

We agree to the Terms and Conditions of enrolling our child at Tiddlywinks


Signature of Parents: ____________________ ______________________


Date: __________________________________________________________

 

Please fill out and return this form along with confirmation of deposit, copy of current immunisation status and copy of birth certificate or equivalent document. The deposit will be deducted from your first term fees.

Please EFT deposit payment to Tiddlywinks account:
BANK: ANZ
ACCOUNT NAME: Tiddlywinks
BSB: 016 281
ACC #: 192476408

* A late fee of $25 will apply.

Please post enrolment form to:
Tiddlywinks
c/o 4 Read Ave
Mosman Park
Perth WA 6012


Or email to: miranda@tiddlywinksprekindy.com.au

Thank you and we look forward to welcoming your child and family to Tiddlywinks. ☺