Enrolments

Parent's Name*

First Last

Street Address*

Street Address City State / Province / Region ZIP / Postal Code

Contact Details

E-mail*

Mobile

Alternate Number

Relationship to Child

Child's Name #1
First Last
Date of Birth #1
Gender #1
Preference for days #1
- Tuesday
- Wednesday
- Thursday
Are your days flexible? #1
- Yes
- No
Preferred commencement date #1

Child's Name #2
First Last
Date of Birth #2
Gender #2
Preference for days #2
- Tuesday
- Wednesday
- Thursday
Are your days flexible? #2
- Yes
- No
Preferred commencement date #2

Child's Name #3
First Last
Date of Birth #3
Gender #3
Preference for days #3
- Tuesday
- Wednesday
- Thursday
Are your days flexible? #3
- Yes
- No
Preferred commencement date #3

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Priority of Access

If priority access applies to you please select one of the following and enter details as required. To read the full guidelines for priority access please click here.

Please select one:

Priority Level 1
Priority Level 2
Priority Level 3

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Enrolments (1)

Contact Details

Priority of Access