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Enrolment

 
Please click on the below links to see our enrolment forms...
 

Blue Form

 

Green Enrolment Form

 

Yellow Enrolment Form


CRANBOURNE DAYCARE & KINDERGARTEN CENTRE.

CHILD HEALTH RECORD

Child’s Name: _____________________________________ Child’s Date of birth: _____/_____/_____

A parent or guardian who has lawful authority in relation to the child must complete this form. A brief

explanation of lawful authority is found at the end our yellow enrolment card.

 

Health information

Child’s usual Medical Centre & Address _______________________________________________________________

_______________________________________________________________________________________________ Phone No:_______________________________

Child’s preferred doctor____________________________________________________________________________

Child’s Medicare No:__________________ Ref. No: ……Health Care Card? YES/NO No:_________________________

 

Health Insurance? YES / NO

 

Member Number:___________________________Fund:  ______________________________

 

Ambulance Subscription?: YES / NO Membership No:____________________________________________________

 

Existing Medical Condition:_________________________________________________________________________

Diagnosis (If applicable)________________________________________________________________

Specialist involvement:____________________________________________________________________

Previous Illness / Infectious Disease __________________________________________________________________

Cultural / Religious Dietary requirements   ____________________________________________________________

Does your child have any special needs? Yes  / No

If yes please provide details of any special needs and any management procedure to be followed with

respect to the special need.

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

 

Does your child have a child health record?    Yes _ No _

 

If yes, please provide to the service for sighting.

Child health record means a record that documents a child’s health and development assessments and immunisations.

 

Name and position of person at the children’s service who has sighted the child’s health record.

 

__________________________________________ ____________________________

 

 

 

 

 

 

 

CRANBOURNE DAYCARE & KINDERGARTEN CENTRE

 

CHILD HEALTH RECORD continued

 

Does your child have any of the following (please circle)

 

ANAPHYLAXIS      ASTHMA      DIABETES     EPILEPSY       ALLERGIES/SENSITIVITIES       FEARS/PHOBIAS    

 

OTHER(PLEASE SPECIFY)_____________________ 

 

 

In the case of Anaphylaxis/Asthma/Diabetes/Epilepsy you will be provided with a copy of the services action plan.

You will be required to provide the service with an individual medical management plan for your child signed

by the medical practitioner who is treating your child, prior to commencement. This will be attached to your child’s enrolment form and displayed in your child’s room.

 

 

DOES YOUR CHILD HAVE THE ANY OF FOLLOWING?  (please tick)                                                                   YES    /     NO

 

Does your child have an auto injection device (eg EpiPen®)?                                                                              ___    /    ___

Does your child have an asthma inhaler?                                                                                                                ___   /    ___

Does your child require any ongoing medication while attending our service?                                               ___   /    ___

Has the medical management plan (in consultation with your doctor) been provided to the service?     ___   /    ___

Do we need a risk minimisation plan in consultation with educators/coordinator?                                       ___   /    ___

 

Parent name:_____________________ Parent signature:______________________

 

 

RISK MINIMISATION PLAN

 

COMPLETED BY:

Parent Name:                                                      Educator/Coordinator Name:                                          Date:

 

Child’s Name:                                                                                              DOB:

Condition:

 

Triggers:

 

 

 

 

What we will do to support your child

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

I ­­­­­­­­­­­­­­­­­­­________________________ (parent/guardian) of ________________________ have provided accurate information regarding my child’s condition. I understand that it is my responsibility to keep the centre updated as required.

 

_____________________________________                                    _____________________

Parent/Guardian Signature                                                                     Date

 

CRANBOURNE DAYCARE & KINDERGARTEN CENTRE

CHILD INFORMATION FORM FOR SCHOOLIES , JUNIOR & SENIOR KINDER

 

CHILD’S NAME:…………………………………………………………………………………………...............................................................................................

Nickname or preferred Name:…………………………………………………………………………........................................................................................

Date of Birth:……………………………………….....................................    Country of Birth:………………………………..................................................

Address:………………………………………………………………………………………………….................................................................................................

(H) Phone:………………………………………...........................................              (W) Phone:……………………………………..........................................

Mobile Phone:…………………………………….

Email address (will be used for communication purposes): _____________________________________________

ACCESS.

The following people have permission to deliver and collect my child, authorise medical

treatment and authorise consent for excursions:

1…………………………………………………..                                                2…………………………………..………………..

3…………………………………………………..                                                4……………………………………………………..

 

CUSTODY

Are there any custody restrictions relating your child? YES / NO.

If YES please provide a copy of the current custody forms.

 

PARENTS / GUARDIANS.

 

Mothers Name:………………………………………………                                       Fathers Name…………………………………………..............

Mothers Country of Birth:………………..…………………                                  Fathers Country of Birth………………………………..............

Mothers Ethnic Self-Identity:……………………………….                                 Fathers Ethnic Self Identity……………………………............

Parent/s Occupations…………………………………………                    /               ……………………………………………..............................

Special Festivals / Celebrations:………………………………………………………………………....................................

How do you celebrate them:……………………………………………………..……………………….................................

Would you be willing to share them with the centre? YES / NO

Do you have any talents/skills that you would be willing to share with the centre? If yes please list ........................................................................................................................................................................................

Would you like to be involved within the centre’s program? YES / NO.

 

Are you willing for your child to participate in celebrations within the centre such as birthdays,

Easter and Christmas? YES / NO.  If no please discuss your requirements with management

and staff to avoid confusion.

 

Is there anything in particular about your child’s family, situation and/or background that you would like staff to be aware of or sensitive to?.................................................................................................................................................

 

FAMILY.

Please list your child’s siblings and their ages, as well as any other significant people involved with your family (ie close family friends, relatives etc). You are welcome to include your pets …………………..…………………………………………………………………………………………………………………......…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….

 

CHILD.

Days of attendance:………………………………..........Usual hours of attendance:……………………………...........

Any specific need/special need?.....................................................................................................................................

Does your child have any involvement with specialists and therapists? ……………………………….............................

If yes please list?.............................................................................................................................................................

Security / comfort items? If Yes please list…………………………………………………………………...........................

Special friends?..............................................................................................................................................................

Previous childcare arrangements (if any):………………………………………………………………….............................

Please list your child’s interests?....................................................................................................................................

......................................................................................................................................................................................Other comments regarding your child (fears, dislikes etc): ………………………………………………………............

………………………………………………………………………………………………………………….............................

CRANBOURNE DAYCARE & KINDERGARTEN CENTRE.

CHILD ENROLMENT FORM

 

SURNAME:…………….…………………                                                             GIVEN NAMES:……………….…………….

Date of Birth……………………………..                                                            Gender:   Male   /   Female      

Birthplace………………………………..                                                              Home Language…………………….……..

Address………………………………..…                                                               Home Telephone…………………………..

Days of attendance……………………………………………………………………………………

Date starting……………………………..       

Child Reference Number (CRN):.......................................................

PARENT / GUARDIAN 1.                                                                            

 

Full name…………………………………     D.O.B……………………………………… Gender:   Male   /   Female      

Country of birth………………………….                                                          Language/s Spoken…………………….                     

Home Address…………………………...…………………………………………...................................                  

Family Ref No ……………………….......                                                                                 

Work address…………………………….………………………………………………........................................                          

Work Place and Occupation……….………………………..............................................................................              

(H)Phone………………………........ (W) Phone.......................................…...Mobile.....................................            

Email: .................................................................

                                                                                                                       Signature:                                

PARENT / GUARDIAN 2.                                                                            

 

Full name…………………………………     D.O.B……………………………………… Gender:   Male   /   Female                   

Country of birth………………………….                                                          Language/s Spoken…………………….                     

Home Address…………………………...…………………………………………...................................                  

Family Ref No ……………………….......                                                                                 

Work address…………………………….………………………………………………........................................                          

Work Place and Occupation……….………………………..............................................................................              

(H)Phone………………………........ (W) Phone.......................................…...Mobile.....................................            

Email: .................................................................

                                                                                                                       Signature:                                

  • Are there any custody restrictions applicable to your child?    YES   /   NO

Court orders must be provided to the centre on enrolment for the centre to uphold

them within reasonable expectations. 

  • Copy of court orders provided?   YES   /   NO

EMERGENCY CONTACTS / AUTHORISED NOMINEE TO COLLECT CHILD FROM SERVICE.

The following people have access to deliver and collect my child (other than parents) and also have the authority to

authorise medication, emergency treatment and for my child to attend excursions and are over 16 years of age.

 

1. Name………………………………………                                                          2. Name:………………………………..……..

Relationship to child:……………………..                                                      Relationship to child:………………………              

Address: ……………………………………                                                            Address: ……………………………………..

………………………………………………...                                                             ………………………………………………….

Phone:………………………………………                                                             Phone:………………………………………..              

Mobile:………………………………………                                                            Mobile:……………………………….……….

I realise that my child whilst in the care of Cranbourne Daycare and Kindergarten Centre will not be given

into the care of any person other than a guardian of the child except where authorisation has been given

by the guardian. I realise that the above emergency contacts & authorised nominees may be contacted in the event of an

emergency where the parents are not able to be reached.

Signature:                         

Authorised nominee means a person who has been given permission by a parent or family member to collect the child from the education and care service or the family day care educator.


 

OUR POLICY & PROCEDURES  – Our policy and procedure manual is displayed for viewing in all centres. If you would like a copy of this please provide an email address ___________________________________________________________

*for Cranbourne Daycare & Kindergarten use only– emailed   Yes / No Date: __________________ Signature _______

FEE POLICYI understand that it is Centre Policy that all entitlements in the form of Childcare assistance are to be paid directly to the service and that CCB will be claimed during absences and the holiday period. The centre maintains records relating to allowable absences. Fees are to be paid weekly or via direct debit. If your fees become more than two weeks in arrears you position will be reviewed. We request that parents apply for childcare benefit before commencing care at our centres.

Signature:                         

 

AFTER HOURS ARRANGEMENT. If your child is not collected from the centre by 6.30pm and you cannot be contacted, the emergency contacts will be telephoned and suitable arrangements will be made. This will however, not apply if you have made prior arrangements with us. A late fee may be charged.

 

EMERGENCY ACTION PLAN. I hereby give permission to the management and staff of CRANBOURNE DAYCARE & KINDERGARTEN CENTRE, in case of accident or emergency, to attend a medical practitioner, or Ambulance at my expense, and I further authorise that said medical practitioner to carry our such treatment as he/she may consider immediately necessary for my child. CRANBOURNE DAYCARE & KINDERGARTEN CENTRE’S EMERGENCY ACTION PLAN IS AS FOLLOWS:

Step 1. Trained first aiders will provide immediate first aid whenever an illness, injury or accident occurs. If after brief consultation with the coordinator or nominee it is felt that further medical attention is warranted we will attempt to contact either the parents or emergency contact immediately to ascertain whether you will take your child for medical attention, or you may prefer CRANBOURNE DAYCARE management or staff to take your child for medical attention immediately and then meet us there as soon as possible.

Step 2. If we are unable to contact either the parents of the emergency contact and your child needs emergency medical attention we will contact Casey Medical Centre and take your child immediately there.

N.B. In both step 1 and 2 if your child requires transportation from a centre staff member, they will be transported in a car with appropriate safety restraints.

Step 3. If we feel your child requires more urgent medical attention we will immediately call for an ambulance for transportation to hospital.

N.B. If your child suffers from a medical condition (i.e Anaphylaxis) staff will follow the Medical Action Plan that a medical practitioner has authorised and that you have provided the centre with.

 

Signature:                         

 

Confidentiality of enrolment records

The proprietor of the children’s service must ensure that information in the child’s enrolment record is not

divulged to another person unless necessary for the care or education of the child, to manage medical

treatment of the child, where expressly authorised by the parent or prescribed in the Education and Care Services National Regulations.

I __________________________________ (name) declare as the person with lawful authority of the child

referred to in this enrolment form that the information provided is true and correct and undertake to

immediately inform the children’s service in the event of any change to this information.

 

Signature:                         

Date: _______________

 

Lawful Authority

Parents
All parents have powers and responsibilities in relation to their children that can only be changed by court order. The Education and Care Services National Regulations refer to these powers and responsibilities as “lawful authority”. It is not affected by the relationship between the parents, such as whether or not they have lived together or are married. A court order, such as under the Family Law Act, may take away the authority of a parent to do something, or may give it to another person.

Guardians
A guardian of a child also has lawful authority. A legal guardian is given lawful authority by a court order. The definition of “guardian” under the Education and Care Services National Law Act 2010, also covers situations where situations where a child does not live with his or her parents and there are no court orders. In these cases, the guardian is the person the child lives with who has day to day care and control of the child.

 

PLEASE ENSURE THIS FORM IS SIGNED IN THE ‘6’ PLACES REQUIRED.

These forms are required to be completed fully prior to commencing care, and must be reviewed and updated annually and as required by the parent/ guardian