Kidzville ELC Waitlist

Kidzville Early Learning Centre Waitlist

A non-refundable $50.00 application fee applies.

Note: A place on our waiting list does not guarantee a position at the service.

Child's Name*:

Gender*:

TBC

DOB/Child Due Date:

Preferred Day(s):

Monday

Tuesday

Wednesday

Thursday

Friday

Are you flexible with the days selected above?:

Yes

Preferred Start Date:

Parent/Carer's Name*:

Parent/Carer's Name 2:

Contact No.*:

Contact No.:

Address:

Email Address:

Does your child have a disability, speech delay, additional need (i.e. behavioural concerns) Comments:

Does your child speak English?

What is the main language spoken at home?

Any children in your family who have/or are attending our service? Name(s):

Is your child of Aboriginal/Torres Strait Islander descent and recognised as such by the community?

Any further information which may be of assistance:

From January 2018, children who are not vaccinated due to parent conscientious objections can no longer be enrolled in child care. Is your child's immunisation up to date?

Payment Details

Please notify us immediately if any of the above information changes in any way. (Failure to do so may result in loss of position on waiting list). We have a firm commitment to protecting the privacy of our clients. Personal information collected on this form is for the purpose of contact and establishing priority of access only.