Parent-Child Class Enrolment

Please complete one form per child. Your enrollment will be based on class availability. You are welcome to contact us to enquire about availability before completing this form, otherwise we will contact you should your chosen day be unavailable.

Child's Name *

First

Last

Age *

Date of Birth *

(dd/mm/yy)

Parent/Guardian's Name *

First

Last

Mobile Phone Number *

Home or Work Phone Number

E-mail *

Day of week preference for Seaford Kindergym? *

What date/week would you like to commence classes?

Please note: Seaford Classes run from 1st day of school year (usually mid-late January) through until last day (usually mid-Dec) with no school term breaks.

Emergency Contact *

First

Last

Emergency Contact Phone Number *

Emergency Contact Relationship

Does your child have any allergies, medical conditions, challenges or sensitivities that we should be aware of? *

(Please note: you will be required to complete a Medical Form at your first class)

Has your child been immunised as per the National Immunisation Program Schedule? *

YES - Please bring a copy of your Child's Immunisation Record with you to class
NO - We will contact you to discuss further

Do you consent to your child being photographed? *

(Please note: more information is provided on our Photography Consent Form to be completed at your first class should you choose to consent)

Lastly, how did you hear about us? *

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