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Waratah OOsh Centre Enrolment Online

Enrolment Steps:

1. Please fill out the form below & submit it to the Waratah OOSH Centre (see the 'Form Submission Options' section below).
2. Please visit the Waratah OOSH Centre to make the payment. NOTE: Enrolment cannot be finalised until the payment is received.

Form Submission Options:
*Please note that for ease of administration, it is more preferrable to choose option A over filling out the online form (option B).

1. Download the form click here, complete it and either :

2. • Email it to us as an attachment to waratahoosh@iccnewcastle.com.au
   • Fax it to us at +61 249 603388.
3. Fill out the online form below.

	CHILD'S SURNAME	CHRISTIAN NAME	DATE OF BIRTH	Gender	Child's CRN
1				Male Female
2				Male Female
3				Male Female
4				Male Female

Child's School Grade

Agree - - I HEREBY GIVE PERMISSION FOR MY CHILD TO BE TRANSPORTED TO/OR FROM SCHOOL AND DURING VACATION CARE. I ALSO AGREE THAT UNDER NO CIRCUMSTANCE WILL I HOLD THOSE PERSONS IN AUTHORITY OF THIS CHILD CARE RESPONSIBLE FOR ANY ACCIDENT OR INJURY THAT MAY OCCUR WHILE TRAVELLING TO AND FROM THE SCHOOL.

Marital Status of Parents: Please select: Married De Facto Separated Divorced Does other parent have access to child/ren : Yes No Are there any custody/court orders made in relation to the child? if so please state conditions.
Mother	Father
Mother's Name Mother's Surname Date of Birth Phone Mobile Home Address Work Details part time full time casual/study Work Address Work Phone	Father's Name Father's Surname Date of Birth Phone Mobile Home Address Work Details part time full time casual/study Work Address Work Phone

Has the child been immunised? Yes No Immunisation date:

If immunised please write date. IF NO please write reason

COLLECTION OF CHILD

I hereby authorise the Director or Staff of the Waratah OOSH Centre to permit any of the following people to collect my child, namely:

I hereby authorise the Director or Staff of the Waratah OOSH Centre to DENY the following people access to my Child. (Please Name)

Contact 1	Contact 2
Name relation to child Home phone Mobile Work Phone	Name relation to child Home phone Mobile Work Phone

Do you agree that if medically warranted, the Director or Staff of the Waratah OOSH Centre should call an ambulance for your child? Yes No

Doctor Name Doctor Phone Medicare number

SPECIAL NEEDS

If your child has any additional needs, it is important for staff to have an understanding of this so that the appropriate level of care and support can be arranged. So please complete a special form relating to your child's needs

Does your child have a disability?


Does your child require extra support?


Is there need for assistance with behavioural management?


ATTENDANCE

Attendance Type Permanent Booking Casual Booking

Before School	After School	Vacation	Comments
Monday Tuesday Wednesday Thursday Friday	Monday Tuesday Wednesday Thursday Friday	Monday Tuesday Wednesday Thursday Friday

 

Vacation Care? Yes No bookings must be made separately each semester.

Date of Commencement

Enrolment fee $10.00 per child OR $20.00 per family

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