Child 1

Child's Name
Gender
Date of Birth	Or estimate if not yet born
Additional Need or Disability

Child 2 (Optional)

Child's Name
Gender
Date of Birth	Or estimate if not yet born
Additional Need or Disability

Child 3 (Optional)

Child's Name
Gender
Date of Birth	Or estimate if not yet born
Additional Need or Disability

Child 4 (Optional)

Child's Name
Gender
Date of Birth	Or estimate if not yet born
Additional Need or Disability

Primary Parent / Guardian

Title
First Name
Last Name
Address
Postcode
Relationship to Child
Phone (Home)
Phone (Work)
Phone (Mobile)
Are You Currently...	Working Studying Seeking Work Home Duties
Place of Work / Study
Email

Other Parent / Guardian (Optional)

Title
First Name
Last Name
Address
Postcode
Relationship to Child
Phone (Home)
Phone (Work)
Phone (Mobile)
Are You Currently...	Working Studying Seeking Work Home Duties
Place of Work / Study
Email

What Days / Times Do You Require Care?

Day	Time
Monday	to
Tuesday	to
Wednesday	to
Thursday	to
Friday	to

When Do You Require Care to Begin?

Date

What Languagues Are Spoken at Home

Languages

How Did You Hear About Our Centre?

Please Select...	Website Newspaper Ad Brochure / Letterbox Drop Phone Book Friend Sibling Already Attends Re-Enrolment
Other

Please Nominate Which Centre/s You Would Prefer For Your Child's Enrolment

	Kids Academy Erina Heights 49 Serpentine Road Erina Heights 2260
	Kids Academy Glenmore Park 66-76 Woodlands Drive Glenmore Park 2745
	Kids Academy Hornsby 36-38 Northcote Road Hornsby 2077
	Kids Academy Penrith 1A Factory Road Regentville 2745
	Kids Academy Preschool 12-14 Womra Cres Glenmore Park 2745
	Kids Academy Regentville 1 Factory Road Regentville 2745
	Kids Academy Spring Hill 170 Leichhardt Street Spring Hill QLD 4000
	Kids Academy Warnervale 82-84 Mataram Road Woongarrah 2259
	Kids Academy Woongarrah 13-17 Hiawatha Road Woongarrah 2259