Enrolment Form

The enrolment form is required to be returned and an orientation attended to at the service within 7 days to secure the offered day of enrolment.

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SGOOSH ENROLMENT FORM

 

Please contact the service if you require assistance in completing this form.


For each child please complete a separate Medical Information Form which includes, medical information, immunisation details & developmental information.

 

CHILDREN'S DETAILS :

 

CHILD 1

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CHILD 2

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CHILD 3

 
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CHILD 4

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DAYS OF ATTENDANCE (Please Tick) :

Please indicate the days of attendance (Before School Care – 7.00am to 8.55am, After School Care - 2.55pm to 6.00pm)

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CULTURAL CONSIDERATION :

 Education and Care Services National Regulations - Regulation 160 (f, g, h)

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 (Please note - for multiple children you will be directed to complete separate Medical Information Forms for each child at the end of this form)


MEDICAL INFORMATION CHILD 1:

Education and Care Services National Regulations - Regulation 160 (3a, I, j)

 

 

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If yes, a copy of the service’s Medical Conditions Policy will be provided, Individual Medical Management Plan, Risk Management and Communication Plan to be completed in consultation with educators medical practitioners, parent/guardian.
(it is best practice for parents/guardians to consult with the child’s registered medical practitioner in the development of this plan)

 

The plan should include:

  • A photo of the child
  • If relevant, state what triggers the medical condition, asthma, allergy or anaphylaxis
  • First aid needed
  • Contact details of the doctor who signed the plan
  • When the plan should be reviewed

Anaphylaxis/Allergy Action plans to be completed by a Medical Practitioner on the ASCIA template form.

Please provide details below

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If your child has diagnosed allergies or anaphylaxis please supply medication as outlined on your child’s management plan & ensure the form is accurate and signed by a medical practitioner.

Asthma

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A Child’s Asthma Record will need to be completed to identify standard asthma first aid plan or a copy of the formal asthma plan. 
Please supply an inhaler spacer and prescribed medication/Ventolin as outlined on your child’s management plan.

 

 

MEDICATION AGREEMENT

Medication will only be administered if it is in the expiry or use by date, original packaging, labelled and instructions that can be clearly read. The service medication form must be completed by the parent/guardian for medication to be administered by staff. Additionally, if the medication has been prescribed by a medical practitioner:

  • The label must contain the child’s name
  • Parent/Guardian must provide any verbal or written instructions provided by the medical practitioner.
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Child’s Registered Medical Practitioner or Service Details:

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Child's Dentist Details

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IMMUNISATION DETAILS/HEALTH: CHILD 1

 

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Please provide a copy of your child's: Immunisation History Statement

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DEVELOPMENTAL INFORMATION CHILD 1:

 

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STAYING IN BOUNDS: CHILD 1:

 

We have expectations that children will be responsible and stay in the designated areas within the school grounds.
Each session (morning/afternoon) children are informed by staff educators which areas are open.
If families have concerns with their child wandering and going out of bounds please discuss with us.

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If no, please discuss with the Centre Manager/Nominated Supervisor

 

FAMILY INFORMATION

 
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PRIMARY PARENT/GUARDIAN

Education and Care Services National Regulations - Regulation 160 (3b)

 
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SECONDARY PARENT/GUARDIAN

*This must be completed, unless you are a single parent/guardian family

 
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COURT ORDER

Education and Care Services National Regulations - Regulation 160 (3c, d)

 

Are there any court orders, parenting orders or parenting plans relating to the powers, duties and responsibilities or authorities of any person in relation to the child/ren or access to the child/ren? *

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If yes, please provide all relevant documentation and paperwork

 

Are there any other court orders relating to the child/rens residence or the child/rens contact with a parent or other person? Have photographs and names of unauthorised people been attatched to this form? *

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If yes, please provide all relevant documentation and paperwork

Please note that without this documentation we cannot legally enforce the order/s
please note all authorised contacts must use their own mobile phone number and pin code when signing in and out.

FIRST EMERGENCY CONTACT (THIS IS MANDATORY TO OBTAIN ENROLMENT)

Education and Care Services National Regulations - Regulation 160 (3b, ii, iii, iv, v) 161 (1a, I, ii, 1b)

There may be times or situations where your child/ren has had an accident, injury, trauma or illness and Parent/guardians cannot be reached or are unable to collect their child/ren.
To deal with these circumstances and in case of an emergency the service will inform the following person to collect and care for the child/ren.
This person must live a maximum of 30 minutes from the service and must provide identification when collecting the child/ren.
Please obtain the person’s consent before listing them as an emergency contact.

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SECOND EMERGENCY CONTACT

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CHILD CARE SUBSIDY (CCS)

Child Care Subsidy will be paid directly to the service to reduce the fees families pay. To claim Child Care Subsidy (CCS) families must meet eligibility requirements which include:

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If you need assistance with completing this form please speak to the Centre Manager who will be happy to assist you. Please ensure that if any details change, you notify the service immediately.

 

ENROLMENT AGREEMENT

Please read the following agreement carefully before signing. If you have any questions please speak with the Service Manager. Please tick the following items to authorise:

HEALTH & SAFETY

I/We give permission for our child/ren to:

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PHOTOGRAPHY & VIDEO:

I/We give permission for our child/ren to:

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WRITTEN AGREEMENT:

Service and Parent/Guardian must agree up-front on the arrangements for the care of a child. Arrangements must be recorded and kept up to date to ensure compliance. A change of days form must be completed when altering sessions of care.

 

Complying Written Arrangement

CWA

A CWA is an enrolment type used for families wishing to claim CCS now or in the future

Relevant Arrangement

RA

An RA is an enrolment type used for families not wishing to claim CCS

Additional Child Care Subsidy

ACCS

ACCS is used when a child care provider identifies that a child is at risk of serious abuse or neglect but there is no individual identifies to pay the child care fees

Arrangement with an organisation

 

 

Arrangement with an organisation is liable for the fees for the care of the child

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and Samuel Gilbert Out of School Hours Care Centre Inc. is an ongoing agreement between the Service provider and the Parent/Guardian, to provide care in return for fees. The Written Arrangement must contain a minimum amount of information set out in subsection 200B (3) of the Family Assistance Administration Act. Claimant registering or registered for Child Care Subsidy to complete.

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Name of Service: Samuel Gilbert Out of School Hours Child Care Inc

Service ID: 19000734V

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Expected session of care (Please Tick):

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Please tick the box to confirm you have read each point:

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ATTACHED DOCUMENTS:

Please ensure ALL of the following documents are attached to this application before submission:

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FURTHER INFORMATION:

 

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PRIVACY DISCLAIMER

We acknowledge and respect the privacy of its clients. The enrolment information that is collected assists us to meet our legislative obligations and to provide the best level of education and care for your child. By completing this form, you have consented to this information being collected. The information will be used by educators/staff members and relevant government authorities. You have the right to access and alter personal information concerning yourself or your child in accordance with the Privacy Act 1988 and our Privacy and Confidentiality Policy.

 

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