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We are licensed to cater for 3-6 year olds. Your child must be 3 before being eligible to start.

CHILD'S NAME:

DOB:

BIRTH COUNTRY:

PARENT 1 NAME:

ADDRESS:

EMAIL:

OCCUPATION:

WORK NO:

HOME PHONE:

MOBILE:

PARENT 2 NAME:

ADDRESS:

EMAIL:

OCCUPATION:

WORK NO:

HOME PHONE:

MOBILE:

Is your child Immunised?

Yes

No

Has your child ever attended or do they currently attend other children's services such as Yarran Early Intervention Centres, Speech Therapy, Kid's on the Coast etc?

No

Yes

If yes, which?

Is your child currently taking regular medication for conditions such as Asthma, Diabetes, A.D.D, A.D.H.D, Epilepsy or other Medical Conditions?

No

Yes

If yes, which?

Please tick the following if applicable:

Health Care Card

Cultural & Linguistic Diversity (CALD))

Aboriginal / Torres Strait Islander

Please circle the day(s) you wish your child to attend (please circle):

How did you hear about our Preschool?

Signature

Date

Contact Our Team

Kinburra Preschool

Wait List Form

Contact Us

Site Links

Enrolment Information

Contact

Trading Hours

Acknowledgment to Country