Enrolment Form Cranley

Enrolment Form Cranley

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  • Enrolment Form

  • Child Information

  •  -  - Pick a Date
    • Parent or Guardian Information  

    • Parent or Guardian Information

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    • Other Person/s Authorisations  

    • Other Person/s Authorisations

      Please list below the details of those people who you have authorised as emergency contacts for the child. This list may be amended at any time. In the event that the parents or guardians cannot be contacted the person/s listed below with authority will be contacted regarding collecting the child, in even of an emergency involving the child, consent or medical treatment or the administration of medication, or to authorise an Educator to take the child outside of the Service premises.

    • Contact #1
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    • Court Orders in Relation to the Child

    • Are there any:

      • Court orders, parenting orders or parenting plans relating relating to the powers, duties, responsibilities or authorities of any person in relation to the child or access to the child?
      • other court orders relating to the child's residence or the child's contact with a parent or other person?
    • Child's Health Information  

    • Child's Health Information

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    •  -  - Pick a Date
    •  -  - Pick a Date
    • Child's Medical Information  

    • ANAPHYLAXIS

    • If Yes, please supply the service a device with a valid expiry date and a copy of of Anaphylaxis Action and/or management Plan.

    • ALLERGIES

    • if Yes, please provide details of any allergies and any management plan/s or risk minimisation plan/s to be followed with respect to the specific health care need/s or medical condition/s. Attach a copy of any plan/s or additional pages if necessary.

    • Child's Immunisation Status  

    • Please attach a copy of the child's Immunisation Record.

    • Additional Information  
    • Authorisation and Declaration  
    • Should be Empty:
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