Tamworth Regional Council

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This form is to be completed BEFORE your child/ren can attend Year Round Care.

The information provided by you will be treated as strictly confidential and will not be used for any other purpose.

Parents are requried to provide Customer Reference Numbers (CRN) for yourself and your child/ren.

First Child to Enrol
Child 2
Child 3
Child 4
Summary
Parent / Guardian Information
Parent / Guardian 2 - Information
Collection / Emergency Contact

Persons collecting children from the centre MUST be 16 years of age or over.  Any person not on this form will be refused collection unless prior arrangements are made with educators.  

If custody orders apply, a copy must be kept on your child/ren's file.

The Medical Consent nominee is authorised to consent to medical treatment of, or to authorise administration of medication to the child/ren.

*These people may be asked to show identification

Collection / Emergency Contact 1
Authorised Contact Type*required
Collection / Emergency Contact 2
Authorised Contact Type*required
Family Doctor
Relevant Medical History

Action Plan, Risk Minimisation and Communication Plan need to be completed prior to enrolment.

Please tick all that apply and provide further information in the space provided below. A Risk Minimisation Form may also need to be completed. Please see an educator for further information.
Immunisation

Please provide an up-to-date copy of your child/ren's immunisation record.  This must be provided before your child/ren can attend Year Round Care.  If you are unable to upload a copy of your child/ren's record at the moment, please ensure a copy is provided to the centre prior to your child/ren commencing care.

Immunisation history statements are available online using your myGov login.  Click here to log in.

Copies may be uploaded in JPG or PDF format and each file must be 10 MegaBytes (10MB) or smaller.

Service Access
Please specify the reason for child care*required
Special Considerations
Service Requirements
Requirements

Confirmation is required each term for Before School Care and After School Care.

Vacation Care bookings are taken from Week 8 each term.

Please select the days you require
General Information
Declaration

All parents wishing to enrol their child/ren at Year Round Care must read and understand the Dealing with Medical Conditions policy.  

Privacy Statement
Any personal information you have supplied to or is collected by Tamworth Regional Council will only be stored and processed by Council for lawful purposes directly related to the functions and activities of Council.  Any personal information supplied will only be disclosed to a third party for the purpose of performing a lawful function or activity and for no other purpose.  Disclosure of personal information to a third party will be in accordance with Tamworth Regional Council's Privacy Management Plan
Mandatory field(s) marked with *