Play CC&K Waitlist/Enrolment/CWA

This enrolment form has been signed and cannot be changed

Password Confirmation

If you are a returning to update your form, please use the link sent by email from Play CC &K

Child Details


 

Payment is required on or prior to Tuesday of each week.

Expected pattern of care required

 

Requested

Monday
Tuesday
Wednesday
Thursday
Friday

Offered

Monday
Tuesday
Wednesday
Thursday
Friday
I have checked my days offered are correct for the year

Parent/Guardian (Primary Contact)

Child details

 

Cultural background of child/child's parents

Name and contact details of the parties to the arrangement

A Parent, Guardian or Person with parental responsibility fo the child under a decision or court order must be listed

 
 
 
 


Child Care Subsidy

 
 
 
 

Emergency Contacts / Authorised Nominee's / People with Authority Authorise

(Do not include parent/s name/s) Your consent is required for other people to: collect your child from Play CC&K on your behalf; be called in an emergency when you cannot be immediately contacted;Acknowledge incident ,illness, injury notification. authorise staff to administer medicine/medical treatment; and authorise the taking of the child outside the service by an educator on excursions/regular outings. Please complete the below details of those people you authorise to act on your behalf in these matters.

** Please ensure these contacts are willing and able to collect your child in the event of an emergency.

*Please inform these contacts that they will need to provide photo ID when collecting your child until they are known to staff.

*A typed name in the signature box is sufficient for initial contacts listed, however any contacts added later will need to be signed.

A minimum of 2 contacts are required



Please review all fields

Medical Information

Doctor / Medical Centre


Child Health Information

Child health record means a record that documents a child's health & development assessments and immunisations

 

If yes, please provide to the service for sighting.

 
Please provide details of any special needs and enter any management procedures to be followed with respect to their additional need?
 
Please provide details of cultural requirements
 
 
 

If your child is at risk of anaphylaxis you will be provided with a copy of our Medical Conditions Policy and a risk minimisation plan will be completed in consultation with you. You will be required to provide Play CC&K with an individual medical management plan, signed by the medical practitioner who is treating your child. This will be attached to your child’s enrolment form and displayed on the wall of the service. You must also provide the exact medication that is listed on the plan for your child for use at the service.

 

Please outline the condition/s below and provide an Action Plan signed by your medical practitioner outlining details of each medical condition and management procedures to be followed with respect to this medical condition.

(eg.Asthma Action Plan). You must also provide the exact medication that is listed on the action plan for use at the service (eg. If the plan states ‘Ventolin’ you must provide ‘Ventolin’ not ‘Asmol’)

 

Please outline these below and provide an Allergy Plan or Letter signed by your medical practitioner outlining details of each allergy/sensitivity and management procedures to be followed with respect to the allergy/sensitivity.

 

You will need to provide a copy of your childs immunisation histroy statement from the Australian Immunisation Register.

You do not meet the requirements for ‘NO Jab, NO Play’ and your child will not be able to commence care until this information is provided.

Consent to Emergency Medical Treatment

a person/s with lawful authority of the child referred to in this enrolment form,

  • Agree to collect or make arrangements for the collection of the child referred to in this enrolment form if s/he becomes unwell at Play CC&K;
  • Consent to the ‘responsible person on duty’ to seek medical treatment for the child from a medical practitioner, hospital or ambulance service & to the transportation of the child by an ambulance service.
  • Agree that I/we will be in all respects liable to meet and pay all costs, fees and expenses associated with the provision of any such services.

Note: you do not need to print and sign this page, Play CC&K staff will present the hard copy for you to sign once you have been offered a space. However by returning this form via email you are acknowledging that all information in this form is true & correct.

Authorisations

I give the management/staff of Play CC&K the authority to:
 
 
 

Court Orders Relating to the Child

 

1. Please bring the original court order/s for staff to see

2. If these orders:
 a) Change the powers of a parent/guardian to:

  • Authorise the taking of the child outside the service by a staff member of the service;
  • Consent to the medical treatment of the child;
  • Request or permit the administration of medication to the child; AND/OR
  • Collect the child from the service,
 b) Give these powers to someone else,

How did you find out about Play CC&K

Acknowledgement

Confidentiality of Enrolment Records

The Approved Provider ensure that information in the child’s enrolment record is not divulged to another person unless necessary for the care or education of the child. Education and Care Services Regulations, 2011.

FEE ARRANGEMNTS & ADDITIONAL AGREEMENTS

I/we understand that:

  • The fee scheulde is set out in the Fee Policy which is reviewed & varied annually, all fees are payable in advance on the Tuesday of each week and late fees will be charged each day until full payment is made.
  • A fee bond is payable per child on enrolment prior to commencing care. This fee bond will be only be refunded when I leave the service providing I have given the required notice to cease care (2 Weeks) and my fees are paid up to date.
  • If fees are in arrears for more than one week, my child’s booked days will be suspended or cancelled (fees will continue to be charged for the required two week notice period) and we will be liable for all additional costs incurred by the Centre in collecting any outstanding fees.
  • Fees will continue to be charged for booked days including public holidays and non-attendance due to illness & being away on holidays (I am aware that ccs may not be claimable for extended absences from care).
  • Full fees are payable until Child Care Subsidy confirmation is received from the Family Assistance office & subsidy is not payable until the first actual attendance or for any notice period that is not attended (as per family assistance law).
  • If my child care subsidy is ceased or revoked at anytime throughout the year, those fees are payable in full as invoiced the following week (ccs adjustments are generally paid to the family, in the case that an adjustment is made to the service a credit will be reflected on a future invoice).
  • I/we must notify office staff of any absent days as soon as possible, including details of any contagious illnesses or planned holidays.
  • I/we must notify staff if my child is to be collected by any person other than those nominated on the enrolment form and sign them in on enrolment form as soon as possible.
  • The staff at Play CC&K may check my child’s hair in the event of a case of head lice being detected.
  • The staff at Play CC&K will apply (or assist in applying) a band-aid, sunscreen, insect repellent &/or nappy rash cream to my child when required unless an allergy to any of these items is identified in the allergy section of this form (there are preference forms to complete if a alternate brand/product is to be used).
  • My child may be observed by students & trainees as they are mentored by Play CC&K Educators.
  • I/we understand and agree that our child may be subject to video surveillance which will be used in accordance with privacy laws. Any cameras that are in the service will be visible, notice of the surveillance will be provided by way of signage visible in the foyer and recorded footage will not be available for families to view on playback at any time. 
  • I/We authorise the service to take, use and store images and videos of my child (my preferences about how these are used by the service is in the authorisations section).
  • I/We understand that whilst we do our best to keep things safe, Play CC&K takes no responsibility for lost or damaged personal items including, but not limited to, clothing, glasses & medical equipment.
  • I/We understand that Play CC&K reserves the right to refuse or terminate my child’s care based on any conflict of interest deemed problematic by management of Play CC&K.
  • I/We confirm that all information contained in this form is true and correct and undertake to notify the centre immediately for any changes.
  • I/We have an obligation to abide by all of the centre policies & procedures and agree to engage with staff in a positive and respectful manner in relation to all aspects of my child’s care/education and if required, follow appropriate grievance procedures.

Educa

Play CC&K uses a program called Educa. The web based program allows us to share photos, learning stories, news snippets & reminders quickly and securely with our families. It is our system of documentation and provides a record of your child’s learning.

Educa allows linked family members (parents/grandparents etc) to view learning updates sent from Play CC&K throughout the day in a secure electronic environment.

Once we have added you to our Educa system and we have linked all desired family members, Play CC&K educators will be able to post photos, learning stories and reminders at any time during the day. You will then be able to access them at anytime on your smart phone, ipad or computer.

If you wish to be a part of the Play CC&K Educa system please complete the form below.

Ongoing Play CC&K Educa Permission Form

I allow Play CC&K educators to add my family to Educa; invite the family member’s nominated below; and post photos of & learning updates for my child/ren to Educa.

I understand that family members I have nominated (below) will see all posts my child/ren is tagged in and any news or reminders and group photos added to Educa. Group photos that feature my child may also be shared with other Play CC&K families via Educa.

 

Family Member/s & email addresses (you can have just 1 or up to 4):



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