Common Contracts

Kenmore South OSHC 2021 Enrolment Form

Enrolment Form • October 21st, 2020

• Contract Type
  Enrolment Form
• Filed
  October 21st, 2020

Account Information Enrolment Type: ☐ Complying Written Agreement (Claiming CCS) ☐ Relevant Arrangement (Not Claiming) Account CRN: CRN Holder name: D.O.B: Child/ren Information Child/ren’s name Class D.O.B. Gender Child’s CRN 1 2 3 4 Parent/Guardian Information Full Name: Relationship to Child/ren: Address: Postcode: Mobile: Work: Home: Email: Authorisations (please tick): ☐ Collection ☐ Medical ☐ Emergency ☐ Excursion Full Name: Relationship to Child/ren: Address: Postcode: Mobile: Work: Home: Email: Authorisations (please tick): ☐ Collection ☐ Medical ☐ Emergency ☐ Excursion Is your child/children subject to a Family Court Order? ☐ Y ☐ N*if yes, please provide a certified copy of the order Is the child/children subject to a Domestic Violence Order? ☐ Y ☐ N*if yes, please provide a certified copy of the order Bookings Any changes made to these bookings must be submitted to KSSS OSHC in writing/emailed to enrolments.oshc@ksss-pnc.org.au Ca