Child's InformationChild's Name(Required) Given Names Last Name Address(Required) Street Address Town State Postcode Gender(Required)FemaleMaleNon-BinaryDate of Birth(Required) Kindergarten Start Year(Required)(Child will turn 4 by June 30th of this year) During their Kindergarten year will your child also attend another early childhood program?(Required) No Kindergarten Child Care Centre Family Day Care Other If your child gains a placement in our Kindergarten program, will you acknowledge this as your only access to a minimum of 15 hours of an Approved Kindergarten Program?(Required)(Priority of offer of placement may be given to those families who acknowledge this service as their provider of an Approved Kindergarten Program for 15 hours due to funding eligibility. Please refer to Access and Admissions policy.) Yes No If no, name of other program: Has your child been diagnosed with additional needs and/or has your child attended any allied health services such as occupational therapist, speech therapist etc?(Required) Yes No If yes, details:Additional CommentsParent/Guardian InformationParent/Guardian 1Parent 1 Name(Required) First Last Parent 1 Email(Required) Parent 1 Phone(Required)Parent 1 Alternative PhoneParent 1 Address(Required) Street Address Town State Postcode Parent 1 Date of Birth(Required) Parent/Guardian 2Parent 2 Name First Last Parent 2 Email Parent 2 PhoneParent 2 Alternative PhoneParent 2 Address Street Address Town State Postcode Parent 2 Date of Birth Waiting List FeeDo you agree to our Waiting List Fee terms(Required)I wish to apply to have my child’s name included on the enrolment list for Beerwah and District Kindergarten, and agree to transfer a non-refundable fee of $10.50 per application. I understand that this does not automatically entitle my child to a place, but will depend on vacancies at the appropriate time. I also understand that it is my responsibility to inform the Director of any changes to the addresses or phone numbers listed below. Yes, I agreeWaiting List Fee(Required) Price: Credit Card(Required) Cardholder Name Card Details CAPTCHACommentsThis field is for validation purposes and should be left unchanged.
