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Registration form
Child's Information and Date of Birth
Child's Information and Date of Birth
Child's Name
*
Child's Surname
*
Date of Birth
*
Gender (optional)
Gender (optional)
Female
Male
Known Allergies or Medical Conditions
*
Parent/Guardian Information
Parent/Guardian Information
Parent/Guardian Full Name(s)
*
Relationship to Child
*
Contact Number
*
Email Address
*
Home Address
*
Emergency Contact Information
Emergency Contact Information
Emergency Contact Full Name
*
Relationship to Child
*
Phone Number
*
Childcare Service Requirements
Childcare Service Requirements
Preferred Start Date
Days of the Week Required (e.g., Monday, Wednesday, Friday)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Service Type
Full Day
Half Day
After Hours
Child's Educational and Care Needs
Child's Educational and Care Needs
Any special educational needs
Preferred activities or interests
Any additional care needs or dietary restrictions
Consents and Permissions
Consents and Permissions
Consents and Permissions
*
Consent for emergency medical treatment
Consent for participation in trips and photo taking for childcare activities
Data protection consent (for storing and using personal information)
Agreement Section
Agreement Section
Acknowledgement of terms and conditions
*
Acknowledgement of terms and conditions
Date
*
HP Name
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