Enrolment Update Form

Yuma!

Thank you for taking the time to update your child's enrolment forms. It is essential to keep your enrolments up to date all the time; this is why we have implemented this annual re-enrollment process.

Please complete all relevant sections of your child's enrolment form and submit it to the centre. This is a regulatory requirement, and it will help educators understand your child's needs as well as record any changes.

** WVELC is bound to protect the privacyof children, families and educators.Educators are only permitted to haveaccess to personal information forprofessional and administrativepurposes. Only information relevant tothe centre will be kept on file.**

Child's Details

My child is currently enrolled in:

Child's Last Name *

Child's Given Names *

Date of Birth *

Child's primary address: *

Parent 1 / Guardian Details

Parent 1 - Last Name *

Parent 1 - Given Names *

Parent 1 - Primary address *

Parent 1 - Phone Number / Mobile *

Parent 1 - Email address *

Parent 1 - Placement of Employment / Occupation

Parent 1 - Work Phone Number

Parent 2 / Guardian Details

Parent 2 - Last Name

Parent 2 - Given Names

Parent 2 - Primary address

Parent 2 - Phone Number / Mobile

Parent 2 - Email address

Parent 2 - Placement of Employment / Occupation

Parent 2 - Work Phone Number

Which parent / guardian is the best to contact in case of emergency? *

Parent / Guardian 1Parent / Guardian 2

Emergency Contacts Other Than Parents / Guardian

To protect your child’s safety, only the people authorised on your child’s enrollment form can collect your child from their early learning centre. When someone other than aparent is coming to collect your child, we must be notified beforehand, and the person will need to produce photoidentification.

All Centre visitors must follow Woden Valley ELC Visitors to the service policy and Code of Conduct for Families.

I agree to give prior notice by phone or in writing, if anyone other than the people mentioned on this form, are to collect my child from the Centre.
*

I understand that the authorised person must produce photographic identification if requested, or my child will not be released to them. *

Suppose the centre has any doubt about the authorised person's ability to care for the child or safely transport them to the parent/guardian. In that case, the responsible person in charge has the right to refuse the child's release to the person, and the parent/guardian or ACT Police may be called. *

Emergency Person 1 - Full Name

Emergency Person 1 - Relationship to child

Emergency Person 1 - Date of birth

Emergency Person 1 - Residential address

Emergency Person 1 - Phone number

The Emergency Person 1 has authority to:

Collect / deliver my child to / from the serviceGive permission for excursions out of the service or incursions to the serviceConsent to medical treatment Permit transport of my child by an ambulanceRequest / permit a medication to be given If the parent / guardian cannot be contacted, this person should be notified of an accident, injury, trauma or illness involving child

The nominated emergency person is aware of them being nominated for that position, as well as all associated responsibilities and privileges.

Emergency Person 2 - Full Name

Emergency Person 2 - Relationship to child

Emergency Person 2 - Date of birth

Emergency Person 2 - Residential address

Emergency Person 2 - Phone Number

Emergency Person 2 has authority to:

Collect / deliver my child to / from the serviceGive permission for excursions out of the service or incursions to the serviceConsent to medical treatment Permit transport of my child by an ambulanceRequest / permit a medication to be given If the parent / guardian cannot be contacted, this person should be notified of an accident, injury, trauma or illness involving child

The nominated emergency person is aware of them being nominated for that position, as well as all associated responsibilities and privileges.

Medical Information

Name of your family doctor / GP clinic

Phone Number

Address

Is your child's immunisation up to date? *

YesNoUnknown

Upload your child's immunisation record

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Does your child have asthma, allergies or any other medical condition? *

YesNoUnknownIn diagnostic process

Upload your child's Emergency Medical Plan or Action Plan

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If yes, please provide details

Does your child takes regular medications? *

YesNo

Does your child have any diagnosed or undiagnosed developmental delays / additional need or is identified as neurodiverse? *

YesNoIn diagnostic process

Please provide details

Do you have any concerns about your child development and wish to discuss this further?

Dietary Requirements

Does your child have any dietary requirements? *

YesNoUnknown

Is the dietary requirement...

Medically diagnosedUndiagnosedFamily preferenceFamily cultural / religious belief

Please specify your child's dietary requirements / allergies or intolerances::

We love to celebrate special occasions such as birthdays, Christmas and cultural events. Remember we are a NUT-FREE CENTRE. If you would like to celebrate an occasion with your child, please speak to the Team Leader. Any food brought to the Centre must be clearly labelled with all allergens and ingredients present. *

Court Orders / Care Arrangements

Is your child a subject to court orders, parent orders or parenting plan relating to the powers and responsibilities of the parent in relation to the child or access to the child? *

YesNoIn process

Upload relevant documents

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Please provide details of the above

I give my permission to the Centre Director to discuss those details relevant to the placement of my child.

Is your child in a shared custody arrangements (not justified by the court orders)? *

YesNoIn process

If yes, please provide details regarding the care arrangements

Authorizations and Permissions

I give my permission to my child to attend Centre's regular outings: *

Community garden at the front of the ServiceGrassed area at the back of the ServiceRegular nature walks / excursions Emergency evacuation off site Neither of the above

I give my permission to take and use respectful photographs of my child for the purpose of: *

Learning documentation, assessment of learning or / and display within the roomGroup learning documentation visible to other families (e.g. daily reflections / excursions / group projects)Promotional purposes (e.g. Facebook Page, website, blog)Internal training materialsExternal training materials Neither of the above

Woden Valley ELC supports open and honest communication and respectful and reciprocal relationships. I understand that I can approach the team leaders or leadership team at any time to discuss any issues or problems I may have encountered. The staff has a right to stop any conversation and remove themselves from the situation if they feel threatened, unsafe or disrespected. *

I understand that Woden Valley Early Learning Centre is a non for profit community-based organisation. Furthermore, a level of community engagement is encouraged and expected. *

Any further comments

DECLARATION
I hereby declare that the information provided is true and correct. I also understand that any wilful dishonesty or withholding of crucial information may render for refusal of care or possible termination of care. *

Sign here *

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