Waitlist Form

Please use a separate form for each child - Field marked with asterik are mandatory

Child's Detail

Given Name

Surname

Child's Address

Sex

Male

Female

Birthday

Place of Birth

Primary Language Spoken

Commencement Date for Care

Days Rquested

I am flexible with my required days but my minimum number of days to commence with are (minimum 2 days required)

Other Notes for days requested

Parent Details

Mother Name

Father Name

Mother CRN Number

Father CRN Number

Mother Date of Birth

Father Date of Birth

Mother Home Address

Father Home Address

Mother Home Phone

Father Home Phone

Mother Work Phone

Father Work Phone

Mother Mobile Phone

Father Mobile Phone

Mother Email Address

Father Email Address

Special Needs

Bambini Day Care is committed to provide quality Child Care for all children including those with special needs, allergies or medical conditions. If your child has any special needs, please provide details in the box below:

Priority of Access

The Commonwealth Government regards children at risk because of abuse or neglect as a priority for access to child care.

Families in crisis are also regarded as a priority, requiring support and assistance from child care services to the maximum extent possible.

The Commonwealth Government provides guidelines for child care centers for the purpose of meeting the child care needs of families with recognized work or work-related commitments.

Where demands for care exceed supply, Bambini Day Care will allocate available places to those families with the greatest need for child care support.

Every effort will be made within the guidelines to accommodate your child care needs, subject to available spaces.

Acknowledgement

I hereby acknowledge that the information provided above is true and accurate:

Parent Signature

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Parents Name

Date