Waiting List Application Form

Please ensure that you inform the centre of any changes in your child’s details

 

    (Date of Birth)

    (When Ideally Commencing Care)

    (Commencement Date)

    Is Your Child Immunised:   

    Approved for Government Rebates.

    Parent/Carer One

    Parent/Carer Two

    Completion of this form places your child on our waiting list but does not guarantee enrollment in our centre.

    There is a $50 non-refundable deposit required with this application.

    Payment Details:
    Acc Name: Kinder Palace Pty Ltd
    BSB: 032-282
    A/C: 347761
    Ref: Childs Name