Section 1
Questions 1-10
Complete the form below.
Write ONE WORD AND/OR A NUMBER for each answer.
Early Learning Childcare Centre
Enrolment Form
Example
Parent or guardian: Carol 0 Smith
Personal Details
Child’s name: Kate
Age: 1
Address: 2 Road, Woodside, 4032
Phone: 3345 9865
Childcare Information
Days enrolled for: Monday and 3
Start time: 4 AM
Childcare group: the 5 group
Which meals are required each day? 6
Medical conditions: needs 7
Emergency contact: Jenny 8
Relationship to child: 9
Phone: 3346 7523
Fees
Will pay each 10
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