Expression of Interest - Marayong South OSHC

Please complete the following in its entirety to confirm your expression of interest to enrol at Marayong South OSCH. A parent or legal guardian, who is listed in the child's enrolment record, must complete this form.

Privacy notice

We are collecting this information to process your request. We may not be able to do so without it. Supplying this information is governed by the Children (Education and Care Services) National Law (NSW).

We will store your personal information on our systems or in our office, where it will be used by our staff, contractors, Department of Education and Communities and Department of Human Services. Other people can request access to it under the Government Information (Public Access) Act 2009. You can ask us to suppress your personal information from a public register and we will consider your request in line with the Privacy and Personal Information Protection Act 1998. Our Privacy Management Plan sets out how you can access or correct your personal information. Please visit www.blacktown.nsw.gov.au for a copy of the plan.

Definitions

BCC or Council Blacktown City Council and/or its servants or agents operating the childcare service.

KEL Kids’ Early Learning

Parent The person signing this Agreement whether it be the natural parent, Court appointed Guardian or Foster Parent or the Department of Family and Community Services.

Parent 1 Is the parent or caregiver who is listed as Parent 1 on the enrolment form and who has applied for childcare subsidy on behalf of the child. The parent or caregiver is the person responsible for a child's care and the person who must pay child care fees. They may be the adult legally responsible for the child's care or their partner. In many cases, the parent or caregiver is the child's parent. However, the parent or caregiver may be another adult who is legally responsible for the day-to-day care, welfare and development of the child. They could be the partner of the child's parent, an adoptive or foster parent, a grandparent or other relative of the child. Only parent or caregiver are eligible for Child Care Subsidy or Additional Child Care Subsidy.

Service The child care service referred to above.

Disclaimer

Completion of this form does not guarantee an enrolment at my preferred Kids' Early Learning Blacktown City service. Your child’s priority of access level, educational needs and any additional needs, will be assessed for enrolment suitability of your preferred service using the information provided in this expression of interest form to ensure that the service can cater for our family needs including your preferred days and start date, service resources and availability.

I understand the conditions in the disclaimer above *

Applicable priority of access guidelines of the Federal Government are as follows: *

Priority 1: a child at risk of serious abuse or neglect Priority 2: a child of single parent who satisfies, or of parents who both satisfy, the work, training, study test Priority 3: any other child Within these main Priority categories, priority will also be given to children in: - Aboriginal and Torres Strait Islander families - families which include a disabled person - families on lower incomes - families from culturally and linguistically diverse backgrounds - socially isolated families - single parent families

Please tick the box that applies to you and your child. *

Expression of interest details

My child was previously enrolled in the SMOSH service *

Yes No

My child attends the following Primary School *

Marayong South Public SchoolBlacktown West Public School St John Vianney Parish School

Select your preferred Service *

Please note that all children who attend Blacktown West Public School or St John Vianney Parish School will need to be dropped off in the AM no later than 8:30 am and picked up in the PM not earlier than 3:20 pm to accommodate the bus timetable.

Drop Off & Pick Up Times Understanding *

I understand the drop-off BSC and pick-up ASC times and conditions described above.

Select your preferred start date *

Child Details

First Name *

Last Name *

Date of Birth *

Child's Primary Address *

Street AddressStreet Address Line 2

City

State / Province

Postal / Zip Code

Does this child have any additional needs including: Anaphylaxis, Asthma, Hearing, Sight, Speech, Dietary Requirements & Restrictions,Medical Conditions, Operations, Illnesses or Intellectual or Physical Impairment, Disability or Delays? * *

Parents Details

Parent 1

First Name *

Last Name *

Email Address *

Mobile Phone *

Signature *

Draw signature|Type signatureClear

Date

Verification *