Holy Cross Outside School Hours Care 31 Kincumber Street, Kincumber NSW 2251 T: 0481 602 034 E: oshc.kincumber@catholiccaredbb.org.au W: Enrolment form All correspondence will be made via email unless otherwise specified. Please select primary email address for the family? Parent/Guardian 1 Parent/Guardian 2 Select days requested Monday Tuesday Wednesday Thursday Friday Before school care After school care Occasional care for special circumstances/emergency Staff only: Child Family name: Given name(s): Preferred name: / / Place of Birth: Gender: Male Female DOB: Address: Religion: Cultural background: Aboriginal Torres Strait Islander N/A Child's CRN (if applicable): Language(s) spoken at home: Name of school attending: Year at school and class: Parent/Guardian 1 Parent/Guardian 2 Full name: Full name: Relationship to child: Relationship to child: / / / / DOB: DOB: Address: Address: AH: M: W: AH: M: W: Email: Email: Preferred method of contact: AH M E Preferred method of contact: AH M E Occupation: Occupation: Employer: Employer: Work days/hours: Work days/hours: Ethnic/cultural background: Ethnic/cultural background:
Holy Cross Outside School Hours Care 31 Kincumber Street, Kincumber NSW 2251 T: 0481 602 034 E: oshc.kincumber@catholiccaredbb.org.au W: Enrolment form All correspondence will be made via email unless otherwise specified. Please select primary email address for the family? Parent/Guardian 1 Parent/Guardian 2 Select days requested Monday Tuesday Wednesday Thursday Friday Before school care After school care Occasional care for special circumstances/emergency Staff only: Child Family name: Given name(s): Preferred name: DOB: / / Place of Birth: Gender: Male Female Address: Religion: Cultural background: Aboriginal Torres Strait Islander N/A Child's CRN (if applicable): Language(s) spoken at home: Name of school attending: Year at school and class: Parent/Guardian 1 Parent/Guardian 2 Full name: Full name: Relationship to child: Relationship to child: DOB: / / DOB: / / Address: Address: AH: M: W: AH: M: W: Email: Email: Preferred method of contact: AH M E Preferred method of contact: AH M E Occupation: Occupation: Employer: Employer: Work days/hours: Work days/hours: Ethnic/cultural background: Ethnic/cultural background:
Holy-Cross-OSHC-Enrolment.docx