Families are responsible for providing their child’s and the registered parents Customer Reference Number (CRN) and dates of birth. CCS cannot be applied to accounts until a successful enrolment is made with DHS. If you are not registered you will not receive any subsidy. Once your booking has been confirmed by Childcare Accounts, a successful link has been made with DHS, the registered parent will be required to approve each child’s booking pattern via their myGov account prior to any Child Care Subsidy being applied. Are you eligible for Child Care Subsidy Yes No CCS Registered Parent/Guardian Registered Parent/Guardian Name: CRN: Date of birth: Each has their own CRN for more information contact the Department of Human Services on 13 61 50. – 1 Name: CRN: Date of birth: Child 2 Name: CRN: Date of birth: Child 3 Name: CRN: Date of birth: Name of doctor: Doctors phone number: Doctors address: Medicare Number: Is your child covered by private health insurance?: Yes No Is your child covered for ambulance insurance?: Yes No Name of Fund: Name of Fund: Membership Number: Membership Number: I give permission for the program to seek information and advice from the doctor/medical centre named above regarding any medical condition experienced by my child/ren: Yes No I/we authorise that I/we have read and understood the YWCA Canberra Behaviour Management Policy and will adhere to the guidelines discussed therein. I/we acknowledge that I/we understand and will adhere to the consequences discussed in the policy if my child/ren has caused physical or emotional harm to another child, educator or visitor, has caused damage to Yes No property, equipment or resources or has caused significant disruption to the conduct of the program. I/we authorise educators of the school age care program to information about my child/ren with their primary school Yes No teacher: I/ we authorise for my child/ren to participate in local incursions/excursions (e.g. walks to local parks and sports ovals) under Yes No the supervision of educators (Permission will be requested for any excursions where transport is required):
Families are responsible for providing their child’s and the registered parents Customer Reference Number (CRN) and dates of birth. CCS cannot be applied to accounts until a successful enrolment is made with DHS. If you are not registered you will not receive any subsidy. Once your booking has been confirmed by Childcare Accounts, a successful link has been made with DHS, the registered parent will be required to approve each child’s booking pattern via their myGov account prior to any Child Care Subsidy being applied. Are you eligible for Child Care Subsidy Yes No CCS Registered Parent/Guardian Registered Parent/Guardian Name: CRN: Date of birth: Each has their own CRN – for more information contact the Department of Human Services on 13 61 50. 1 Name: CRN: Date of birth: Child 2 Name: CRN: Date of birth: Child 3 Name: CRN: Date of birth: Name of doctor: Doctors phone number: Doctors address: Medicare Number: Is your child covered by private health insurance?: Yes No Name of Fund: Membership Number: Is your child covered for ambulance insurance?: Yes No Name of Fund: Membership Number: I give permission for the program to seek information and advice from the doctor/medical centre named above regarding any medical condition experienced by my child/ren: Yes No I/we authorise that I/we have read and understood the YWCA Canberra Behaviour Management Policy and will adhere to the guidelines discussed therein. I/we acknowledge that I/we understand and will adhere to the consequences discussed in the policy if my child/ren has caused physical or emotional harm to another child, educator or visitor, has caused damage to property, equipment or resources or has caused significant disruption to the conduct of the program. Yes No I/we authorise educators of the school age care program to information about my child/ren with their primary school teacher: Yes No I/ we authorise for my child/ren to participate in local incursions/excursions (e.g. walks to local parks and sports ovals) under the supervision of educators (Permission will be requested for any excursions where transport is required): Yes No
Turner-School-Age-Care-Enrolment-Form.docx