Child Details

Given name

Surname/family name

Child’s official first name

Child’s official last name

Official Middle Name 1

Official Middle Name 2

Birth Date

Gender

Residential Address

Alternative Address

Languages

Ethnicity

IWI

How did you hear about us?

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Have you created an enquiry account on our website before, or have another child at the centre?

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Contact(s)

Parent(s) / Guardian(s)

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Title

Relationship

First Name

Last Name

Phone (Mobile)

Phone (Work)

Phone (Home)

Personal Email

Address

Occupation

Emergency contact(s)

Add emergency contact(s) other than Parent/Guardian - must be able to pickup your child.

Emergency Contacts

Title

Relationship

First Name

Last Name

Phone (Mobile)

Phone (Work)

Phone (Home)

Personal Email

Address

Additional contact(s)

Do you have any additional people that can pickup your child? If so, please enter them here and press Next when you are done.

Contact Details

Title

Relationship

First Name

Last Name

Phone (Mobile)

Phone (Work)

Phone (Home)

Personal Email

Address

Pickups prohibited by

Important - are there people who specifically cannot pickup your child? If so, please enter their details here.

Contacts who can not pickup your child

Title

Relationship

First Name

Last Name

Phone (Mobile)

Phone (Work)

Phone (Home)

Personal Email

Address

Please note: A copy of any court document/custody order and details of any custodial arrangements will be required to keep on file for staff to sight.

Health

Child's Doctor

Health

Medicines

Permissions

Please indicate below whether you give permission for your child to:

Custom Fields

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Enrolment

Please choose the dates and days below. Note the service may require you to enrol a certain number of days.

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Last day

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Mon To

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Tue From

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Wed From

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Thu From

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Fri From

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Sat From

Sat To

Sat Ece hrs

Sun From

Sun To

Sun Ece hrs

Mon Session

Tue Session

Wed Session

Thu Session

Fri Session

Sat Session

Sun Session

STATUTORY HOLIDAYS/ TERM BREAKS

This enrolment agreement is inclusive of all school term breaks. Little Pohutukawa Preschool Childcare is closed on all Statutory Holidays and for approximately two weeks over Christmas period. Please speak to the centre administrator for more details.

Enrolment Uploads

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Child Details

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Contact(s)

Parent(s) / Guardian(s)

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Add Parents / Guardians

Emergency contact(s)

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Emergency Contacts

Additional contact(s)

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Contact Details

Pickups prohibited by

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Contacts who can not pickup your child

Health

Child's Doctor

Health

Medicines

Permissions

Permissions

Custom Fields

Enrolment

Enrolment

STATUTORY HOLIDAYS/ TERM BREAKS

Enrolment Uploads

Little Pohutukawa Preschool

Little Pohutukawa Preschool