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Please use a separate form for each child - Field marked with an asterisk are mandatory

A $50 waitlist administration fee is required for each application (please refer to payment options below)

Child's Details:

Sex

Days Requested

Please select (minimum 2 days required)
Cottage at Commencement:

Parent Details:

Mother

Home Address:

Father

Home Address:

Special Needs

Shadforth Cottage is committed to providing quality Child Care for all children including those with special needs, allergies or medical conditions. If your child has any special needs, please provide details in the box below:

Priority of Access

The Commonwealth Government regards children at risk of abuse or neglect as a priority for access to Child Care.
Families in Crisis are also regarded as priority requiring support and assistance from Child Care services to the maximum extent possible.

The Commonwealth Government provides guidelines for Child Care centres for the purpose of meeting the Child Care needs of families with recognized work or work-related committmemts.

Where demands for care exceed supply, Shadforth Cottage will allocate available places to those families with the greatest need for Child Care support.

Every effort will be made within the guidelines to accommodate your Child Care needs, subject to available spaces.

Acknowledgement

I hereby acknowledge that the information provided above is true and accurate:

Clear Signature

Waitlist Administration Payment Options:

Payment of the $50 administrative fee is required to be submitted with this completed form.

Price: $50.00