CRECHE ENROLMENT FORM BENEFITNESS & HEALTH CENTRE
Welcome to our Creche/Kids Club
Terms of Creche
Welcome to our creche. In order to provide a safe and happy environment for your child/ren, we have a few terms we ask everyone to abide by:

If your child/ren are unwell, please do not bring them into the creche. If they are displaying any flu like symptoms, please keep them home. We also cannot accept any children with such conditions as chicken pox, conjunctivitis, gastroenteritis, diarrhoea, vomiting and head lice.

Due to COVID-19 restrictions, we will not be feeding children snacks while in the creche.

Please bring a named water bottle.

All possessions, bottles, dummies, bags etc. must be clearly named.

Please bring any necessary toilet provisions (nappies, change of clothing for emergencies) and sunscreen and a sun hat.

Child's First Name *
Child's Surname *
Child's Date of Birth *
MM
/
DD
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Gender *
Medical Conditions including medications
Allergies
Special Needs
Parent's First Name *
Parent's Surname *
Parent's Contact Number *
Emergency Contact:
The following emergency contact person has permission to collect my child from creche if unforseen circumstances arise.
Emergency Contact Name *
Relationship to Child *
Emergency Contact Number *
Date *
MM
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DD
/
YYYY
In the case of an emergency or accident, I give permission for staff to administer first aid to my child or call an ambulance if required. *
Required
By ticking yes below, I agree to the terms of creche. *
Required
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