Rainbow Kidz Start After school/Before school Programme Enrolment

Rainbow Kidz - rainbow.kidz.start@gmail.com / 0210587675
Child's Name *
Your answer
Gender *
Date of Birth *
Caregiver/Parent Name *
Your answer
Relationship to Child *
Your answer
Address *
Your answer
Phone (home)
Your answer
Phone (work)
Your answer
Phone (mobile)
Your answer
Email *
Your answer
First emergency contact person - day phone *
Your answer
First emergency contact person *
Your answer
Second emergency contact person *
Your answer
Second emergency contact person - day phone *
Your answer
Child’s Doctor/Medical Centre (or last doctor seen) *
Your answer
Person/s authorised to collect child/ren *
Your answer
Personal info we should know (eg; custody arrangements, special needs)
Your answer
Medical Conditions/Allergies
Your answer
Special Instructions (eg; allowed to walk)
Your answer
School attending
Your answer
Will you be applying for a WINZ subsidy? *
If applying for a WINZ subsidy – your application with photocopies of documents need to be provided to us for processing
Rates & Payment
Full-time (before/afterschool ) $100 per week
Daily rate afterschool $15.00
Before School $10.00
Casual hourly $10
Transport $2.50 per day

Payment is required in advance of the programme. Once payment is received this will confirm your child/ren’s place.

Bank deposits/internet banking account details are:

Rainbow Kidz Start
ANZ Bank
A/C No 010 542 0087876 00

Please ensure your put your child/children’s initial and surname.

If you are applying for a WINZ subsidy, please complete all forms required and relevant documentation and hand into the coordinator for processing – no enrolments will be accepted without your WINZ subsidy forms.

Days attending
Please tick days attending
Weekly (before school)
Weekly (after school)
Parent Contract
I wish to enrol my child/ren in your Out of School Care and Recreation Service. I acknowledge and agree to the following conditions:

All children, including those attending casually must be formally enrolled.

All children attending after school care are to be collected no later than 5.45pm each day. A penalty fee ($20.00) will be charged for failure to collect children by this time as per the Fees Policy.

Parents/Caregivers are to sign their child/ren in and out of the programme every day they attend.

I give consent/permission for my child/ren using the transportation service provided by Rainbow Kidz.

Written consent must be given if their child/ren has permission to walk, bike or catch a bus home. This can be noted on the enrolment form.

If your child has other activities on after school and will not be using the transport provided, written consent must be given to Management/Supervisors advising where the activity is, what time the child/ren is expected at after school care.

Only persons appropriately identified on the enrolment form will be allowed to pick up a child unless Management/Supervisors have been previously advised, preferably in person or by phone.

On each occasion that the child/ren will not be attending, Management/Supervisors must be informed at least one day prior. Children will still be charged for absences and statutory holidays if they are booked on that day.

Any disagreement regarding fees is to be addressed to Management. Unpaid debts will be placed with a debt collection agency or Department of Courts and parents/caregivers will be liable for collection fees incurred.

Management/Supervisors will be advised immediately of any change in details contained in the enrolment form.

Management/Supervisors may arrange urgent medical treatment at my expense.

Management/Supervisors are allowed to administer Panadol/Paracetamol) to child/children if it is required

Management/Supervisors will be advised of any situation which may be disturbing my child/ren.

It is ultimately my responsibility to ensure that my child/ren acts in an appropriate manner while at Rainbow Kidz. Behaviour which consistently affects the quality of care available to other children may result in suspension or removal from the programme as set out in the Behaviour Management Policy.

Parents/Caregivers will pay for damage wilfully caused by my child/ren. I understand that my child/ren is responsible for their own property.

I give my permission for my child/ren to go on pre-arranged outings.

Photographs of my child/ren may be used for genuine resources or publicity.

If care is no longer required, two weeks’ notice in writing must be given to Management/Supervisors.

I agree to abide by the rules and procedures of Rainbow Kidz (a copy of all current policies/procedures & terms/conditions are held at the centre.

I understand that all staff are police vetted, and have appropriate experience for the job they do and that Rainbow Kidz complies with Health and Safety Policies and the National OSCAR standard. However accidents do happen and I will not hold Rainbow Kidz, its staff or volunteers responsible for genuine mishaps.

I acknowledge that the information contained herein is confidential and pursuant to the Privacy Act and will be only used by RKS – however representatives of MSD may view this information for programme assessment purposes

Declaration of acceptance
By sending this registration form, you agree/accept to Rainbow Kidz Start Policies & procedures/terms and conditions – copies available at Centre and on our website.
Name *
Your answer
Date *
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