$10,000 Grant for our Youth Space from Clovelly Community Bank Branch

Service & Care Requirements

Tell us about the care you need

Welcome to WAYS OOSH. This form takes around 15–20 minutes. You’ll need your child’s Medicare card, CRN (Centrelink Reference Number) and immunisation history.

What type of care are you enrolling for? *

Please select a service type.

Preferred start date *

Please enter a start date.

Child Details

Information about the child being enrolled

Child’s first name *

Required.

Child’s last name *

Required.

Preferred name

Date of birth *

Required.

Gender

Lives with

Home Address

Street address *

Required.

Suburb *

Required.

State

Postcode *

Required.

Centrelink / CCS

Child’s CRN *

Centrelink Reference Number — on your Medicare card or MyGov

Required.

Parent / Guardian 1

Primary contact details

First name *

Required.

Last name *

Required.

Relationship to child *

Required.

Mobile *

Required.

Email *

Please enter a valid email.

Parent CRN *

Your own CRN — required for CCS

Required.

Home phone

Work phone

Address

Street address *

Required.

Suburb *

Required.

State

Postcode *

Required.

Date of birth

Country of birth

Cultural background

Child lives with this parent?

Parent / Guardian 2

Complete if there is a second parent or guardian — otherwise click Continue

First name

Last name

Relationship to child

Mobile

Parent 2 CRN

Only if Parent 2 is claiming CCS

Home phone

Work phone

Street address

Suburb

State

Postcode

Child lives with this parent?

Emergency Contacts

At least one contact who is not a parent listed above

Emergency Contact 1

Full name *

Must be different from parents listed above

Required.

Relationship *

Required.

Mobile *

Required.

Home phone

Authorised to collect? *

Required.

Consent to medical treatment? *

Required.

Emergency Contact 2 (recommended)

Full name

Relationship

Mobile

Authorised to collect?

Are there any court orders affecting collection? *

Required.

Please provide details

Medical & Agreements

Final step — medical details, consents and declaration

Medicare

Medicare number *

Required.

Expiry *

Required.

Child’s number on card *

Required.

GP / Doctor

Doctor / Practice name *

Required.

Doctor phone *

Required.

Medical Conditions

Does your child have anaphylaxis? *

Required.

An anaphylaxis management plan must be provided before enrolment is confirmed. Staff will follow up.

Does your child have any allergies? *

Required.

Please describe

Does your child have asthma? *

Required.

An asthma action plan will be required. Staff will follow up.

Any other medical conditions? *

Required.

Please describe

Any dietary restrictions? *

Required.

Please describe

Is your child’s immunisation up to date? *

Required.

You’ll need to provide your AIR record. Download from MyGov > Medicare > Immunisation History.

Is your child currently on any medications? *

Required.

Name, dose, frequency and storage

Photo Consents

Learning stories (internal use only)

Social media

Marketing & website

Authorisations & Agreements

I authorise WAYS OOSH staff to administer first aid treatment to my child as required.
I authorise WAYS OOSH staff to seek emergency medical treatment for my child if I cannot be contacted.
I authorise WAYS OOSH to arrange transport for my child in an emergency situation.
I consent to routine care items being used as needed: sunscreen, band-aids, and insect repellent.
I have read and agree to the WAYS OOSH Family Handbook and all associated policies.
I have read and agree to the WAYS OOSH Fee Schedule and payment terms.

Declaration

Type your full name to confirm this enrolment is accurate and complete *

Please type your full name to confirm.

This serves as your digital declaration that all information provided is true and correct.

✓

Enrolment Submitted!

Thank you — we’ve received your enrolment for your child.

We’ll review your submission and be in touch within 2 business days to confirm everything is in order.

Questions? Call 0423 056 900 or email [email protected]

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