Online Form - Creche enrolment form » Victoria Park Leisure Centre

Leisurelife	Gym
Monday - Thursday	5:30am - 8:30pm
Friday	5:30am - 8pm
Saturday	8am - 6pm
Sunday	8am - 4pm

Aqualife	Gym	Pool
Monday - Friday	5:30am - 8:30pm	5:30am - 8:30pm
Saturday and Sunday	7am - 5pm	7am - 5pm

Child 1 name*

Child 1 date of birth

childs sex

Child 2 name

Child 2 date of birth

child sex

Child 3 name

Child 3 date of birth

child sex

Parent/gaurdian name*

parent/guardian relationship to the child

Address

postcode

mobile contact number*

Email address*

Emergency contact*

Emergency contact number*

Emergency contact 2

Emergency 2 contact number

Does your child suffer from any medical or physical condition that needs to be brought to the attention of the creche staff? (For example: allergies; anaphylaxis; disability; medical conditions)

YesNo

If so please give a brief description of the condition or what will be required from creche staff

Please upload your child's vaccination history. Please note your child/ren must be fully vaccinated or up to date with their vacination history to attend creche*

Max File Size: 10.00 MB
Allowed File Types: .avi, .doc, .docx, .gif, .jpeg, .jpg, .mov, .mp3, .mp4, .mpeg, .mpg, .pdf, .png, .ppt, .pptx, .xls, .xlsx

I declare the information I have provided is complete and accurate.*

YesNo

I acknowledge that I have read and understood the condition of entry and will abide by this*

YesNo

I acknowledge that I will stay on premises while my child/ren are using the creche.

YesNo