Knox City Council - Registration Form

Central Registration for Participating Kindergartens

Registration for 3YO and 4YO Kindergarten
Knox City Council

LDC – Registration for Knox Long Day Care (Childcare)
Deferral Form

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Please note if you are interested in attending Funded Kindergarten in Long day care, please visit this link to complete the Long day Care registration form.
Child's Details
Child's Name*

First NameLast Name
Child's Date of Birth*

DayMonthYear
To be eligible for three or four-year-old kindergarten children must be three or four by 30 April in the year they commence. Please note Children are unable to commence until they turn 3. Contact the Central Registration team for further information.
Please attach confirmation of your child’s date of birth

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Gender*

MaleFemaleOther
Child's Residential Address*
Parent's Details
Parent / Guardian 1*

First NameLast Name
Relationship to the child*
Does the family require an interpreter?*

YesNo
Parent / Guardian 1 language
Does this parent live at the same address provided for the child?

Same as childDifferent address
Parent's Residential Address
Phone Number*
Mobile preferred
Email*
All correspondence will be sent to this email address
Would you like to add a second parent / guardian?*

YesNo
Parent / Guardian 2*

First NameLast Name
Relationship to the child*
Does this parent live at the same address provided for the child?

Same as childDifferent address
Residential Address
Phone Number*
Mobile preferred
Email*
Please Note: You will be notified of all correspondence via email
Please indicate your preferred approach for the sharing of data between you and Parent / Guardian 2 when completing enrolment details via our online portal.

Both parents can view and edit each others detailsParent / Guardian 1 can view and edit Parent / Guardian 2's detailsNeither Parent / Guardian 1 or 2 can view or edit each others details
Do you want parent 2 to view or edit your details when completing enrolment details?

YesNo
Do you want parent 1 to view or edit your details when completing enrolment details?

YesNo
Preferences
Registrations are prioritised using the Department of Education Priority of Access and local area criteria found on the Knox City Council Website
Do you wish to apply for Sessional Kindergarten or Long Day Care for this child?*

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Are you applying for an additional year of 4 year old funded kindergarten for your child as recommended by their teacher and approved by the Department of Education and Training?*

YesNo
Where did your child previously attend 4 year old Kindergarten?*
max 255 characters
Privacy Collection Notice
The personal information requested on this form is being collected by Knox City Council for the purpose of:
- Registration and allocation of kindergarten places as per the Department of Education Priority Access Criteria and local requirements,
- seeking updated information of kindergarten requirements,
- providing updates about the allocation process and/or
- directly related secondary purpose(s).
The personal information will be disclosed to the kindergarten service provider(s) operating kindergarten services preferenced on this form, or subsequent forms, for the purpose of enrolling children to funded sessional kindergarten places. All service providers are governed by Victorian privacy laws.

Personal, health, wellbeing and developmental information may be shared with relevant government departments and organisations including, but not limited to, the Department of Education, Municipal Association of Victoria, Knox City Council Maternal Child Health Nurses, Knox City Council Preschool Field Officers, medical, Allied Health and Specialist Support Service professionals. Information may also be shared under approved schemes including, but not limited to, the Family Violence Information Sharing Scheme and Child Information Sharing Scheme. It will not be disclosed to any other external party without your consent, unless required or authorised by law.

If the information requested on this form is not collected, Council will be unable to allocate a funded sessional kindergarten place.

Requests for information about what data is shared, access to and/or amendment of personal information, please contact the Early Years Registration and Support Officers via telephone 9298 8000 or email kindergarten@knox.vic.gov.au or contact Council’s Chief Privacy Officer.

Personal information will be stored with EnrolNow Pty Ltd ABN 711 497 11580 which is located in Australia for the purpose of registration, allocation and enrolment to participating funded sessional kindergarten programs.
Authorisation and Declaration
By submitting this registration form, I understand and agree to the following:
- All information provided by me is true and correct
- All information provided by me may be audited at any time. This registration or subsequent kindergarten allocation could be reallocated or withdrawn if the information is incorrect
- Failure to provide complete and correct information may result in the registration being excluded from the allocation process
- This is a registration form and does not guarantee a three or four-year-old kindergarten or long daycare placement
- Three and four-year-old kindergarten places are allocated separately. Every effort will be made to place my child at the same service for four-year-old kindergarten. However, there is no guarantee of this.
By submitting this registration form, I understand and agree to the following:
- All information provided by me is true and correct
- All information provided by me may be audited at any time. This registration or subsequent kindergarten allocation could be reallocated or withdrawn if the information is incorrect
- Failure to provide complete and correct information may result in the registration being excluded from the allocation process
- This is a registration form and does not guarantee a three or four-year-old kindergarten or long daycare placement
- Three and four-year-old kindergarten places are allocated separately. Every effort will be made to place my child at the same service for four-year-old kindergarten. However, there is no guarantee of this.
By submitting this registration form, I understand and agree to the following:
- All information provided by me is true and correct
- All information provided by me may be audited at any time. This registration or subsequent kindergarten allocation could be reallocated or withdrawn if the information is incorrect
- Failure to provide complete and correct information may result in the registration being excluded from the allocation process
- This is a registration form and does not guarantee a three or four-year-old kindergarten or long daycare placement
- Three and four-year-old kindergarten places are allocated separately. Every effort will be made to place my child at the same service for four-year-old kindergarten. However, there is no guarantee of this.
- I understand a bond payment of $75 per booked day is charged upon the acceptance of an offer of place and is payable via EFTPOS at the service, on or before the first orientation day.
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Yes
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Yes
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Yes
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Date

DayMonthYear
Date
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Cutoff Date

DayMonthYear
Date
Age as at cutoff
ineligible to apply
Country Of Birth
Offer_Response
Cultural background of the child and, if applicable, the child's parents
DNU Does the family require an interpreter?
DNU Language spoken at home
programType
transfers

Yes
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