• AFAC Creche Enrolment Form

    Please complete below form. Immunisation Records are also required for Creche enrolments.

  • Child 1 Details

  • Date of Birth*
     - -
    • Select drop down to enrol multiple children 

    • Child 2 Details

    • Date of Birth
       - -

    • Child 3 Details

    • Date of Birth
       - -

    • Child 4 Details

    • Date of Birth
       - -

  • Parent/Guardian 1 Details

  • Format: 0000 000 000.

  • Parent/Guardian 2 Details

  • Format: 0000 000 000.

  • Emergency Contact 1

    Please provide the details of an emergency contact person who is different from the parent/guardian listed above
  • Format: 0000 000 000.

  • Emergency Contact 2

  • Format: 0000 000 000.

  • Who is authorised to collect the child/ren from the service?

  • Family Court Orders

    If unable to upload documentation at this time, please email afaccreche@armadale.wa.gov.au when available. Alternatively bring all documentation on your first visit to the Creche.
  • Are there any family court orders affecting custody or access to the child/ren?*
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  • Allergies & Medical

    If unable to upload documentation at this time, please email afaccreche@armadale.wa.gov.au when available. Alternatively bring all documentation on your first visit to the Creche.
  • Does your child suffer from any medical or physical condition that needs to be brought to the attention of the staff?*
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  • Does your child suffer from Anaphylaxis*
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  • Does your child suffer from Asthma?*
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  • Have you given an Allergy Treatment/Asthma Action Plan to staff?*
  • In the event of accident or illness I authorise staff to obtain medical treatment and/or transport by ambulance for my child and agree to pay expenses incurred for for medical treatment and transport.*
  • Photo Permission: I agree to have photographs taken, of myself and/or the family members of which I am the parent/guardian, by the City of Armadale and grant the rights to use/publish the photograph(s) taken. I grant these rights with the understanding that they incur no fee and that I have no interest in the copyright of the photographs. I further understand that the photograph(s) may be used in a number of different publications and promotional items (both printed and electronic mediums), including provision to news publications.*
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  • Declarations

  • Disclaimer:

  • Should be Empty: