Preschool Registration Form For South Port Kindergarten

Parent's Name (Required)

Child's Name (Required)

Child's Date of Birth (Required)

Address (Required)

Email (Required)

Phone (Required)

In Catchment Area* (Required) - (Click on link above to see catchment areas) In Catchment Area* (Required) - (Click on link above to see catchment areas) Yes No

Please Select One or More (Required) Please Select One or More (Required) Special Needs Aboriginal Guardian of the Minister Not Applicable

Please Describe Your Child's Special Needs

Siblings Previously at Centre (Required) Siblings Previously at Centre (Required) Yes No

Preferred Days (Required) Preferred Days (Required) Monday/Tuesday Wednesday/Thursday

Intended School (if known)

Eligible Preschool Year (Required)

Kindergarten Start Date (Required)

Additional Information