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    Student information











    DiabetesAnaphylaxisAsthmaEpilepsyAllergiesOther






    Primary Guardian information






    Secondary Guardian information






    Personal Information




    Program Selection



    Program Details



    Monday

    Tuesday

    Wednesday

    Thursday

    Friday

    Saturday

    Sunday

    Morning
    Morning classes available 9am to noon

    Preference:

    Preference:

    Preference:

    Preference:

    Preference:

    Preference:

    Afternoon/Evening
    Afternoon classes available 12pm to 8:30pm

    Preference:

    Preference:

    Preference:

    Preference:

    Preference:

    Preference:

    Program Details

    Monday

    Tuesday

    Wednesday

    Thursday

    Friday

    Saturday

    Sunday

    Morning
    Morning classes available 9am to noon

    Preference:

    Preference:

    Preference:

    Preference:

    Preference:

    Preference:

    Preference:

    Afternoon/Evening
    Afternoon classes available 12pm to 8:30pm

    Preference:

    Preference:

    Preference:

    Preference:

    Preference:

    Preference:

    Preference:

    Program Details

    Monday

    Tuesday

    Wednesday

    Thursday

    Friday

    Saturday

    Sunday

    Morning
    Morning classes available 9am to noon

    Preference:

    Preference:

    Preference:

    Preference:

    Preference:

    Preference:

    Afternoon/Evening
    Afternoon classes available 12pm to 8:30pm

    Preference:

    Preference:

    Preference:

    Preference:

    Preference:

    Preference:



    Program Details


    Family Information






    Medical History






    DiabetesAnaphylaxisAsthmaEpilepsyAllergiesOther







    Please provide your local GPs details:





    Emergency Details

    Emergency Contact 1






    Emergency Contact 2







    Pick Up Authorisation

    Person/s who may pick up your child on a less frequent basis. Any person unfamiliar to our staff will be required to show identification and will not be allowed to collect your child without written and/or verbal permission from the parents/guardians.

    Authorised Pick Up Person 1






    Authorised Pick Up Person 2






    Acknowledgement