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 *

Maximum size of ALL attachments is 976.56 MB

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