Step 1: Tell us a bit about yourself
Your Name
*
Your Email
*
Your Phone
*
Your Suburb
*
Step 2: About your child
Child's Name
*
Child's Birthday/Due Date
*
When are you looking to start care?
*
What days do you need care for?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Would you like to register another child?
*
Yes
No
Child's Name
*
Child's Birthday/Due Date
*
When are you looking to start care?
*
What days do you need care for?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Would you like to register another child?
*
Yes
No
Child's Name
*
Child's Birthday/Due Date
*
When are you looking to start care?
*
What days do you need care for?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Step 3: Additional information
Are you flexible with the days?
Yes
No
How did you hear about us?
*
Please select an option
Centre Event
Centre Signage
Community Event
Direct Mail
Email Campaign
Facebook
Flyer
Other Social Media
Publication Adv
Staff Referral
Website
Care for Kids
Google
Word of Mouth
Unknown
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