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    • 1

      Guardian Details

    • 2

      Child Details

    • 3

      Finalise

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    Guardian Details

    Guardian's Details

    Parent/Guardian registered for Child Care Subsidy

    0%

    Child's Details

    Number of Children:*

    Child 1

    Child Date Of Birth:*
    Child Requested Days of Care:*
    Expected Start Date*

    Child 2

    Child 2 Date Of Birth:*
    Child 2 Requested Days of Care:*
    Expected Start Date*

    Child 3

    Child 3 Date Of Birth:*
    Child 3 Requested Days of Care:*
    Expected Start Date*

    Child 4

    Child 4 First Name:*
    Child 4 Last Name:*
    Child 4 Date Of Birth:*
    Child 4 Requested Days of Care:*
    Expected Start Date*

    50%

    Additional Comments

    Please let us know if you have any additional questions or comments. eg. days of care required, start date, additional children information.
    How did you hear about us?

    100%

    © 2026 Company Name.

    Shaped by Hopscotch Digital.

    Address

    1 Street Name
    Suburb, City, 4000

    Email & Phone

    name@emailaddress.com.au
    +61 7 123 456 289