First Connections Academy for Kids Edmondson Park Waitlist

6 Alberry Road, Edmondson Park NSW 2174 | edmondsonpark@firstconnections.com.au

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Child's Details

Gender*
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Preferred Days
Are you flexible with the days selected above?

Primary Parent/Carer's Details

Secondary Parent/Carer's Details

Child's Personal Information

Does your Child have a Disability, Speech Delay, Additional Need (i.e. Behavioural Concerns)
Does your child speak English
Any children in your family who have/or are attending our Service?
Is your child of Aboriginal or Torres Strait Islander descent and recognised as such by the community?
Children who are not Vaccinated or have not provided Vaccination Records may be excluded in the event of a Vaccine Preventable Disease. Is your Child's Immunisation up to date?
Please notify us immediately if any of the above information changes in any way. (Failure to do so may result in loss of position on waiting list). We have a firm commitment to protecting the privacy of our clients. Personal information collected on this form is for the purpose of contact and establishing priority of access only.