Parent Registration

Type of Care*
- Care at Home (Babysitter/Mothers Helper)
- Defence Families & Emergency Services (ADF, Police etc.)
- Register Attendance for an Event (i.e Wedding, Business party etc.)
Client Details
Parent / Guardian 1
Family/Surname*
Given Names/s*
Address*
Street Address Address Line 2 City / Suburb State Post Code
Date of Birth
Gender
Occupation
Religion
Phone
Mobile*
Email Address*
Parent / Guardian 2
Family/Surname
Given Names/s
Address
Street Address Address Line 2 City / Suburb State Post Code
Date of Birth
Gender
Occupation
Religion
Phone
Mobile
Email Address
Emergency Contact
Contact Name*
Contact Number*
Relationship to child/children*

Register Attendance for an Event
Please enter your Event Name or Code
Are you already a Little Wonders Family? i.e this means you have also submitted your registration forms for and event or care within the last 6-2 months*
- Yes
- No
What is your client number? (if known)

Defence Families
Are you (or your spouse) a member of defence?*
- Yes
- No
Are you registering for a defence related event? (i.e Function)*
- Yes
- No
What is the name of the event you have registered for?
Are you already a Little Wonders Family? i.e this means your have also submitted your registration forms for and event or care within the last 2-6 months*
- Yes
- No
Are you already a Little Wonders Family? i.e this means your have also submitted your registration forms for and event or care within the last 6-2 months*
- Yes
- No

Consent & Submit
Insurance Acknowledgement*
Parents are responsible for any insurances related to home contents, home insurance, and vehicle insurance
- I agree
Safe Location Acknowledgement*
Parents are responsible for providing a safe care location for the children
- I agree
By signing this Client Registration Form, you hereby acknowledge and agree that:*
(a) your email address will be added to our mailing list and you will receive emails from Us from time to time;
(b) the information provided in this Membership Application Form is accurate, honest, true and correct;
(c) you will promptly notify Us of any changes to the details provided in this form; and
(d) you have read and agree to the Terms & Conditions
I agree
Date
DD slash MM slash YYYY
Signature

Client Details