St Mary's Preschool Enrolment

Complete the enrolment form below.

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    Child

    Child's first names *

    Surname *

    Preferred name *

    Child's date of birth *

    Child's home address *

    Postcode *

    Ethnic origin

    Iwi your child belongs to

    Is there anything else we should know about your child’s ethnicity, religion or culture so we can ensure the best cared and understanding?

    Child Medical Information

    Doctors Name

    Address

    Phone

    Medical Facility

    Allergy or medical conditions

    Immunisation certificate supplied? *

    Please upload certificate

    Parents/Guardians

    First Names *

    Surname *

    Address *

    Postcode

    Phone (Home) *

    Phone (Work)

    Phone (Mobile) *

    Email *

    Add New

    Emergency Contacts / Authority to Collect

    First Names *

    Surname *

    Address *

    Postcode

    Phone (Home) *

    Phone (Work)

    Phone (Mobile) *

    Add New

    Custodial Statement

    Are there any custodial arrangements concerning your child?

    Enrolment Terms and Conditions

    Enrolment-Terms-and-Conditions-St-Marys-Preschool

    Signature *

    Contact St Mary's Preschool

    Email

    [email protected]

    Phone

    (09) 276 3729