St Mary's Preschool Enrolment HomeWhat we doEarly Childhood EducationSt Mary’s Family PreschoolEnrolment Complete the enrolment form below. 1Step 12Step 23Step 31/3Step 1Child Child's first names * Surname * Preferred name * Child's date of birth * MaleFemale Child's home address * Postcode * Ethnic origin MaoriTokelaunFijianChinese (incl. Taiwanese)NiueanTonganCook Is MaoriOther AsianSamoanOther Pacific PeoplesSouth East AsianMiddle Eastern, Latin American, AfricanIndianNZ EuropeanOther EuropeanOther (ethnicity not stated) 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? * NoYes Please upload certificate Next 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? NoYes BackNext Enrolment Terms and Conditions Enrolment-Terms-and-Conditions-St-Marys-Preschool I undertake to adhere to the requirements of these terms and conditions and I also take responsibility for the payment of fees on time. I undertake that failure to comply with these requirements of the Preschool could lead to my child’s exclusion from the Preschool. Signature * [signature* signature-651] Back Contact St Mary's Preschool Email [email protected] Phone (09) 276 3729