Child Care in Tasmania with NCN

Update Information or Add a New Child

* required fields

Do you require an interpreter to help you with this form?

Enrolled Parent

Which service do you require?


Child One

Child Two

Child Three


Are you using the same contacts as the original parent enrolment?

If no, please add new contacts below.

Contact Person One

Contact Person Two


If your child has any medical conditions or developmental delays, please identify and provide details. For diagnosed medical conditions, an Action Plan will be required.

Allergies (Foods, insect bites, pollen etc)

Intellectual (Autism, Down Syndrome, Foetal Alcohol Syndrome etc)

Physical/Sensory (Cerebral Palsy, Cystic Fybrosis, Hearing/Visual impairment etc)

Developmental Delays (Language, Muscle Tone, Mobility etc)

Other Conditions (Asthma, ADHD, other Medical Conditions etc)

Other (including Cultural, Diet or Religion that the Educator needs to be aware of etc)


* I give consent for my Educator/Service to authorise medical treatment for my child from a registered Medical Practitioner and/or administer medication on my behalf as directed:
* Do you have any objections to pets? If yes, please detail below.
* Can NCN use images of your child for promotional / media or social media (e.g. Facebook) purposes?
* Can your Educator/Service use images of your child for program planning and resources?
* Are there any Family Court, Custody, Care and Protection or Restraining Orders relevant to any children listed on this enrolment form?
If yes, a copy needs to be provided to the service and if applicable, the Educator.
* Are your child's immunisations up to date?
All immunisation evidence must be provided before care can take place.

Ensure all relevant medical action plans completed by a GP are attached, eg Asthma or anaphylaxis action plans.


Do you have a child attending this service who is also attending another approved child care service?
Does the child have a sibling listed on the family assessment notice that is attending another approved child care service?

Answering YES to any of the above questions may affect your child's CCS entitlement to eligible hours and allowable absence days. To avoid an underpayment, contact NCN if your usage of other child care services changes.


You should supply us with any supporting documentation, such as Immunisation Records, JET letters, Court Orders etc.

Send us your supporting documentation


I agree to abide by the current conditions and policies of Northern Children’s Network Inc. (available to view at each service/offices or educator).

I agree to my child/ren being cared for and/or transported by service staff in an emergency.

I agree to my child/ren receiving medical attention and being transported by ambulance in an emergency as recommended by the doctor, hospital, ambulance staff or paramedics.

I understand that non work related care hours may be reduced or ‘placed on hold’ to accommodate work or study related care. This practice is in accordance with the Commonwealth Priority of Access Guidelines.

I agree to pay the organisation’s Administration Levy every week to the Educator and understand this amount will be deducted from any Child Care Subsidy payment due to the Educator on my behalf.

I agree to complete a Service/Parent Care Agreement at the commencement of care.

I agree to a copy of the information contained on this enrolment form being forwarded to the Educator/service upon the commencement of care.

I agree to advise the service and my Educator/s within 14 days of any change in the information provided.

I agree that the service may from time to time send newsletters and other relevant information electronically to my email account.

I agree to pay the account received by me by the due date. If the account is not paid by the due date, then that account may be lodged with a mercantile agent for recovery. If lodged with a mercantile agent for recovery, I, the parent, will bear all collection costs to cover the agent’s commission. In addition, I agree to bear all legal costs and disbursements incurred in the recovery of the debt.

The information that I have provided on this form is true and accurate at the time of completion.