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Before School Enrolment Form

How many Cubs would you like to enrol?

Cub details - 1

This field is required*

This field is required*

This field is required* (Only number)

Cubs Doctor details

Medical details

Does your cub(s) have any medical conditions? (Including allergy, health, special requirements, disability)

Does your cub require a 1-on-1 support?

Cub details - 4

Cubs Doctor details

Medical details:

Does your cub(s) have any medical conditions? (Including allergy, health, special requirements, disability)

Does your cub require a 1-on-1 support?

Cub details - 5

Cubs Doctor details

Medical details

Does your cub(s) have any medical conditions? (Including allergy, health, special requirements, disability)

Does your cub require a 1-on-1 support?

Term of Choice*:

Centre*:

Please choose start date:

This field is required*

Weeks/Days Attending:

Regular or Casual Attending:

Wild Card Discounts(15% Off All Services)

Do you want to purchase a Wild Card?

Do you require shuttles?

Address for pick-up/drop off

Time for pick-up

Time for drop off

Parent/Caregivers details - 1

This field is required*

This field is required* (number only)

This field is required*

This field is required*

Parent/Caregivers details - 2 (Optional)

Emergency Contacts (required)

This field is required*

This field is required*

(Optional)
Authorised Pickup (optional)
(optional)

Would you like your cub(s) to attend our fitness programme Keep Fit Karapu

Home Work Assistance?

Are you eligible for a WINZ subsidy?

Are you a refugee?(Funding may be available)

Can we use images of your cub(s) on social media or in advertising (identifying names will not be included)

Would you like to receive regular E-mail updates?

I understand and accept the Terms and Conditions of Pride Lands

Survey (Optional)
How did you hear about Pride Lands?
Is there anything we could improve?
If you have any issues with the enrolment form(e.g: can not send the form), Please download this hard copy form to make your enrolment.
This Information is private and confidential. Thank you for your support.
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