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C&K Parkhurst Childcare Centre Expression of Interest

Please complete the form below to register your interest for C&K Parkhurst Childcare Centre. You will be added to our database and we will keep you updated with our progress.

If you have more than one child you'd like to register, please complete a separate form for each child. Thank you.

Guardian's First Name *

Guardian's Last Name *

Child's First Name *

Child's Last Name *

Child's Date of Birth *

Day

Month

Year

Guardian's Email Address *

Guardian's Relationship to Child *

Parent

Grandparent

Foster Parent

Other Relative

Other

Guardian's Mobile Number *

When would you like care to commence? *

Day

Month

Year

Please select the days of care required. *

Monday

Tuesday

Wednesday

Thursday

Friday

Please select which room you'd like to enrol in? *

Nursery 1 (6 weeks to 12 months)

Nursery 2 (13 months to 2 years old)

Toddlers (2 years to 3 years old)

Pre-Kindy (3 years to 4 years old)

Kindy (4 years to 5 years old)

Additional comments:

Leave this field blank

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C&K acknowledges and pays its respects to the Traditional Custodians of the lands on which our offices and centres are located across Queensland and their continuing connection to land, sea and Community. C&K also pay respects to all Elders past, present and emerging.