Enrol With Us Today

Alternatively, you can download the form as a PDF, complete it and return it to us.

Required fields are marked with a *.

Child Details *

Please enter the details for the child you wish to enrol.

Name

First Name

Last Name

Gender

Male

Female

Date of Birth

Ideal Start Date

Session Preferences

Please indicate your preference for each day:

Monday

Tuesday

Wednesday

Thursday

Friday

First Parent/Guardian Details *

First Parent/Guardian Name

First Name

Last Name

First Parent/Guardian Address

First Parent/Guardian Phone

First Parent/Guardian Alternate Phone

First Parent/Guardian Email

Second Parent/Guardian Details

Second Parent/Guardian Name

First Name

Last Name

Second Parent/Guardian Adress

Second Parent/Guardian Phone

Second Parent/Guardian Alternate Phone

Second Parent/Guardian Email

How did you hear about Coastlands Preschool?

Any other comments you'd like to add?

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