Southern Barossa Community Child Care

Registration Form

We invite you to register interest for your child to attend our centre. Please book a time to visit us, we would love to show you around

Get in touch with us
call 08 8524 5395

Lot 1 Lyndoch Valley Rd
Lyndoch SA 5351

News from the Director

Please enter your details to place your child on our waiting list. All information collected on this page is only used for our waiting list records. Please contact us directly to remove your child from the waiting list.

Childs Name*
A value is required.

Family Name*
A value is required.

DOB

Due Date

Allergies/Special Needs

Days Required

	All Day	AM	PM
Mon
Tues
Wed
Thurs
Fri

Parent/Guardian*
A value is required.

Telephone*
A value is required.

Mobile

Address*
A value is required.

How did you hear about our centre?

Agreement

I understand that this is an application to be included on the waiting list and this is not a guarantee of a place.
I agree to keep in regular contact with the centre regarding my requirements for care.

I Agree * Please make a selection.

Please make a selection.