Harvey Recreation and Cultural Centre

Harvey Recreation and Cultural Centre

Outside School Hours Care Enrolment Form

The details on this form are a requirement of The Department of Eduction, Employment and Workplace Relations (DEEWR) and the Education and Care Regulatory Unit (ECRU). A new enrolment form is to be filled out each year. All information given is treated in the strictest of confidence. 

Enrolment forms will not be accepted unless accompanied by:

  1. Your child's Birth Certificate
  2. Your child's current Immunisation Record
  3. Child Care Assessment Notice (CRN Numbers)


Child Details (Must complete a separate form for each child)


Parent / Guardian Details (1) - The person who is claiming Child Care Benefit or Rebate


Parent / Guardian Details (2)


Authority to Collect and Emergency Contacts

Staff will not allow your child(ren) to go with adults unless their names are provided on this form. I authorise the staff at this centre to give the above names access to my children (must be over 16 years). Please ensure these emergency contact persons are willing to collect your child in the event of an emergency.


Child's Health and Medical Information

About the Child

Please Read Carefully and Sign Medical Agreement

I understand the Harvey Recreation and Cultural Centre Outside School Hours Care are unable to care for sick children, or children with contagious illness. 

In the event of an illness or accident (when parents/guardians or authorised person/s cannot be contacted), I consent to medical treatment from a registered medical practitioner, hospital or ambulance service being sought for the child and transportation of the child by ambulance. I agree to pay any expenses incurred for medical treatment and transport. 

In case of an emergency when those people authorised to collect a child cannot be contacted, I consent to the approved provider/nominated supervisor having due regard to the wellbeing of the child, authorizing an adult educator who is responsible for the child to take the child from the education and care service. 

I have read and agree to follow the service policy on administration of medication. I understand that for all medications I must complete and sign 'Authority to administer medication' form on the day in which it is to be administered.

My medical practitioner is advised that he/she may be consulted and has my permission to treat the child. 

I give permission for HRCC OSHC to use sunscreens, ointments, creams and applications for First Aid when necessary. Any allergies to the above have been noted on the enrolment form.


  1. I have read and understood the Harvey Recreation and Cultural Centre (HRCC) Outside School Hours Care (OSHC) parent handbook including policies on Fees, Charges and Cancellations of Bookings. 
  2. A staff member must be notified of the arrival and departure of your child at the HRCC. All children are to be signed in and out by an authorised person. I understand that my child will only be allowed to leave HRCC with an authorised person over the age of 16 listed on the enrolment form. 
  3. I acknowledge that if my child needs to leave the service for sporting events/training I will fill in an Extracurricular Permission Slip prior to this taking place. 
  4. All children must be collected from HRCC by the HRCC closing times (After School Care 6.00pm and Holiday Program 5.30pm) Due to staffing requirements, late fees apply to the collection of children after these times. A late fee of $5 per 5 minutes will be charged every 5 minutes after closing time. 
  5. I understand that the HRCC OSHC program, its staff and management will take all reasonable care for my child and I will not hold them responsible for any damage and or loss of property and/or accident. 
  6. I am willing for my child to participate in all activities offered in the program and agree it is my responsibility to familiarize myself with the program and to advise the staff in writing if I do not wish my child to participate in a particular activity.
  7. I acknowledge it is my responsibility to approve any CCS offered to me by the Government through my myGov account. Failure to do this means that my CCS will not be credited to my account.
  8. I am aware that the program may occasionally have visitors/volunteers/work experience students that may assist at HRCC and I consent to my child being in the presence of these people. 
  9. I am aware that my child is to use appropriate behaviour in HRCC. If my child does not act appropriately I am aware I will be notified by staff during operating hours of HRCC. 
  10. HRCC OSHC reserves the right to terminate this agreement when, at its discretion, it considers that to do so would be in the best interest of HRCC. It agrees to give the parent/guardian reasonable notice of its intention to exercise this right and will refund any payment in credit. 
  11. I acknowledge that all care offered by Harvey Recreation and Cultural Centre OSHC services is on a casual basis only.
  12. I acknowledge that the current fees are as follows: ASC $25 per day; HP $55 per day. I understand these fees may vary from time to time.

Make an Enquiry


Become a Gym or Group Fitness Member today.


Join our mailing list to keep up to date: