NON registered children Permission Form

Parent/Guardian Details

First Name*
Please enter your first name.
Please enter your first name.
Last Name*
Please enter your last name.
Please enter your last name.
Parent/Guardian relationship to child(ren)*
  • - select an option -
  • Mother
  • Father
  • Grandmother
  • Grandfather
  • Guardian
  • Other
Please enter the relationship to child(ren).
Please enter the relationship to child(ren).
Email*
Please enter your email.
Please enter your email.
Mobile Phone*
Please enter your mobile phone number.
Please enter your mobile phone number.

If the intention is for your child to be present for more than one occasion during the registered families shifts, your family will be required to formally register and pay a one off $75 registration fee.

Will your child be present for more than one shift?*
Please answer the question.
Please answer the question.

As your child will be present on more than one occasion, we require you to formally register here https://melbournesleadingnannyagency.com.au/family-registration-form/

As your child/children will be present during a shift at a registered family’s home and your family is not registered, we require you to fill in the below permission form prior to commencement of the shift.

Emergency Contact Information

First Name*
Please enter the emergency contact first name.
Please enter the emergency contact first name.
Last Name*
Please enter the emergency contact last name.
Please enter the emergency contact last name.
Emergency Contact relationship to child(ren)*
  • - select an option -
  • Mother
  • Father
  • Grandmother
  • Grandfather
  • Guardian
  • Other
Please enter the relationship to child(ren).
Please enter the relationship to child(ren).
Email*
Please enter the emergency contact email.
Please enter the emergency contact email.
Mobile Phone*
Please enter the emergency contact mobile phone number.
Please enter the emergency contact mobile phone number.

Child Information

It is important to fill in all information for all your children.

Child Details

First Name*
Please enter your child's first name.
Please enter your child's first name.
Last Name*
Please enter your child's last name.
Please enter your child's last name.

Date of Birth*

Day
  • - enter the day -
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • 21
  • 22
  • 23
  • 24
  • 25
  • 26
  • 27
  • 28
  • 29
  • 30
  • 31
Please enter your child's date of birth
Please enter your child's date of birth
Month
  • - enter the month -
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
Please enter your child's date of birth
Please enter your child's date of birth
Year
Please enter your child's date of birth
Please enter your child's date of birth
Tell us about their hobbies, interests / are they breast, bottle fed, eating solids / are they crawling, walking, sitting / are they a good sleeper, eater / what are their personality traits?*
Limit of 200 characters
Please enter details and limit your answer to 200 characters (including spaces).
Please enter details and limit your answer to 200 characters (including spaces).
Child's Medical Conditions or Allergies*
Limit of 200 characters
Please enter details and limit your answer to 200 characters (including spaces).
Please enter details and limit your answer to 200 characters (including spaces).

Add/Remove Child

Permission

I give permission for the above-mentioned child/children to be solely cared for by a carer who is already providing care for the registered family as listed below

First Name*
Please enter the current client's first name.
Please enter the current client's first name.
Last Name*
Please enter the current client's last name.
Please enter the current client's last name.
Email*
Please enter the current client's email.
Please enter the current client's email.
Mobile Phone*
Please enter the current client's mobile phone number.
Please enter the current client's mobile phone number.

I understand that Armadalia Pty. Ltd. has terms and conditions found here https://melbournesleadingnannyagency.com.au/terms-of-agreement/ which I have read, understood and agree with the terms.

Please confirm.
Please confirm.
Submit