Gumnut Permanent Booking Form : Canberra Montessori School

Name of child (Surname/Given Name): *

Classroom

Parent/Guardian's Name *

Parent/Guardian's Phone Number

Parent/Guardian's Email Address *

What type of booking do you need to make?

New permanent booking

Change to existing permanent booking. This supersedes any previous booking and your bookings will be changed to the days that you select below.

Date for bookings/change to commence *

Breakfast Club $13 per day

Mondays 7:30am - 8:30am

Tuesdays 7:30am - 8:30am

Wednesdays 7:30am - 8:30am

Thursdays 7:30am - 8:30am

Fridays 7:30am - 8:30am

After School Care Option 1 $16.50 per day

Mondays 3:00pm - 4:30pm

Tuesdays 3:00pm - 4:30pm

Wednesdays 3:00pm - 4:30pm

Thursdays 3:00pm - 4:30pm

Fridays 3:00pm - 4:30pm

After School Care Option 2 $33.00 per day

Mondays 3:00pm - 6:00pm

Tuesdays 3:00pm - 6:00pm

Wednesdays 3:00pm - 6:00pm

Thursdays 3:00pm - 6:00pm

Fridays 3:00pm - 6:00pm

Please tick if your child is new to Gumnut and you would like a room orientation

Room orientation

Please Note:

Please advise if your child has any allergies or other health issues? *

Yes - an Emergency Treatment Plan must be provided. If your child suffers from asthma, please provide a clearly labelled puffer with spacer to be kept in Gumnut for them. If your child suffers from anaphylaxis, please provide a clearly labelled epipen to be kept in Gumnut for them.

No

If Yes: Details of allergies/health issues

Comments if required

Signature *

Clear

Date *

Dogs ACT

Gumnut Permanent Booking Form

Breakfast Club $13 per day

After School Care Option 1 $16.50 per day

After School Care Option 2 $33.00 per day