Winter School Holiday Care Booking Request and Permission Form

The staff at Moe School Holiday Program provide a variety of activities for educational and recreational purposes that occur regularly. We provide opportunities to enhance and foster children’s relationships and participation in peer related activities and experiences, whilst nurturing their connection to their world and learning.

Please complete the following form to request a booking for the Autumn school holidays.

Child Care Agreement and Child Care Subsidy (CCS)

An ECEC Service provider and Parent/Guardian must agree up-front on the arrangements for the care of a child.  Arrangements must be recorded and kept up to date to ensure Compliance.

Once your enrolment details have been entered into Xplor (our booking management software), you will receive an email from Xplor to set your password for your account. Once you’ve created your password, you will be able to login to your account from a Google chrome web browser and approve the Complying Written Arrangement (if this is what you select below for your enrolment).

Please read your booking confirmation email carefully for more detailed instructions. You will need to complete this step to receive the Child Care Subsidy


  • Complying Written Agreement (CWA) 
    A CWA is an enrolment type used for families wishing to claim CCS now or in the future
  • Relevant Agreement - (RA) 
    An RA is an enrolment Type used for families not wishing to claim CCS
  • Additional Child Care Subsidy - ACCS 
    A ACCS is used when a child care provider identifies that a child is at risk of serious abuse or neglect but there is no individual identified to pay the child care fees.
Parent details
Children's details
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Child Care Agreement and Child Care Subsidy (CCS) - Please read the CCS information above the form.
Arrangment type

Expected session/s of care

Which activity would you like to book?
If there is a possibility of adding days/activities, please select 'permission only granted' for all activities. This will ensure you won't need to complete an additional form. School Holiday Program service users will be required to give ONE WEEKS NOTICE to the service administration staff if cancelling a booking.
Monday 1st July: Welcome Back Breakfast and Henna Painting with Miss Monica

Tuesday 2nd July: Water Safety Program & Swimming and Basketball and warm winter lunch at Moe/Newborough Leisure Centre

Wednesday 3rd July: BRICKS 4 KIDZ Incursion and Marvellous Mitten Creations

Thursday 4th July: Wyncity Bowling Fun and Mini Golf

Friday 5th July: Treasure Hunt and Slime Time

Monday 8th July: Wheels Up and NAIDOC Week Celebrations

Tuesday 9th July: Scarf Making and Mr Peavey’s Sports Session

Wednesday 10th July: Gumbuya World Excursion

Thursday 11th July: Build a Bear Incursion and Teddy Bear Mask Making and Picnic on the Oval

Friday 12th July: Subway Lunch and Movie Time at Warragul Cinemas

Your children will travel to all excursions with Latrobe Valley Bus Lines. The children will be supervised with the ratio of one educator to ten children. Risk assessments have been prepared and are available at the service.
I authorise my child/ren to attend the incursions/excursions indicated and agree that the Latrobe City Council and its officers, educators, staff and agents shall be released from, and shall not incur, any responsibility or liability whatsoever for any accident or injury to the child/ren participating in the School Holiday Program, or for any damage to or loss of property of the child/ren participating in the program.
I authorise Latrobe City Council to obtain medical/ambulance assistance in the case of accident or emergency involving the child/ren and I agree to bear any costs thereby incurred.
I give permission to the staff of the School Holiday Program to take my child/ren on walking routine outings to Ted Summerton Reserve Moe (oval), Moe South Primary School, Fire Evacuation Practice, Moe Early Learning Centre and Stadium or/and Apex Park, Waterloo Road.
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Latrobe City Council is committed to the protection of your privacy.
The information on this form will be collated on a database, to assist with planning of vacation care services. The information sought through this form will only be used by Latrobe City Council in conjunction with the Department of Education and Training.