Spring 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 Summer 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

Definitions

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

First Name

Last Name

Parent/Guardian Email

Parent/Guardian Contact Phone

Child Details

First Name

Last Name

Child 1 Date of Birth

First Name

Last Name

Child 2 Date of Birth

First Name

Last Name

Child 3 Date of Birth

First Name

Last Name

Child 4 Date of Birth

Child Care Agreement and Child Care Subsidy (CCS)

Arrangment type

CWA

ACCS

I agree to the above statement

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 Vacation Care 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 Moe Vacation Care, 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 or/and Apex Park, Waterloo Road.

Protection of your privacy

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.

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Spring School Holiday Care Booking Request and Permission Form

Child Care Agreement and Child Care Subsidy (CCS)

Definitions

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