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65 Sutherland Street Kilmore Victoria View Location


Enrolment Form- Please make sure you complete all FOUR pages and that your child has all of their immunisations up to date.

Note the format of this hard copy Enrolment Form varies from the soft copy available on the Myfamilylounge link on the Home Page.

Parents MUST provide a copy of the child’s  current Medicare Immunisation History Statement before enrolment will be confirmed.

See more information relating to “No Jab No Pay”  and “No Jab No Play” on the Family Information page.

Enrolment Form SSCCK Page 1 with boxes

Enrolment Form SSCCK Page 2

Enrolment Form SSCCK Page 3

Enrolment Form SSCCK Page 4

Ezidebit Form Sutherland Street 2017

Centrepay is a bill paying service, free for Centrelink customers, through which deductions can be made from a customer’s payment directly to our Business.

Long Term Illness Notification Form Sutherland Street

To be used when a child has a pre-existing illness which is not Asthma.


2016 ASCIA_Action_Plan_Anaphylaxis_EpiPen_Personal


Please complete our Enrolment Forms, and either scan, fax or mail  to Sutherland Street.

No bookings will be confirmed unless we have received:

1) a fully completed Enrolment Form for each child, with the relevant days required listed.

2) a aopy of the child’s current Immunisation History Record showing all immunisations are up to date.

3) an EziDebit Form or Centrepay Form for paying your weekly account, and any other forms required depending on your child’s health, allergies etc.