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Klub Kallangur
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Intake form
Help us serve you better
Name
*
Email address
*
Child's date of birth
Parent/Guardian's phone number
Child's primary school
Preferred start date for care
Care type required
Please select at least one option.
Before school care
After school care
Vacation care
Days of the week required for care
Please select at least one option.
Monday
Tuesday
Wednesday
Thursday
Friday
Additional notes or special requirements
Which service or services are you interested in?
Please select at least one option.
Before school care
After school care
Vacation programs
Additional questions or comments
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