Your Child is

in Safe Hands

Servicing the Port Fairy & Warnambool Regions

Coastal Childcare offers you affordable childcare through hourly rates and special package options.

We work on a very reasonable hourly rate basis and are happy to discuss a ‘fee for service’ rate for regular customers.

Our Services Include:

Regular Ongoing Child Care
Casual Child Care Bookings
Care in Your Accommodation Whilst Visiting
Child Care for Weddings etc
Care While You Are at the Conference or Other Special Event

Our Difference:

Planned Activities for Your Child
Personalised Approach to Your Child Care Needs
Special Arrangements for Short and Long Term Care
The Carer is security checked with Working With Children (WWC) – Dept of Justice, Vic

RATES:

RATES: minimum charge is for 4 hours care
No. Children	Before 12 am	After 12 am	RATES INCREASE AFTER 12 AM
1 – 2	$25.00 per hour	$35.00 per hour	PLEASE NOTE: BOOKINGS & CANCELLATIONS made within 24 HOURS of the time care is required will incur a FEE of the 1st hours care or 1/3 of the scheduled booking, which ever amount is greater.
3 – 4	$30.00 per hour	$40.00 per hour
PUBLIC HOLIDAYS – Rates increase to time and ½. PACKAGE DEALS AVAILABLE FOR REGULAR CUSTOMERS – prices as negotiated**

Name of Booking Contact(Required)

Please provide the name of the person we may contact regarding this Booking request.

First Name Last Name

Mobile Phone of Booking Contact(Required)

Please provide the mobile phone number of the person we may contact regarding this Booking request.

Alternative Phone of Booking Contact

Email Address of Booking Contact(Required)

Please provide the email address of the person we may contact regarding this Booking request.

Address of Booking Contact(Required)

Street Address Address Line 2 City State Post Code

Emergency Contact - Name(Required)

Please provide a contact in the event the Booking Contact is not available.

First Name Last Name

Emergency Contact - Phone(Required)

Please provide the phone number of the Emergency Contact.

Doctor / Medical Clinic – Name(Required)

Please provide the name of your Doctor or Medical Clinic that we may contact in the event of an emergency.

Doctor / Clinic Phone(Required)

Number of Children Requiring Care - **Max 4**(Required)

Select the Number of Children you require care for and then enter their details below.

Details of 1st Child(Required)

First Name Last Name

Age(Required)

Date of Birth(Required)

Special Requirements

Diet / Medication / Transport / Other

Details of 2nd Child(Required)

First Name Last Name

Age(Required)

Date of Birth(Required)

Special Requirements

Diet / Medication / Transport / Other

Details of 3rd Child(Required)

First name Last Name

Age(Required)

Date of Birth(Required)

Special Requirements

Diet / Medication / Transport / Other

Details of 4th Child(Required)

First Name Last Name

Age(Required)

Date of Birth(Required)

Special Requirements

Diet / Medication / Transport / Other

Type of Care (Casual/Regular - Multiple Days/times)(Required)

Number of Times Care is Required(Required)

Date Care is Required(Required)

Start Time for Care(Required)

End Time for Care(Required)

* Note: Higher rate if care extends beyond midnight.

Location where Care is to be Provided(Required)

Will care be provided at the Carer's location or an alternative location?

Address for providing the Care.(Required)

Street Address Address Line 2 City State Post Code

Other

If you have other information relevant to the Booking you would like us to know which is not covered in this form, please add it here.

Fees(Required)

RATES ARE HOURLY - maximum 4 children. **Minimum charge will be for 4 hours care.** Before Midnight 1 - 2 Children $25.00 per hour; 3 - 4 Children $30.00 per hour. After Midnight 1 - 2 Children $35.00 per hour; 3 - 4 Children $40.00 per hour. **PUBLIC HOLIDAYS - Rates increase to time and ½.

I acknowledge and agree to pay the rates for Childcare as stated here.

Cancellation Policy(Required)

Bookings and Cancelations made within 24 hours of the required time will incur a FEE of the 1st hours care or 1/3rd of the scheduled booking whichever is greater

I agree to the Cancelation Policy.

Carer's Authority(Required)

I authorise the carer to care for the child as per the above detail.

Carer's Authority(Required)

I authorise the carer to care for the children as per the above detail.

Name

This field is for validation purposes and should be left unchanged.