This form is for child/children who has/have an educator/caregiver (person who looks after the child/children on a regular basis. The person cannot be the parents of the child/children). If you are looking for an educator, please click here.

Name of Child Required

Caregiver Name (Adult who looks after the child apart from parents) Required

What is the relationship between the child and the caregiver?

Parents Email address Required

Parents contact number Required

What is the area you live in? Required

What days do you require Happy Tots In-home Childcare? Required

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