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Family day care child travelling overseas form

Family day care educators should fill out this form with a parent before a child travels overseas.

Educator details

Scheme name (required)

-- Please Select --Central MetroCountry CentralEastern DistrictsEastern EyreFar NorthHills MurraylandsNorth MetroNorthsideSouth East RiverlandSouthern DistrictsSouthern ValesWest Country

Educator’s first name (required)

Educator’s last name (required)

Educator’s email (required)

Family details

Parent or carer's first name (required)

Parent or carer's last name (required)

Parent or carer's email (required)

Parent or carer’s mobile number

Number of children (required)

-- Please Select --1234

Child 1

Child's first name

Child's last name

Child 2

Child's first name

Child's last name

Child 3

Child's first name

Child's last name

Child 4

Child's first name

Child's last name

Departure details

Date (required)

What day will the child leave South Australia?

Day 12345678910111213141516171819202122232425262728293031 Month JanFebMarAprMayJunJulAugSepOctNovDec Year 202220232024202520262027202820292030203120322033203420352036203720382039204020412042204320442045204620472048204920502051205220532054205520562057205820592060206120622063206420652066206720682069207020712072207320742075207620772078207920802081208220832084208520862087208820892090209120922093209420952096209720982099

Time (required)

What time will the child leave South Australia?

Hour 000102030405060708091011121314151617181920212223 Minute 000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859

Will the child attend family day care on the day they leave? (required)

• yes
• no

Countries visiting or travelling through (required)

Return details

Date (required)

What day will the child return to South Australia?

Day 12345678910111213141516171819202122232425262728293031 Month JanFebMarAprMayJunJulAugSepOctNovDec Year 202220232024202520262027202820292030203120322033203420352036203720382039204020412042204320442045204620472048204920502051205220532054205520562057205820592060206120622063206420652066206720682069207020712072207320742075207620772078207920802081208220832084208520862087208820892090209120922093209420952096209720982099

Time (required)

What time will the child return to South Australia?

Hour 000102030405060708091011121314151617181920212223 Minute 000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859

Will the child attend family day care on the day they return to South Australia? (required)

• yes
• no

Check above information

Please check all data is true and correct.

By submitting this form, you declare all information to be true and correct on 26 April 2024.