Important

Please fill out the following registration, and we will
get back to you as soon as possible, regarding
your requirements and web access (either by email or phone).

The use of this form does not involve any commitment or engagement on your part or ours at this stage. For further inquiries or if you would
prefer to discuss anything personally with us, please use the contact information above.
Note: All fields with an * are required.

Select Your Enrolment Requirements:

I want to access the CosCare Web Page
I want to receive the CosCare News Letter
I want to enrol for OOSH (we will contact you to confirm your childs after school care booking.)

Your Contact Details

*Username:
*Password:
*Confirm Password:
*Email:
*First Name:
*Last Name:
Number of Kids:
Title:
*Phone Home:
Phone Mobile:
Phone Work:
Fax:
*Address:
*Suburb:
*State:
*Pcode:

Your Childrens Details

Child 1

First Name:
Last Name:
School:
DOB:
Year:
Class:
Class Name:
Class Teacher:
Required OOSH Days:
Required OOSH Times:

Child 2

First Name:
Last Name:
School:
DOB:
Year:
Class:
Class Name:
Class Teacher:
Required OOSH Days:
Required OOSH Times:

Child 3

First Name:
Last Name:
School:
DOB:
Year:
Class:
Class Name:
Class Teacher:
Required OOSH Days:
Required OOSH Times:

Child 4

First Name:
Last Name:
School:
DOB:
Year:
Class:
Class Name:
Class Teacher:
Required OOSH Days:
Required OOSH Times: