Day Pass Program Registration Form

Welcome to our Day Pass Program.

We are delighted to welcome you to our House, where families like yours have found comfort and support for over 40 years.

During your visit, you will have access to our ground floor and outdoor areas, which offer:

Complimentary coffee and light refreshments
Quiet spaces to unwind away from the hospital
Comfortable lounge areas, including a massage chair
Kitchen facilities for preparing meals and snacks, with free access to food and drinks
Beautiful gardens and a covered outdoor playground
Child-friendly spaces for craft, homework, and activities in our Learning Centre
Free wi-fi

Please register by filling in the form below. If you have any questions, our friendly Family Liaison Ambassadors at reception will be more than happy to assist you.

Day Pass Program Registration Form

Name(Required)

First Last

Email(Required)

Phone(Required)

Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Referring Ward at The Children's Hospital at Westmead(Required)

Date of Visit(Required)

# of Adults Visiting(Required)

Please enter a number from 1 to 3.

Please fill in name/s below.(Required)

First Last

Please fill in guest names below.(Required)

First Last

Please fill in guest names below.(Required)

First Last

# of Children Visiting(Required)

Please enter a number from 0 to 6.

Please fill in name/s below.(Required)

First Last

Please fill in guest names below.(Required)

First Last

Please fill in guest names below.(Required)

First Last

Please fill in guest names below.(Required)

First Last

Please fill in guest names below.(Required)

First Last

Please fill in guest names below.(Required)

First Last

Day Pass Program Guest Agreement(Required)

As a children's charity, the safety of the children, families, volunteers, and staff at Ronald McDonald House Charities Greater Western Sydney (RMHC GWS) is our absolute priority. For this reason, we ask all guests/families to confirm the statements below:

• I have not been convicted of or am under investigation for an offence against a child (this can be by Child Protective Services or another similar agency).

I acknowledge and agree that I will abide by the following conditions while staying at Ronald McDonald House in Westmead:

• No one can be in the possession of any weapons or illegal drugs and these cannot be used, consumed, or stored anywhere on Ronald McDonald House property.
• All children under the age of 18 years of age must be supervised by a responsible adult in my family at all times.
• Only take photos and videos of my own family member and visitors.
• No one has been exposed to or diagnosed with a contagious illness, and we understand we must notify management immediately if that changes.
• The Day Pass provided to you is of temporary nature and is at the discretion of RMHC GWS. With notice from management, you may be asked to leave early. Management reserves the right to refuse entry.
• Day Pass visitor hours are from 9:30 am to 3:00 pm. All visitors must sign in with reception. Visitors are only allowed in the communal areas of the House located on the ground floor and basement, not in accommodation rooms.
• You acknowledge that while visiting RMHC GWS, you are subject to continuous and ongoing camera surveillance in all public areas.
• The security and safety of your personal possessions is your own responsibility and RMHC GWS is not liable for any loss, theft, or damage.
• Smoking is only permitted in the designated smoking area provided, which is the Multi-Purpose Hut located near the oval. Lighting and burning of any substance (candles, toasters in non-apartment rooms, etc.), smoking, and vaping are not allowed in the House and you may be liable for call-out fees charged by Emergency Services responding to an activated smoke alarm. These call-out fees are in excess of $1,500.
• You agree to notify RMHC GWS about any incidents during your visit.
• An appropriate dress code must be maintained in common areas of the House. Shoes or slippers must be worn at all times.
• You are required to properly handle and dispose of any potentially toxic or infectious materials.
• No medical or therapy services will be conducted in the House unless in the case of an emergency or with prior approval from RMHC GWS.
• Should the fire alert tone sound, you will follow all instructions given by staff or volunteers. In the event of an evacuation, you will leave the House immediately.
• RMHC GWS are committed to safeguarding all children and young people and you agree to take care to ensure inappropriate behaviour does not occur. You agree to notify a staff member if a child discloses information that indicates they may be at risk of harm, abuse, or neglect.

I acknowledge and agree that I will always display respectful and courteous behaviour. The following behaviours will not be tolerated within a Ronald McDonald House:

• Physical, verbal or written abuse, and/or assault
• Discrimination and/or harassment of any kind, including sexual harassment, intimidation, victimisation, or bullying
• Any behaviour that is harmful, including derogatory, belittling, or negative communication
• Careless or reckless behaviour
• Behaviour that breaches any applicable laws or regulations

By checking this box, I confirm I have read the Day Pass Program Guest Agreement and agree to abide by the conditions set forth in this agreement. I understand that if a family has been asked to leave the House because they have violated one or more of the conditions in place, they may not be eligible to return as a guest of the House or other RMHC GWS programs.

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Make a Difference for Families & Children

Parents don’t know when their children will need medical help. But they should know they can always access the care they need. With your help, we can support them throughout their journey.