2017 Playgroup Registration
Child/ren's Details
Child 1 Name
Your answer
Date of Birth
Your answer
Child 2 Name
Your answer
Date of Birth
Your answer
Child 3 Name
Your answer
Date of Birth
Your answer
Parent Details
Parent Name
Your answer
Address
Your answer
Mobile Number
Your answer
Email
Your answer
Name of the Caregiver (if any) who will be bringing the child/ren to Playgroup
Your answer
Does your child/ren suffer from any medical condition?
Your answer
Is there anything else we need to know about your child/ren?
Your answer
Please select the day you wish to attend Playgroup. Please note it is one session per week per family. Sessions run from 8.40 to 10.40am at the cost of $25 per term.
Required
Second preference of days
Third preference of days
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