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Karingal Neighbourhood Centre
Playgroup family enrolment form
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* Indicates required question
Fees
*
$5.00 per session
$50 per Term
Parent/Guardian Name:
*
Your answer
Mobile
*
Your answer
Email
*
Your answer
Address
*
Your answer
Are you of aboriginal or Torres Strait Islander Origin?
*
Aboriginal
Torres Strait Islander
CALD (culturally and linguistically diverse)
Other
Child's Name
*
Your answer
Date of birth
*
MM
/
DD
/
YYYY
Allergies
*
Your answer
Child's Name
Your answer
Date of birth
MM
/
DD
/
YYYY
Allergies
Your answer
Child's Name
Your answer
Date of birth
MM
/
DD
/
YYYY
Allergies
Your answer
I am aware that Karingal Neighbourhood Centre is a not-for-profit group. All sessions are run by parents/careers that kindly volunteer their time but may have no formal qualifications. I understand that Playgroup is a time for parents and children to play together and I am ultimately responsible for the safety and wellbeing of my family during these sessions.
*
Yes
No
I give permission for Karingal Neighbourhood Centre to use photos of my child(ren) in Social media, Karingal website, The newsletter, Advertising posters, brochures, and/or newspapers
*
Yes, I consent
No, I do NOT consent
Additional Comments
Your answer
Date
*
MM
/
DD
/
YYYY
Parent/Guardian Signature
*
Your answer
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