2023 Johnsonville Evening Group

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Thank you for your registration of interest for the Mothers Network Johnsonville Evening Group, running from Thursday 16th February - Thursday 23 March from 6.30pm-8.30pm. Please note this is not a confirmation, you will be sent a confirmation email separately

Please fill in all information below and we will contact you as soon as possible to confirm.

Email *

First and Last name *

Preferred name *

Best contact number *

Do you have any dietary requirements? *

Gluten Free

Dairy Free

Vegan

Vegetarian

Other*

Required

If you selected 'Other' please specify below

The course runs for six weeks and to get the most out of the group it is best (if you can!) to attend all six weeks *

I acknowledge that the group runs for 6 weeks

It is helpful for us to know if you can contribute to our group cost (NB this is not a requirement, you can still attend) *

Yes, I can contribute the full $60 ($10 per week)

Sorry, I am not able to at this time

I can contribute another amount (higher or lower)

Anything else you would like us to know?

Ethnicity (Used for statistical purposes only)

What age group do you belong to? (Used for statistical purposes only)

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