Mini Online Playgroup Registration Form

Parent/Carer Details

Child’s Details

First Name:
Last Name:
Date Of Birth: (DD/MM/YYYY)
Your answers to the following questions are confidential and will assist us with your child's enrolment in our Mini Playgroup Online. Please check the following boxes that apply:
My child does not currently attend an early learning service. Eg; Child Care Centre or Preschool
My child has been diagnosed with specific difficulties or disabilities:
Any further comments regarding your child?