Elsternwick Toddlers Playgroup

Username *

Email Address *

First Name *

Last Name *

Family name *

Parent Names

Mobile

Street Address *

Suburb *

Postcode *

Child's name *

DOB *

Child's name

DOB

Child's name

DOB

In case of emergency (name) *

Mobile *

Relationship to child

Full name

Mobile

How would you like to contribute to the running of ETP? *
Join the committee of managementHelp run a fundraising eventHelp set up a special eventAttend a weekend family eventAttend a working beeMake play doughPut council bins out on Tuesday afternoonsOther

Do you or your children identify as Aboriginal or Torres Strait Islanders?
Yes   No

Playgroup Victoria Member Number

Concession number

I have read and agree to the terms and conditions * I have read and agree to the terms and conditions

Yes, I want to receive occasional updates and important messages regarding my account via email (required).

Registration confirmation will be emailed to you.