Playgroup Enquiry Form | Wyndham City

Privacy Statement

Your personal information is being collected by Council to respond to your Playgroup enquiry. Your personal information will be used by Council to administer your enquiry.

The personal information will be stored in Council’s Customer Database and used to identify you when communicating with Council.

For further information about how your personal information is handled, refer to Council’s Privacy Policy.

I have read and understood the Privacy Statement mentioned above

What would you like to do?

I want to attend a playgroup with my child

I want to start a Community Playgroup

Which playgroups you are interested in?

Supported Playgroup

Community Playgroup

I'm not sure and need help to decide

Complete your details below so our team can contact you and support the next steps:

First name:

Surname:

Contact number

Email address:

Parent / Carer Details

First Name

Family/Surname

Preferred Contact Number

Address

Email Address

Child details

Will more than one child attend playgroup with you?

Yes

CHILD 1

First name

Surname:

Date of Birth:

CHILD 2

First name

Surname:

Date of Birth:

CHILD 3

First name

Surname:

Date of Birth:

Does any of the following apply to you or a member of your household?

Health Care Card

A Pension Card

A Humanitarian visa

Identifies as Aboriginal and/or Torres Strait Islander

I care for a child in kinship care (out-of-home care)

I was referred by Child FIRST or Child Protection

I am receiving, or have been referred to, Enhanced Maternal and Child Health Services or a Young

Parents Program

None of the above

Anything else you’d like to tell us?

How did you hear about Playgroups?

Wyndham City Council website

Community Centre

Shopping Centre Playgroup

Maternal & Child Health

Health provider

Social Media

Word of mouth

Other (please specify)

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