Please fill out this form only if you have received the 'Welcome to Supported Playgroups' email from Wyndham City. If you have not received the email and would like more information, please visit the Supported Playgroups page. If you need support completing this form, your facilitator can help you complete it on your first day.

 

PRIVACY STATEMENT

Supported playgroup is funded by the Department of Education and Training and delivered by Wyndham City Council under a service agreement. Council is required to collect personal and health information about you and your child/children through this form. This information will be used to (1) register your child/children for the Supported Playgroup, (2) allow the Department to evaluate whether the playgroup meets the outcomes required by the service agreement, and (3) enable the Council to deliver services and communicate with you. Council will store your information in its Customer Database and use it to identify you when communicating and delivering services. Your personal information will be handled in accordance with the Privacy and Data Protection Act 2014 (Vic).For more information on how your personal and health information will be handled, refer to the Department of Education Privacy Policy and to the Council’s Privacy Policy.  

Parent/ primary caregiver details
Are you of Aboriginal/Torres Strait Islander origin? (required)
Family Status
Are you or anyone in your family household a primary carer, holds a Health Care Card or a Visa? (required)
What’s your Highest level of Education? (required)
Approximately how many books do you have at home? (required)
Emergency contact
Child /Children Details
Are you enrolling more than one child for the Supported Playgroup? (required)
Child 1
Of Aboriginal/Torres Strait Islander Origin: (required)
Has this child been diagnosed with a developmental delay/disability? (required)
Is this child up to date with their Maternal and Child Health Key Ages and Stages visits?
Is this child enrolled in 4 years old kindergarten?
Child 2
Of Aboriginal/Torres Strait Islander Origin:
Has this child been diagnosed with a developmental delay/disability?
Is this child up to date with their Maternal and Child Health Key Ages and Stages visits?
Is this child enrolled in 4 years old kindergarten?
Child 3
Of Aboriginal/Torres Strait Islander Origin:
Has this child been diagnosed with a developmental delay/disability?
Is this child up to date with their Maternal and Child Health Key Ages and Stages visits?
Is this child enrolled in 4 years old kindergarten?
Parenting Questionnaire

Thank you for completing this Parent/primary caregiver Questionnaire for Supported Playgroups. This questionnaire helps us learn about you as a parent and understand whether what we provide at Supported Playgroups is helpful to you.

Thinking about your parenting Focussing on child/ren participating in the playgroup with you:
When something goes wrong between me and my child, there is little I can do to fix it
I know how to solve most problems that arise with parenting
I have confidence in myself as a parent
My child usually ends up getting their own way, so why try
I have the skills to deal with new situations with my child as they arise
When changes are needed in my family I am good at setting goals to achieve those changes
I can find out what’s needed to resolve any problems my child has
I meet my expectations for providing emotional support for my child
I often feel helpless about my child’s behaviour
I am good at making plans and arranging fun and educational activities for my child to engage in
I have all the skills necessary to be a good parent to my child
I know I am doing a good job as a parent
I know how to work out which situations my child is likely to be happiest in
I can stay focused on the things I need to do as a parent even when I've had an upsetting experience
My parenting skills are effective
How my child turns out is mainly due to luck
Thinking about what happens in your home In a typical week, how often do you do the following with your child:
Play music, sing songs, or do other musical activities?
Tell stories to your child?
Read books to your child?
Play indoors with toys or games with your child?
Involve your child in everyday activities at home, such as cooking or caring for pets?
Play with your child in the bath?
Play finger/rhyming games with your child (e.g. eensy weensy spider)?
Play peek-a-boo or hide and seek with your child?
Talk about the day while your child is eating?
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