Membership Application - Highgate Playgroup

Complete & submit this form to enrol or register your interest in membership for 2021. Please also complete the form if you were a member of Highgate Playgroup in 2020 and wish to re-enrol, as this enables us to review and make any required updates to your details.

Playgroup WA (PGWA) also requests some information on the diversity of Hightgate Playgroup families, however providing this information is voluntary.

You’ll receive an email within a few days of submitting your application, confirming your session time(s) and membership fee. Membership fees are payable via direct deposit to:

BSB: 036-046

Account: 104221

Account Name: Highgate Forrest Park Playgroup Inc

Reference: 2021 Surname (i.e. 2021 Smith)

Membership Type

Parent First Name

Parent Surname

Mobile

Home Address

Cultural Background

Is a language other than English spoken at home?

Yes No

Is your family of Aboriginal or Torres Straight Islander descent?

Yes No

Do any playgroup attendees in your family have a disability?

Yes No

Child 1 Full Name

Child 1 Date of Birth

Child 2 Full Name

Child 2 Date of Birth

Child 3 Full Name

Child 3 Date of Birth

No. of Regular Sessions

1st Session Preference

2nd Session Preference

3rd Session Preference

4th Session Preference

5th Session Preference