Enrolment Details

Enrolment Process

Once you have had your session confirmed by the Enrolment Secretary, please complete this enrolment form to secure your place at Concord Playgroup. If you have not been allocated a session day and time, please contact our Enrolment Secretary on 0490 439 267 or enrolments@concordplaygroup.org.au to discuss your preferences and to organise a FREE TRIAL prior to making any payment.

Enrolment Form

Please complete all required fields for your family. Multiple children in one family can be added to a single enrolment form.

NOTE: Fields marked with a (*) are mandatory.

Parent or Carer's Details

First Name (*):
Last Name (*):
Date of Birth (*):
Email (*):
Mobile (*):
Home Phone:
Address (*):
Suburb (*):
Postcode (*):
Council area you reside in (*):

Allocated Session

Day (*): Time (*):

Child(ren)'s Details

Child's First Name Child's Last Name Child's D.O.B Relationship to Parent/Guardian

Does your child have any allergies or medical condition?

Child's Name Details

Emergency Contact Details

please list another adult who does not normally accompany the child(ren) to playgroup.
Name (*):
Relationship to child (*):
Phone (*):
Doctor's Name (*):
Doctor's Address (*):
Doctor's Phone (*):

How did you hear about Concord Playgroup (*)?

Please Select:

Payment Details (*)

Select which terms to enrol for:

Term 1($50 / $40 concession)

Term 2($50 / $40 concession)

Term 3($50 / $40 concession)

Term 4($50 / $40 concession)

Concession Card Holder? (Concession will be applied to total below)
Concession Card Details

Total Amount Due: $