Membership Form

Membership Form
Family Details

My Details
Name *

Prefix First Name Last Name
Date of birth

Day Month Year
Date
Gender
Mobile phone *
Email
example@example.com
Suburb
Postcode
State
How did you hear about us

Facebook Website From a friend
Are you currently attending a playgroup?

Yes No
Which playgroup do you currently attend?
My Family

About me
Do you identify as Aboriginal or Torres Strait Islander

Yes No Prefer not to say
Relationship to child

Mother Father Grandparent Carer
Country of birth
Main language spoken at home
Do you have a disability?

Yes No Prefer not to say
My Family

About my child
Name

First Name Last Name
Date of birth

Day Month Year
Date
Gender
Does your child identify as Aboriginal or Torres Strait Islander

Yes No Prefer not to say
Does your child have a disability?

Yes No Prefer not to say
Add another child to your membership *

Yes No
Name

First Name Last Name
Date of birth

Day Month Year
Date
Gender
Does your child identify as Aboriginal or Torres Strait Islander?

Yes No Prefer not to say
Does your child have a disability?

Yes No Prefer not to say
Membership Benefits
Playgroup NSW membership includes a subscription to our eNewsletter. Members also receive other updates via email. Please advise whether you would like to subscribe to Playgroup NSW member communications. *

Yes No
Would you like a free membership to Small Ideas? Small Ideas membership offers you and your family discounts to hundreds of family attractions, play centres, animal farms, retailers and more. Tick the box if you would like access to these benefits and Small Ideas will automatically create you a membership. *

Small Ideas membership
Terms and Conditions

Playgroup members are bound by the Playgroup NSW Constitution, Playgroup Charter and general terms and conditions.
Should be Empty:

Membership Form

Family Details

My Family

My Family

Membership Benefits