Playgroup Registration

Registration form for community music playgroups

First name


Last name


Home phone


Mobile phone


Address


Email


Child 1

First name


Last name


Date of birth


Preferred venue, day and time (Ctrl-click to select multiple options)


Child 2

First name


Last name


Date of birth


Preferred venue, day and time (Ctrl-click to select multiple options)


Child 3

First name


Last name


Date of birth


Preferred venue, day and time (Ctrl-click to select multiple options)


Other comments or questions