Playtime Registration • Chatswood Baptist

Playtime Registration Form

Thanks for your interest in attending playtime at Chatswood Baptist Church!

Please fill out all the relevant information in the form below, regarding yourself, your partner (if relevant), any children attending and the carer actually attending with the child if not yourself.

Come along for a free trial visit. You can get to know what happens at our playtime and meet our co-ordinator.

Personal Information

First Name *

Preferred Name

Last Name *

Gender *

Email Address *

Mobile Number

Phone Number

Date of Birth

Marital Status

Partner's First Name

Partner's Last Name

Nationality *

Language Spoken at Home *

Church Currently Attending

Child and Carer Information

Child's First Name *

Child's Last Name *

Child's Gender *

Male

Female

Child's Date of Birth *

Allergies *

Carer's Name

Tip: If you are not able to regularly attend playtime with your child, who will be the primary carer attending?

Relationship of Carer to Child

Language spoken by carer

Can carer speak English?

Details of any additional children attending

2nd Child's Name

2nd Child's Gender

Male

Female

2nd Child's Date of Birth

2nd Child's Allergies

If you have more than 2 children you wish to register, please provide the same information as above: Name, Gender, DOB and any Allergies.

(Note: you can only register your own children, and any children of friends or relatives must be registered and accompanied by their own parent or carer)

Additional Children Details

Registration and Attendance

Day(s) Requested *

Tuesday

Wednesday

Tip: Please indicate which days you would be able to attend (note: only one day will be offered)

Permission for Photographs *

I give permission for photos of myself, my child and any other carer attending with my child, to be photographed for the purposes of promoting playtime

How did you hear about Playtime?

Free trial booking date

Tip: You are welcome to come along for one free trial visit. You can get to know what happens at our playtime and meet our co-ordinator. Playtime runs from 10am - 12pm during the school terms.

Visited Playtime? *

Yes

Tip: If you haven't visited for a free trial then fill in the date above.

Home Address

Mailing Address

Fill out if different from home address

Home Address

Home Address Line 2

Home City

Home Postcode

Mailing Address

Mailing Address Line 2

Mailing City

Mailing Postcode