Enrol | Belgrave Lake Park Cottage

Please complete the below form to submit your enrolment. Once we have received your completed form we will send you an email to complete your payment. If you have any questions or issues completing the form please contact us at enrolments.blpc@gmail.com. Playgroup awaits!

Which session are you attending? *

Are you: *

Enroling
Re-enroling

How would you like to pay fees:

Annually (only available until 1st April each calendar year)
Term by term

If you have a valid Concession Card, please list

Carer's First Name *

Carer's Last Name *

Email *

Phone

Address *

Address Line 2

City *

State *

Postcode *

How many children will attend playgroup?

1st Child’s First & Last Name *

1st Child’s Birth Date *

Is the 1st child attending Playgroup regularly? *

2nd Child’s First & Last Name

2nd Child’s Birth Date

Is the 2nd child attending Playgroup regularly?

3rd Child’s First & Last Name

3rd Child’s Birth Date

Is the 3rd child attending Playgroup regularly?

4th Child’s First & Last Name

4th Child’s Birth Date

Is the 4th child attending Playgroup regularly?

Any conditions/illnesses/allergies to be aware of?

Emergency Contact 1 First & Last Name *

Emergency Contact 1 Relationship to Child *

Emergency Contact 1 Phone Number *

Emergency Contact 2 First & Last Name

Emergency Contact 2 Relationship to Child

Emergency Contact 2 Phone Number

Do you, or any of your family, have any skills/hobbies that would help the cottage?