explore kindori Gallery Lorem ipsum dolor sit amet, consectetur adipiscing elit. Integer a viverra arcu. Nullam ac nisl in nunc consequat fermentum in in nisi. All Activities classes Event Outings + + + + + + Register for Toddler Time coming on 11th MarchForm is successfully submitted. Thank you!Toddler Time Sing & Grow 2021REGISTRTION FORM - Please complete this registration for TERM 1First Name*Last Name*Phone*Date of BirthFacebook name that appears on the accountEmail*Address*City*State*Please selectWAPostal Code*Childs NameChilds NameChilds NameChilds NameChilds AgePlease select012345Childs AgePlease select012345Childs AgePlease select012345Childs AgePlease select012345Any allergies we need to know about?Which Program are you interested in*Please selectToddler Time ThursdaysAny comments or questions you may have for us!Is it ok for us to contact and keep you updated via Email / Facebook?YesIs your child/children up to date with immunisations?*YesNoEmergency contact personEmergency contact numberName of family member that may occasionally attendName, Address and Telephone number of family doctor (in case of emergency)Photograph PermissionI give permission for Warnbro Community and Family Centre Incorporated to take photographs of my above-named children, which may be used for promotional purposes ONLY. The photographs may be displayed at shopping centres, the newspaper, or at community events within Australia or posted on the Warnbro Community and Family Centre/Warnbro Playgroup website or Facebook page.YesNoI the above mentioned Parent/Guardian Sign this form electronicallyHow did you hear about our playgroup or community centre?Bank Details for EFTBank DetailsPlease enquire to purchase these in the centre mangers office if you do not wish to do it onlinePayment is per term in advance if you wish to pay cash please arrange this with the centre manager. You can pay by Bank Transfer (see above please use the initials 'TTSG and your name' as the reference on the bank transfer), or by credit card on the form, over the phone or at the centre.Cardholder NameCard NumberExpiration MonthPlease SelectJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberExpiration YearPlease Select2020202120222023202420252026202720282029203020312032203320342035203620372038203920402041204220432044204520462047204820492050CVCI Authorise to take payment on the following DateAmount to payPrivacyAll information is strictly confidential and will not be passed onto third parties. As such, the information contained will only be used or referred to when there is a need to inform you about Toddler TIme or other WCFC user group info.SignatureDateOFFICE USE ONLYPAYMENT TYPEPAID AMOUNT $DATE PROCESSEDPAYMENT PROCESSED BYTERMTerm 1PAYMENT CHECKLISTReceiptDatabaseStripeMEMBER CHECKLISTSubscribedDatabaseAttendance SheetOFFICE USE ONLYPAYMENT TYPEPAID AMOUNT $PAYMENT PROCESSED BYDATE PROCESSEDTERMTerm 2PAYMENT CHECKLISTReceiptDatabaseStripeMEMBER CHECKLISTSubscribedDatabaseAttendance SheetOFFICE USE ONLYPAYMENT TYPEPAID AMOUNT $PAYMENT PROCESSED BYDATE PROCESSEDTERMTerm 3PAYMENT CHECKLISTReceiptDatabaseStripeMEMBER CHECKLISTSubscribedDatabaseAttendance SheetOFFICE USE ONLYPAYMENT TYPEPAID AMOUNT $PAYMENT PROCESSED BYDATE PROCESSEDTERMTerm 4PAYMENT CHECKLISTReceiptDatabaseStripeMEMBER CHECKLISTSubscribedDatabaseAttendance Sheet SubmitToddler Time Sing & Grow 2021Confirm
