Affiliate with Playgroup NT - Playgroup Association of the Northern Territory

Playgroup Details

New or Renewing Playgroup

Playgroup Name

Please describe your playgroup. This will help us to refer potential members to your group. For example, age group of the children, cultural aspects, religion, special needs, structure and routines.

Session Fee

Website / Facebook Page

Playgroup Contact Phone Number

Venue Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Venue Type

Please describe the Venue Type if not listed above:

Does your playgroup venue have wheelchair access?*

Yes
No

Does your playgroup have an outdoor area?*

Yes
No

Is the outdoor area fenced?*

Yes
No
Not applicable

Session Information: Please state the playgroup session times and age group:

Frequency

Day

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Start Time

Finish Time

Children's age group of your playgroup?

Does your playgroup meet during school holidays?*

Yes
No

Do you give permission for the below details to be published on the playgroup timetable, which is a printed document that is shared on Playgroup NT's website and social media pages?*

Yes
No

Primary contact details:*

First Name Surname

Primary contact phone number:*

Primary contact email address:*

Consent*

I understand that my first name, phone number and/or email address may be shared to members of the public who are inquiring about playgroups in the area.

Second contact details (if applicable) :

First Name Surname

Second contact phone number:

Second contact email address:

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