PM | Membership Renewal Form

Play Matters Membership Renewal Form

To update any details, you will need to enter the email you created your membership with.
First Name
Last Name
Email
example@example.com
- Phone Number
  This number doesn't have to be a mobile phone number
- Date of Birth
  
  DayMonthYear
  Date
- Is your date of birth an estimate?
- Country of Birth
- Identify as:
  
  Other
- Do you have any disabilities?
  
  Other
- Gender
- Are you a Refugee or Asylum Seeker
- Street Address
  
  Street Address Line 2
  
  CityState
  
  Post Code
- Suburb
- Post Code
- State
- Please note - submitting the below does not change or update any of the children currently associated with your membership, it will only add a new child to your membership.
- Child First Name
- Child Last Name
- Child's Date of Birth
  
  DayMonthYear
  Date
- Is this date of birth an estimate?
- Child's Country of Birth
- Child identifies as:
  
  Other
- Does the child have any disabilities?
  
  Other
- Child's Gender
- Is the child a refugee or asylum seeker?
- Does the child have any allergies?
- If so, to what?
- Does the child live at the primary parents address?
- Child's Address
  
  Street Address
  
  Street Address Line 2
  
  SuburbState
  
  Post Code
- State
- Consent to receive emails
- Consent to be contacted about research opportunities
- Agree to Terms & Conditions
- Agree to Privacy Policy
- Consent for this data to be recorded on the DSS Data Exchange, on the understanding that all information will be de-identified?
- Personal information collected on this form will be used by Play Matters Australia as it relates. directly to the programs and services we provide to you and it is required by law. Your personal information will be handled in accordance with The Privacy Act 1988 (Cth), Australian Privacy Principles. Our Privacy Policy is available at playmatters.org.au For information about our Privacy Policy please contact us by email info@playmatters.org.au or telephone 1800 007529.
- Membership Renewed
- Should be Empty:

Play Matters Membership Renewal Form