Family Membership Application Form 2026

Family Membership Application Form 2026

The Keith Playgroup and Rhyme Time is a not-for-profit, member-based organisation. We are only able to function through member participation. Please fill in the details on the form below and click submit to return to the Playgroup and Rhyme Time. This form is to be filled out at the start of every year. If your details change throughout the year, please contact one of the committee members with updated details.
Parent/Caregiver Name

First NameLast Name
Parent/Caregiver Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please list your Child/ren's full names and birthdays
Secondary/Emergency Contact

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to child
Do you or your child have any allergies or medical conditions?
If yes, please specify any details and/or medication required
Social Media Consent
I do/do not give permission for Keith Playgroup and Rhyme Time to post images of my child/ren on our social media platforms (Facebook, Instagram)
I do/do not give permission for Keith Playgroup and Rhyme Time and associated committee to store these images on my behalf and use them for community purposes.
Enrolment
Everyone who attends a Registered Playgroup is required to pay the Family Enrolment Fee to Playgroup SA. Once enrolled you become a Playgroup SA member. This low-cost enrolment allows families to enjoy all the member services of Playgroup SA including individual Playgroup insurance cover. New members can enjoy two weeks of attending Playgroup as a trial before they are required to pay the Family Enrolment Fee.

It’s easy to become enrolled. Simply visit https://www.playgroupsa.com.au/enrolment.html and complete the Family Enrolment Form and pay the appropriate fee to Playgroup SA.

A Family Enrolment also entitles families to attend other Registered Playgroups. There’s no limit to how many Playgroups you can attend.

Please note that the Family Enrolment Form and fee payable to Playgroup SA is completely separate to this form and separate to the weekly attendance fee of $3 per family to Keith Playgroup Inc.
Have you paid for your Playgroup SA Membership for 2026?
If yes, please provide your Membership Number
Signature
Date

DayMonthYear
Date
Should be Empty:

Family Membership Application Form 2026

Social Media Consent

Enrolment