Fine Motor Fun Program Interest Form

Fine Motor Fun Program Interest Form
Welcome to the Play Move Improve Fine Motor Fun Scheduling Survey!

Thank you for your interest in our Fine Motor Fun Program. To create the best group experience for your child, we are asking for your feedback on age group, goals, and scheduling.

Your feedback will influence our 2026 weekly timetable.
Contact & Child Details
Your Name:

First NameLast Name
Email Address:
example@example.com
Phone Number:
Please enter a valid phone number.
Child's Name:

First NameLast Name
Child's Date of Birth:

MonthDayYear
Date
Are you currently using NDIS funding?

YesNoPending
Tell Us About Your Child's Needs
Which age group are you inquiring about?

Toddler (Ages 2-3)Preschool (Ages 3-5)Primary School (Ages 6-12)Teen/Adolescent (Ages 13+)Other
What is the main goal you would like to achieve in this program?
Examples: Better handwriting, less frustration with building, improved scissor skills, stronger hand grip, etc.
Vote for Your Preferred Schedule!
Which weekday/s are you most available for the session?

MondayTuesdayWednesdayThursdayFridaySaturday
Which time slot/s generally work best for your child's session?

Morning (9:00 AM – 12:00 PM)Mid-Day (12:00 PM – 3:00 PM)After School (3:30 PM – 6:00 PM)Other
Is there anything else we should know about your child's goals, sensory sensitivities (e.g., dislikes getting messy), or specific needs related to this program?
Consent & What Happens Next
Consent:*

I consent to Play Move Improve contacting me about group scheduling, program enrolment, and future workshops.
Thank you for registering your interest! You will hear from the Play Move Improve team within 48 hours to confirm we received your submission and to answer any initial questions you may have.
Should be Empty:

Fine Motor Fun Program Interest Form

Contact & Child Details

Tell Us About Your Child's Needs

Vote for Your Preferred Schedule!

Consent & What Happens Next