Get the latest Melton Learning Directory updates to your inbox
Search Site
Search
Participants
New Participant
Close X
Is this registration for a person over 18 years?
Personal Details
Name
Street Address
Suburb
State
Postcode
Mobile Phone Number
Age Range
Age Range
Emergency Contact
Full Name
Relationship
Mobile number
Child Details
Child's date of birth
Medical Information
Does the participant have any medical history or allergies we need to know about?
Please provide details:
Does the participant have any medical conditions or disability which may affect safe participation?
Please provide details:
Does the participant take any medication we need to know about in case of an emergency?
Please provide details of the medication:
Does the participant have any additional needs program staff need to be aware of?
Please provide additional details:
Other details
Other details
Would you like to receive updates about Melton Learning Directory programs via email and SMS?
Have you participated in a Melton Learning Directory program before?
Has your child participated in a Melton Learning Directory program before?
Which program/s?
What is your gender?
What is your child's gender?
Do you speak any language other than English at home?
Which language?
Do you identify as Aboriginal or Torres Strait Islander?
Melton City Council will not be responsible for any loss, damage or injury to my person or property. Information on this form will be kept private and used only to help provide access to better services in the community.
Cart
Login
