Little Moments Mums & Bubs

Name: Little Moments Mums & Bubs
Start: 2026-03-24T12:30:00+11:00
End: 2026-03-24T14:30:00+11:00
Location: Thrive Lithgow Office

Children Activity Registration Form

First Name

Family Name

Gender

Date of birth

Phone

Residential Address

Post Code

Do you identify as:

Aboriginal

Torres Strait Islander

CALD

N/A

Country of birth

Main language spoken at home

Household Details

Number of adults living in your household:

Family Composition

Single parent with dependent/s

Couple with dependent/s

Children Details

Please include all children's details, add more children by clicking the '+' symbol

Children

First Name	Family Name	Date of birth

Does your child identify as:

Aboriginal

Torres Strait Islander

CALD

N/A

Privacy & Consent

This form provides consent to collect, use and store yours and your child/ren’s personal information in Thrive Services secure client online data system. You can withdraw or change your consent at any time by telling Thrive Services. You understand that this information remains confidential within the service and will only be accessed by Thrive Services staff members or where you have given consent for any information to be shared with third parties. You accept that Thrive Services is bound by the Privacy Act 1988 and will not disclose any information to a third party without your permission unless they are required to do so by law.

DEX Consent for all family members

Yes

Consent to participate in surveys & research

Yes

By ticking this box, I consent for mine and my child/ren's personal information to be collected, used and stored in Thrive Services secure client data system. I confirm the information entered in this form is true and correct.

Please enter full name

Date

Please add me to your newsletter.

Venue

Household Details

Children Details

Privacy & Consent

Details

Organizer

Event Navigation

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