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Registration Form

This form must be completed in order to register for the Beach Art Workshop

Personal Details

Snacks may be provided. Does your child have any allergies/dietary needs? If so, please specify

Does your child have any medical conditions (e.g. asthma, epilepsy) If so, please specify

Does your child carry an epipen or asthma puffer?

Does your child have any behavioural of learning needs that we should be made aware of? If so, please specify

Emergency contact name and phone number

Who is authorised to pick up your child? Please provide name and phone number

Children may be photographed/video-graphed for parents, do you give consent for these photos and videos to be used for CAPA Kids/Co-facilitator promotional purposes? Such as newsletters, website, brochures etc. If you do not provide consent, CAPA Kids/Co-facilitators will fully attempt to maintain privacy through measures that may involve blurring/covering the child's face in public photos and videos to avoid identification.

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B

I give permission for my child to attend this Beach Art Workshop

In the unlikely case of an emergency, I consent for first aid to be administered and for emergency services to be contacted if required.

I understand that CAPA Kids/Co-facilitators maintains a safe and respectful learning environment, and I agree that my child will follow workshop rules and expectations. I understand that any disrespect, hate speech, bullying, abuse and discrimination from my child may cause the child to be terminated from the workshop.

Please provide payment of $70 (or $63 is this is the sibling of a registered child) to the following bank details. Please write your child's full name in the description.  BSB 062-948 Account 3162 4283 Account Name: Rabia Majeed  This payment covers the whole program, including resources. I understand that this payment is non-refundable and must be paid before the program commences. I understand that my registration is incomplete until payment is made. I understand it is my responsibility to ensure my child attends the workshop, as absences will not be refunded. 

I declare that all information provided in this form is true and accurate to the best of my knowledge. I understand that CAPA Kids and Co-facilitators cannot be held responsible for any issues that arise from false, incomplete, or undisclosed information. I have read and agreed to the Terms and Conditions Parent/Guardian sign below

How did you hear about us?

Would you like to be notified about future programs?

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