Creative Workshop Registration Form
Cartooning and Songwriting Workshops May-June 2017
Participant Details
Name
*
First Name
Last Name
Date of Birth
*
Phone number (if applicable)
E-mail (if applicable)
Workshop Session
*
Storylab: Cartooning
Storylab: Songwriting
How did you find out about these workshops?
Parent/Guardian Details
Name
*
First Name
Last Name
Relationship to participant
*
Phone number
*
E-mail
2nd Contact Person
(In case of an emergency)
Name
First Name
Last Name
Relationship to participant
Phone number
Medical/Allergy Information
Please let us know of any medical, allergy or important information relevant to the participant:
Photography Permission
I give permission for myself (if over 16)/my child to be photographed and/or filmed whilst taking part in a Story Lab session. I understand that photos and footage taken during Story Lab sessions might be used as part of publicity, resource and/or archive material by the artists and/or facilitators of StoryLab and headspace.
*
Yes
No
Submit
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