Workshop Enrolment Form Workshop Enrolment Page 1 Participant Details First Name Last Name Email Mobile Home Phone Street Address Suburb Postcode GenderPlease select... Female Male Trans Other Date of Birth Facebook Name School Emergency Contact Information Emergency Contact First Name Emergency Contact Last Name Relationship to Participant Phone Email Would this contact like to receive our Newsletter? Yes No Medical information we should know (allergies, injuries, phobias etc) Page 2 What Cultural background do you most identify with? What language other than English do you speak? Which Workshop are you registering for?Please select... Wyndham Edge: Hoppers Crossing Youth Resource Centre Footscray Edge: Kindred Studios St Albans Edge: St Albans Community Arts Centre North Geelong Edge: fOrte Youth Centre, Corio Geelong Edge: The Pulse, Geelong How did you find out about this workshop?Please select... Friend School Poster/Flyer Council Communications Youth Services Other During our programs we take photos and videos to keep a record and celebrate what we've created together. Do you consent to your/or the young person's image being used for this purpose?YesNo Click here to view Terms and Conditions and Code of Conduct I agree to these Terms and Conditions Yes Need assistance with this form?