Magical Art Registration Form

Wacky Workshops Artistic Science Registration Form

Artistic Science Workshop - Wednesday, April 7 from 10 am-11.30 am
PLEASE NOTE: Registration is the first step and does NOT guarantee you a spot in the workshop. To complete your booking, please follow the link after you submit this form and pay for the workshop. Only prepaid students will be added to the workshop list of participants.
Name *

First Name Last Name
Gender *
Age *
Date of Birth *
School and Grade *
Parent/carer name *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Email *
Emergency contact and phone number *

Name Phone Number
Medical conditions/special needs
How did you hear about the workshop?

Friend Google Facebook Web site Other
I am happy for Wacky Workshops to use photos of my child for promotional purposes with the understanding that no names will be used.Y/N *
I understand that all care will be taken but agree to hold Wacky Workshops harmless for any personal injuries that may occur during the workshop. *

Yes
Date
Newsletter

Yes, subscribe me to this newsletter.
You will be redirected to the payment page once you submit this form, where you can complete your booking and secure your spot. Please note, your booking is not secure until payment has been made.
Should be Empty:

Wacky Workshops Artistic Science Registration Form