YACAW Registration Form

YACAW REGISTRATION FORM

Youth In Arts and Culture Action Workshop
Please ensure that all questions are answered with honesty and help us protect our community against Covid-19. Any false information will be considered unlawful and criminal charges may be laid against you. Let us stop the spread of Covid-19 and save lives.
Have you been out of Limpopo Province in the last 21 days?*
Have you been in contact with a confirmed or suspected case of Covid-19?*
Have you been to an event/conference with 50> people in the last 14 days?*
Have you had fever in the last 14 days?*
Have you had cough/sore throat in the last 14 days?*
Have you had shortness of breath/loss of smell in the last 14 days?*

YACAW REGISTRATION FORM

Youth In Arts and Culture Action Workshop
MarapongShongoaneKauletsi
The information to be provided will be used for emergency purposes. Ensure that you provide relevant information.
Next of kin*

First NameLast Name/ Surname
Phone Number*

Area CodePhone Number
Alternative Number

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please carefully read and understand the terms and conditions set by the Youth in Arts and Culture Action Workshop organizers. Your name below will be used as a signature for this online application.
Signature*
Initials & Surname
Please read these terms and conditions carefully as they set out our respective rights and obligations. By submitting this application, we are entitled to assume that you have had the opportunity to read and have read these travelling conditions and agree to them.

I, the applicant as stated on the application, agree to the following;

1.       The personal information furnished by me is true, accurate and complete;

2.       I will travel with other artists to Pretoria for Youth in Arts & Culture Action Workshop programme, hosted by Unity and Cultural Diversity Council.

3.       I will be picked up and dropped off at the selected point as per my application.

4.       The Covid-19 questionnaire furnished by me is true, and should the information the information be wrong, I will be held liable for spreading the virus.

5.       In case of emergency, including medical conditions or accident, the organization will not be held liable but they can assist wherever they can.

6.       Any craft sold during this period of the programme, all proceeds goes to the artists

7.       The artists shall not pay anyone to be part of this programme.
Should be Empty:

YACAW Registration Form

YACAW REGISTRATION FORM

YACAW REGISTRATION FORM