Geelong Arts Centre - Us and All Of This

Please note: Your information will be shared with the Producers and Venue so you can receive communications regarding rehearsals and the performance.

The minimum age for participation is 15.

Name

First NameLast Name

Email

example@example.com

Phone Number

Pronouns

Age

Do you have any access needs?

Do you identify as Aboriginal or Torres Strait Islander?

Do you identify as Deaf or living with a disability?

Do you identify as Culturally or Linguistically diverse?

Do you live in a remote or regional community?

Postcode

Which gender do you identify with most?

Do you have any dietary requirements? If so, please list below.

Do you have any existing medical conditions that may affect your participation? If so, please list below.

Emergency Contact Name

First NameLast Name

Emergency Contact Phone Number

How do you plan to travel to the location?

The minimum age for participation is 15. you are under 18 years of age, please have your parent/guardian complete the following section.

Guardian Name

First NameLast Name

Guardian Mobile Phone Number

Guardian Relationship

Will your child be participating with you or independently?

If participating independently, will your child get to and from rehearsals and performances independently?

I give permission to Geelong Arts Centre to share the information on this submission / form with Us And All Of This event and rehearsal facilitators, Performing Lines and the appointed Local Community Coordinator for the project*

Please note:

Any information we collect is used in accordance with Geelong Arts Centre's Privacy Policy
This information will be used to communicate essential participant information such as performance and rehearsal details

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