MYS Registration Form

Multicultural Youth Space Registration

Friday, 10 October 2025
Join us this school holidays for a vibrant and inclusive day of creativity, food, dance, and storytelling. Designed by young people for young people aged 12–25, this free workshop explores cultural identity, builds community, and celebrates diversity through art, cooking, music, and film.

Date: Friday, 10 October 2025
Location: Ellenbrook Youth Centre, 7 Plaza Turn, Ellenbrook WA 6069
Time: [10:00AM – 2:00PM | Ages 12–17] [2:30PM – 6:30PM | Ages 18–25]

Parents and carers – You're welcome too!

While young people are enjoying the workshop, parents and carers can join a welcoming and relaxing space to learn and connect. There will be refreshments, community chats, and helpful parenting tips for supporting young people across cultures.

Spots are limited - register now to secure your place!
Participant Registration
This Registration Form is for:*

A Young Person aged 12-17A Young Person aged 18-25Parent / CarerSupport Person (please provide a WWCC)
Legal Name*

First NameLast Name
Preferred Name
Pronouns
Phone Number*
Email *
Date of Birth*

DayMonthYear
Date
Address (required in case of an emergency)*

Street Address

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Do you have any dietary requirements?*
Food and refreshments will be provided.
Are there any safety or risk concerns we should be aware of?*
Example: allergies, mental and/or physical conditions.
Emergency Contact Details
Emergency Contact Name*

First NameLast Name
Relationship To You*
Example: Parent, Guardian
Email *
Phone Number (Mobile)*
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Should be Empty:

Multicultural Youth Space Registration

Participant Registration

Emergency Contact Details