Mix & Move Registration Form

Mix & Move Registration Form

Fill in your details to complete the registration process.
Full Name

First NameLast Name
Date Of Birth

DayMonthYear
Date
Email
example@example.com
contact number

Area CodePhone Number
Medical Conditions
Dietry Requirements
Consent

Zinc Arts may take photographs and/or video recordings during activities and events.These images/videos may be used for the following purposes:

• Social media platforms

• Local news features

• Promotional and marketing materials for Zinc Arts

We will ensure that all images and videos are used in a respectful and appropriate manner.
Signature
Should be Empty: