Family Day Registration Form

YASG's Dizney In Drag

Thursday 23rd January, 5:30pm to 9pm

To kick off 2025, YASG will be meeting to watch Fringe Festival performance 'Dizney in Drag: Once Upon a Parody' at Perth Town Hall before catching up over dinner at Ivy & Jack restaurant, just down the road (350m).

Let us know who you are*

First NameLast Name

Would you like to have a support person (family member, support worker, partner, close friend) attend with you?*

YesNo

Please list all other people you would like to attend the event in addition to yourself.

Will you require a seat to be removed to accommodate a wheelchair?*

YesNo

Does anyone attending have any dietary requirements we can accommodate?*

YesNo

Please list all dietary requirements & allergies for each attendee below.

Do you have a companion card?*

YesNo

If you have a companion card, please upload a photograph of your companion card below.

Declaration

By ticking this box and submitting this form, I acknowledge that I may be photographed at this event, and photographs taken may be used for promotional materials on Neuromuscular WA's website, social media platforms and/or resources developed and may be shared with sponsors who have provided funding towards the program for use on their marketing collateral. I acknowledge that if I do not want to be photographed, I am required to contact the program coordinator prior to the event RSVP date to inform them.

As this document collects personal information, please read our Privacy Policy to understand how we will use and store this information.